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p. 1523-1547
Received: 14 March 2012; in revised form: 2 April 2012 / Accepted: 3 April 2012 / Published: 25 April 2012
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| Download PDF Full-text (285 KB) | Download XML Full-text Abstract: In recent years there has been a large scientific and public debate on climate change and its direct as well as indirect effects on human health. In particular, a large amount of research on the effects of climate changes on human health has addressed two fundamental questions. First, can historical data be of some help in revealing how short-run or long-run climate variations affect the occurrence of infectious diseases? Second, is it possible to build more accurate quantitative models which are capable of predicting the future effects of different climate conditions on the transmissibility of particularly dangerous infectious diseases? The primary goal of this paper is to review the most relevant contributions which have directly tackled those questions, both with respect to the effects of climate changes on the diffusion of non-infectious and infectious diseases, with malaria as a case study. Specific attention will be drawn on the methodological aspects of each study, which will be classified according to the type of quantitative model considered, namely time series models, panel data and spatial models, and non-statistical approaches. Since many different disciplines and approaches are involved, a broader view is necessary in order to provide a better understanding of the interactions between climate and health. In this respect, our paper also presents a critical summary of the recent literature related to more general aspects of the impacts of climate changes on human health, such as: the economics of climate change; how to manage the health effects of climate change; the establishment of Early Warning Systems for infectious diseases.
p. 1548-1565
Received: 3 March 2012; in revised form: 2 April 2012 / Accepted: 9 April 2012 / Published: 25 April 2012
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| Download PDF Full-text (287 KB) | Download XML Full-text Abstract: Bacteriological water quality criteria have been recommended to ensure bathers’ health. However, this risk-assessment approach is based mainly on routine measurements of fecal pollution indicator bacteria in seawater, and may not be adequate to protect bathers effectively. The aim of this study was to assess the risks of symptoms related to infectious diseases among bathers after exposure to seawater which was of excellent quality according to EU guidelines. This study is a cohort study recruiting bathers and non-bathers. Water samples were collected for estimating bacterial indicators. Univariable and multivariable analysis was performed to compare the risks of developing symptoms/diseases between bathers and non-bathers. A total of 3805 bathers and 572 non-bathers were included in the study. Water analysis results demonstrated excellent quality of bathing water. Significantly increased risks of symptoms related to gastrointestinal infections (OR = 3.60, 95% CI 1.28–10.13), respiratory infections (OR = 1.92, 95% CI 1.00–3.67), eye infections (OR = 2.43, 95% CI 1.27–4.63) and ear infections (OR = 17.21, 95% CI 2.42–122.34) were observed among bathers compared with non-bathers. Increased rates of medical consultation and medication use were also observed among bathers. There was evidence that bathers experienced increased morbidity compared with non-bathers though the bathing waters met bacteriological water quality criteria. These results suggest that risk assessments of recreational seawaters should not only focus on bacteriological water quality criteria.
p. 1566-1580
Received: 26 March 2012; in revised form: 16 April 2012 / Accepted: 18 April 2012 / Published: 30 April 2012
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| Download PDF Full-text (279 KB) | Download XML Full-text Abstract: The use of indoor, three-stone fire pits in resource–poor countries is a substantial burden on human health and the environment. We conducted a pilot intervention promoting the purchase and use of an improved cookstove in rural Kenya. The goals of this qualitative inquiry were to understand the motivation to purchase and use; perceived benefits and challenges of cookstove use; and the most influential promotion activities for scaling up future cookstove promotion. Purposive sampling was used to recruit 10 cookstove promoters and 30 cookstove purchasers in the Luo community. Qualitative semi-structured interviews were transcribed and a thematic analysis conducted. Women reported the need for less firewood, fuel cost savings, reduced smoke, improved cooking efficiency, reduced eye irritation, lung congestion and coughing as major benefits of the cookstove. Cost appeared to be a barrier to wider adoption. The most persuasive promotion strategies were interpersonal communication through social networks and cooking demonstrations. Despite this cost barrier, many women still considered the improved cookstove to be a great asset within their household. This inquiry provided important guidance for future cookstove implementation projects.
p. 1581-1592
Received: 26 March 2012; in revised form: 25 April 2012 / Accepted: 27 April 2012 / Published: 3 May 2012
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| Download PDF Full-text (582 KB) | Download XML Full-text Abstract: The potential long term environmental impacts of a landfill on groundwater quality depend on its liner material properties. In case synthetic liner materials are damaged during the construction or operation, many of the original chemical and biological constituents are removed by filtration and the adsorptive action of natural liner materials such as natural zeolite, perlite and bentonite minerals. Before leachate treatment, reduction of these constituents is important not only to leachate percolation, but also treatment cost and efficiency. In this study, the pollutant removal efficiency from the leachate was investigated for natural natural zeolite, expanded perlite and bentonite. Experimental studies was performed in boxes made of glass and with 1:10 sloping. Leachate quantity was determined and pH, electrical conductivity (EC), nitrate (NO3 -N), ammonium-nitrogen (NH4 -N), phosphate (PO4 ), chemical oxygen demand (COD) and organic matter in leachate samples were measured and the measurement was compared with control process (System 4). The results showed that natural zeolite was effective in removing NO3 , NH4 , PO4 , COD and organic matter with removal efficiencies of 91.20, 95.6, 95.5, 83.4 and 87.8%, respectively. Expanded perlite has high efficiency removing of NO3 , PO4 and COD 83.2, 91.0 and 62.5%, respectively, but it was unsuccessful in reducing NH4 (1.5%).
p. 1593-1608
Received: 19 March 2012; in revised form: 16 April 2012 / Accepted: 27 April 2012 / Published: 3 May 2012
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| Download PDF Full-text (1015 KB) | Download XML Full-text Abstract: The identification of “environmental justice (EJ) communities” is an increasingly common element in environmental planning, policy, and regulation. As a result, the choice of methods to define and identify these communities is a critical and often contentious process. This contentiousness is, in turn, a factor of the lack of a commonly accepted method, the concern among many EJ advocates and some regulators that existing frameworks are inadequate, and ultimately, the significant consequences of such designations for both public policy and community residents. With the aim of assisting regulators and advocates to more strategically focus their efforts, the authors developed a Cumulative Environmental Vulnerability Assessment (CEVA). This CEVA is composed of a Cumulative Environmental Hazard Index and a Social Vulnerability Index, with a Health Index as a reference. Applying CEVA produces spatial analysis that identifies the places that are subject to both the highest concentrations of cumulative environmental hazards and the fewest social, economic and political resources to prevent, mitigate, or adapt to these conditions. We recommended that these areas receive special consideration in permitting, monitoring, and enforcement actions, as well as investments in public participation, capacity building, and community economic development.
p. 1609-1625
Received: 29 February 2012; in revised form: 17 April 2012 / Accepted: 17 April 2012 / Published: 4 May 2012
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| Download PDF Full-text (248 KB) | Download XML Full-text Abstract: Microbial drinking-water quality testing plays an essential role in measures to protect public health. However, such testing remains a significant challenge where resources are limited. With a wide variety of tests available, researchers and practitioners have expressed difficulties in selecting the most appropriate test(s) for a particular budget, application and setting. To assist the selection process we identified the characteristics associated with low and medium resource settings and we specified the basic information that is needed for different forms of water quality monitoring. We then searched for available faecal indicator bacteria tests and collated this information. In total 44 tests have been identified, 18 of which yield a presence/absence result and 26 of which provide enumeration of bacterial concentration. The suitability of each test is assessed for use in the three settings. The cost per test was found to vary from $0.60 to $5.00 for a presence/absence test and from $0.50 to $7.50 for a quantitative format, though it is likely to be only a small component of the overall costs of testing. This article presents the first comprehensive catalogue of the characteristics of available and emerging low-cost tests for faecal indicator bacteria. It will be of value to organizations responsible for monitoring national water quality, water service providers, researchers and policy makers in selecting water quality tests appropriate for a given setting and application.
p. 1626-1629
Received: 10 April 2012 / Accepted: 28 April 2012 / Published: 4 May 2012
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| Download PDF Full-text (126 KB) | Download XML Full-text Abstract: This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Eighth International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU) from September 18-21, 2011 at the Marriott Hotel in Jackson, Mississippi. It was built upon the overwhelming success of seven previous symposia hosted by JSU. [...]
p. 1630-1648
Received: 12 December 2011; in revised form: 5 January 2012 / Accepted: 11 January 2012 / Published: 4 May 2012
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| Download PDF Full-text (4344 KB) | Download XML Full-text Abstract: The use of organophosphorous insecticides in agricultural environments and in urban settings has increased significantly. The aim of the present study was to analyze morphological alterations induced by malathion and 17β-estradiol (estrogen) in rat kidney tissues. There were four groups of animals: control, malathion, estrogen and combination of both substances. The animals were injected for five days and sacrificed 30, 124 and 240 days after treatments. Kidney tissues were analyzed for histomorphological and immunocytochemical alterations. Morphometric analysis indicated that malathion plus estrogen-treated animals showed a significantly (p < 0.05) higher grade of glomerular hypertrophy, signs of tubular damage, atypical proliferation in cortical and hilium zone than malathion or estrogen alone-treated and control animals after 240 days. Results indicated that MFG, ER-α, ER-β, PgR, CYP1A1, Neu/ErbB2, PCNA, vimentin and Thrombospondin 1 (THB) protein expression was increased in convoluted tubules of animals treated with combination of malathion and estrogen after 240 days of 5 day treatment. Malignant proliferation was observed in the hilium zone. In summary, the combination of malathion and estrogen induced pathological lesions in glomeruli, convoluted tubules, atypical cell proliferation and malignant proliferation in hilium zone and immunocytochemical alterations in comparison to control animals or animals treated with either substance alone. It can be concluded that an increased risk of kidney malignant transformation can be induced by exposure to environmental and endogenous substances.
p. 1649-1662
Received: 16 November 2011; in revised form: 12 December 2011 / Accepted: 13 December 2011 / Published: 4 May 2012
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| Download PDF Full-text (1725 KB) | Download XML Full-text Abstract: The use of silver nanoparticles (AgNPs) in commercial products has increased significantly in recent years. Although there have been some attempts to determine the toxic effects of AgNPs in mammalian and human cell-lines, there is little information on plants which play a vital role in ecosystems. The study reports the use of Vicia faba root-tip meristem to investigate the genotoxicity of AgNPs under modified GENE-TOX test conditions. The root tip cells of V. faba were treated with four different concentrations of engineered AgNPs dispersion to study toxicological endpoints such as mitotic index (MI), chromosomal aberrations (CA) and micronucleus induction (MN). For each concentration, five sets of microscopy observations were carried out. The results demonstrated that AgNPs exposure significantly increased (p < 0.05) the number of chromosomal aberrations, micronuclei, and decreased the MI in exposed groups compared to control. From this study we infer that AgNPs might have penetrated the plant system and may have impaired mitosis causing CA and MN. The results of this study demonstrate that AgNPs are genotoxic to plant cells. Since plant assays have been integrated as a genotoxicity component in risk assessment for detection of environmental mutagens, they should be given full consideration when evaluating the overall toxicological impact of the nanoparticles in the environment.
p. 1663-1676
Received: 13 December 2011; in revised form: 28 December 2011 / Accepted: 11 January 2012 / Published: 4 May 2012
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| Download PDF Full-text (739 KB) | Download XML Full-text Abstract: The macronutrient component of diets is critical for metabolic control and insulin action. The aim of this study was to compare the effects of high fat diets (HFDs) vs. high carbohydrate diets (HCDs) on metabolic control and insulin resistance in Wistar rats. Thirty animals divided into five groups (n = 6) were fed: (1) Control diet (CD); (2) High-saturated fat diet (HSFD); (3) High-unsaturated fat diet (HUFD); (4) High-digestible starch diet, (HDSD); and (5) High-resistant starch diet (HRSD) during eight weeks. HFDs and HCDs reduced weight gain in comparison with CD, however no statistical significance was reached. Calorie intake was similar in both HFDs and CD, but rats receiving HCDs showed higher calorie consumption than other groups, (p < 0.01). HRSD showed the lowest levels of serum and hepatic lipids. The HUFD induced the lowest fasting glycemia levels and HOMA-IR values. The HDSD group exhibited the highest insulin resistance and hepatic cholesterol content. In conclusion, HUFD exhibited the most beneficial effects on glycemic control meanwhile HRSD induced the highest reduction on lipid content and did not modify insulin sensitivity. In both groups, HFDs and HCDs, the diet constituents were more important factors than caloric intake for metabolic disturbance and insulin resistance.
p. 1677-1686
Received: 21 October 2011; in revised form: 5 December 2011 / Accepted: 7 December 2011 / Published: 4 May 2012
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| Download PDF Full-text (199 KB) | Download XML Full-text Abstract: The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations.
p. 1687-1698
Received: 11 January 2012; in revised form: 14 February 2012 / Accepted: 21 February 2012 / Published: 4 May 2012
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| Download PDF Full-text (347 KB) | Download XML Full-text Abstract: A Water Quality Index (WQI) is a useful statistical tool for simplifying, reporting and interpreting complex information obtained from any body of water. A simple number given by any WQI model explains the level of water contamination. The objective was to develop a WQI for the water of the Luis L. Leon dam located in the state of Chihuahua, Mexico. Monthly water samples were obtained in 2009; January 10, February 12, March 8, May 20, June 10, July 9, August 12, September 10, October 11, November 15 and December 13. Ten sampling sites were randomly selected after dividing the study area using a geographic package. In each site, two samples at the top depth of 0.20 m and 1.0 m were obtained to quantify physical-chemical parameters. The following 11 parameters were considered to calculate the WQI; pH, Electrical Conductivity (EC), Dissolved Oxygen (DO), color, turbidity, ammonia nitrogen, fluorides, chlorides, sulfates, Total Solids (TS) and phosphorous (P). The data analysis involved two steps; a single analysis for each parameter and the WQI calculation. The resulted WQI value classified the water quality according to the following ranges: 2.8 excellent water. The results showed that the WQI values changed from low levels (WQI < 2.3) in some points during autumn time to high levels (WQI > 2.8) most of the year and the variation was due to time of sampling generally rainy season.
p. 1699-1714
Received: 13 March 2012; in revised form: 16 April 2012 / Accepted: 23 April 2012 / Published: 4 May 2012
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| Download PDF Full-text (691 KB) | Download XML Full-text Abstract: Meat samples (n = 100) from semi-domesticated reindeer (Rangifer tarandus tarandus L. ) were randomly collected from 10 grazing districts distributed over four Norwegian counties in 2008 and 2009. The main aim was to study concentrations and geographical variations in selected toxic elements; cadmium (Cd), lead (Pb), arsenic (As), copper (Cu), nickel (Ni) and vanadium (V) in order to assess the risk associated with reindeer meat consumption. Sample solutions were analysed using an inductively coupled plasma high resolution mass spectrometer (ICP-HRMS), whereas analysis of variance (ANOVA) was used for statistical analyses. Geographical variations in element concentrations were revealed, with As and Cd demonstrating the largest geographical differences. No clear geographical gradient was observed except for the east-west downward gradient for As. The As concentrations were highest in the vicinity of the Russian border, and only Cd was shown to increase with age (p < 0.05). Sex had no significant effect on the concentration of the studied elements. The concentrations of all the studied elements in reindeer meat were generally low and considerably below the maximum levels (ML) available for toxic elements set by the European Commission (EC). Thus, reindeer meat is not likely to be a significant contributor to the human body burden of toxic elements.
p. 1715-1731
Received: 28 March 2012; in revised form: 28 April 2012 / Accepted: 2 May 2012 / Published: 7 May 2012
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| Download PDF Full-text (1042 KB) | Download XML Full-text Abstract: Emission of heavy metals from traffic activities is an important pollution source to roadside farmland ecosystems. However, little previous research has been conducted to investigate heavy metal concentrations of roadside farmland soil in mountainous areas. Owing to more complex roadside environments and more intense driving conditions on mountainous highways, heavy metal accumulation and distribution patterns in farmland soil due to traffic activity could be different from those on plain highways. In this study, design factors including altitude, roadside distance, terrain, and tree protection were considered to analyze their influences on Cu, Zn, Cd, and Pb concentrations in farmland soils along a mountain highway around Kathmandu, Nepal. On average, the concentrations of Cu, Zn, Cd, and Pb at the sampling sites are lower than the tolerable levels. Correspondingly, pollution index analysis does not show serious roadside pollution owing to traffic emissions either. However, some maximum Zn, Cd, and Pb concentrations are close to or higher than the tolerable level, indicating that although average accumulations of heavy metals pose no hazard in the region, some spots with peak concentrations may be severely polluted. The correlation analysis indicates that either Cu or Cd content is found to be significantly correlated with Zn and Pb content while there is no significant correlation between Cu and Cd. The pattern can be reasonably explained by the vehicular heavy metal emission mechanisms, which proves the heavy metals’ homology of the traffic pollution source. Furthermore, the independent factors show complex interaction effects on heavy metal concentrations in the mountainous roadside soil, which indicate quite a different distribution pattern from previous studies focusing on urban roadside environments. It is found that the Pb concentration in the downgrade roadside soil is significantly lower than that in the upgrade soil while the Zn concentration in the downgrade roadside soil is marginally higher than in the upgrade soil; and the concentrations of Cu and Pb in the roadside soils with tree protection are significantly lower than those without tree protection. However, the attenuation pattern of heavy metal concentrations as a function of roadside distance within a 100 m range cannot be identified consistently.
p. 1732-1747
Received: 16 March 2012; in revised form: 23 April 2012 / Accepted: 25 April 2012 / Published: 7 May 2012
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| Download PDF Full-text (1206 KB) | Download XML Full-text | Abstract: This is the first report of registration at birth, and of incidence of major structural birth defects (BD) obtained in Gaza at Al Shifa Hospital, where 28% of total births in Gaza Strip occur. Doctors registered 4,027 deliveries, with a protocol comprehensive of clinical, demographic, kin and environmental questions. Prevalence of BD is 14/1,000, without association with intermarriage or gender of the child. Prevalence of late miscarriages and still births are respectively 23.3/1,000 and 7.4/1,000, and of premature births 19.6/1,000. Couples with a BD child have about 10 times higher frequency of recurrence of a BD in their progeny than those with normal children, but none of their 694 siblings and only 10/1,000 of their 1,423 progeny had BD, similar to the frequency in general population. These data suggest occurrence of novel genetic and epigenetic events in determination of BD. Children with BD were born with higher frequency (p < 0 001) in families where one or both parents were under “white phosphorus” attack, that in the general population. Bombing of the family home and removal of the rubble were also frequently reported by couples with BD occurrence. These data suggests a causative/favoring role of acute exposure of parents to the weapons-associated contaminants, and/or of their chronic exposure from their persistence in the environment on the embryonic development of their children.
p. 1748-1756
Received: 7 March 2012; in revised form: 14 April 2012 / Accepted: 20 April 2012 / Published: 7 May 2012
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| Download PDF Full-text (156 KB) | Download XML Full-text Abstract: There have been few epidemiological surveys to establish prevalence and associated risk factors of psychosis in Sub-Saharan Africa. This paper reports a population- based epidemiological survey in rural Kenya of the prevalence of psychotic symptoms and their relationship with demographic, socio-economic and other risk factors. A random sample of 2% of all adults living in Maseno, Kisumu District of Nyanza province, Kenya (50,000 population) were studied, aiming for a sample size of 1,000 people. The psychosis screening questionnaire was used to assess the prevalence of psychotic symptoms in the preceding twelve months. The response rate was 87.6%. The prevalence of single psychotic symptoms in rural Kenya was 8% of the adult population, but only 0.6% had two symptoms and none had three or more psychotic symptoms in this sample size. Psychotic symptoms were evenly distributed across this relatively poor rural population and were significantly associated with presence of common mental disorders, and to a lesser extent with poor physical health and housing type. We conclude that single psychotic symptoms are relatively common in rural Kenya and rates are elevated in those with CMD, poor physical health and poor housing.
p. 1757-1770
Received: 6 March 2012; in revised form: 1 April 2012 / Accepted: 23 April 2012 / Published: 7 May 2012
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| Download PDF Full-text (1399 KB) | Download XML Full-text Abstract: A new type of grafting chitosan (CTS) was synthesized using 2-hydroxyethyl- trimethyl ammonium chloride (HGCTS). The adsorption of Cr(VI) on HGCTS was studied. The effect factors on adsorption and the adsorption mechanism were considered. The results indicated that the HGCTS could concentrate and separate Cr(VI) at pH 4.0; the adsorption equilibrium time was 80 min; the maximum adsorption capacity was 205 mg/g. The adsorption isotherm and kinetics were investigated, equilibrium data agreed very well with the Langmuir model and the pseudo second-order model could describe the adsorption process better than the pseudo first-order model. A novel method for speciation of Cr(VI) and Cr(III) in environmental water samples has been developed using HGCTS as adsorbent and FAAS as determination means. The detection limit of this method was 20 ng/L, the relatively standard deviation was 1.2% and the recovery was 99%~105%.
p. 1771-1790
Received: 30 March 2012; in revised form: 12 April 2012 / Accepted: 20 April 2012 / Published: 7 May 2012
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| Download PDF Full-text (1738 KB) | Download XML Full-text Abstract: Waterborne gastrointestinal (GI) illnesses demonstrate seasonal increases associated with water quality and meteorological characteristics. However, few studies have been conducted on the association of hydrological parameters, such as streamflow, and seasonality of GI illnesses. Streamflow is correlated with biological contamination and can be used as proxy for drinking water contamination. We compare seasonal patterns of GI illnesses in the elderly (65 years and older) along the Ohio River for a 14-year period (1991–2004) to seasonal patterns of streamflow. Focusing on six counties in close proximity to the river, we compiled weekly time series of hospitalizations for GI illnesses and streamflow data. Seasonal patterns were explored using Poisson annual harmonic regression with and without adjustment for streamflow. GI illnesses demonstrated significant seasonal patterns with peak timing preceding peak timing of streamflow for all six counties. Seasonal patterns of illness remain consistent after adjusting for streamflow. This study found that the time of peak GI illness precedes the peak of streamflow, suggesting either an indirect relationship or a more direct path whereby pathogens enter water supplies prior to the peak in streamflow. Such findings call for interdisciplinary research to better understand associations among streamflow, pathogen loading, and rates of gastrointestinal illnesses.
p. 1791-1809
Received: 23 March 2012; in revised form: 19 April 2012 / Accepted: 30 April 2012 / Published: 9 May 2012
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| Download PDF Full-text (210 KB) | Download XML Full-text Abstract: Undernutrition during fetal and postnatal life is still a major problem in many low- and middle-income countries. Even in high-income countries malnutrition may exist in cases of intrauterine growth retardation, as well as in chronic conditions such as anorexia nervosa and inflammatory bowel disease. Children adopted from developing countries are often chronically malnourished. Nutritional rehabilitation, resulting in catch-up growth, is often complicated by influences originating in fetal life as well as during postnatal growth. This may result in hormonal and metabolic changes as well as alterations in pubertal development. The present review focuses on fetal, postnatal and fetal-postnatal undernutrition and subsequent catch-up growth as well as catch-up growth in relation to pubertal development. Catch-up growth in children can be associated with early puberty following fetal or combined fetal-postnatal undernutrition. However, early puberty does not seem to occur following catch-up growth after isolated postnatal undernutrition. Gonadotropins have been reported to be elevated in prepubertal adopted girls as well as during catch-up growth in animals. Even if other factors may contribute, linear catch-up growth seems to be associated with the timing of pubertal development. The mechanisms behind this are still unknown. Future research may elucidate how to carry out nutritional rehabilitation without risk for early pubertal development.
p. 1810-1819
Received: 7 March 2012; in revised form: 20 April 2012 / Accepted: 26 April 2012 / Published: 9 May 2012
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| Download PDF Full-text (177 KB) | Download XML Full-text Abstract: Association between common mental disorders (CMDs), equity, poverty and socio-economic functioning are relatively well explored in high income countries, but there have been fewer studies in low and middle income countries, despite the considerable burden posed by mental disorders, especially in Africa, and their potential impact on development. This paper reports a population-based epidemiological survey of a rural area in Kenya. A random sample of 2% of all adults living in private households in Maseno, Kisumu District of Nyanza Province, Kenya (50,000 population), were studied. The Clinical Interview Schedule-Revised (CIS-R) was used to determine the prevalence of common mental disorders (CMDs). Associations with socio-demographic and economic characteristics were explored. A CMD prevalence of 10.8% was found, with no gender difference. Higher rates of illness were found in those who were of older age and those in poor physical health. We conclude that CMDs are common in Kenya and rates are elevated among people who are older, and those in poor health.
p. 1820-1835
Received: 31 March 2012; in revised form: 28 April 2012 / Accepted: 2 May 2012 / Published: 10 May 2012
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| Download PDF Full-text (1811 KB) | Download XML Full-text Abstract: The purpose of this study is to apply the Human Security Index (HSI) as a tool to detect social and economic cumulative risk burden at a county-level in the state of Texas. The HSI is an index comprising a network of three sub-components or “fabrics”; the Economic, Environmental, and Social Fabrics. We hypothesized that the HSI will be a useful instrument for identifying and analyzing socioeconomic conditions that contribute to cumulative risk burden in vulnerable counties. We expected to identify statistical associations between cumulative risk burden and (a) ethnic concentration and (b) geographic proximity to the Texas-Mexico border. Findings from this study indicate that the Texas-Mexico border region did not have consistently higher total or individual fabric scores as would be suggested by the high disease burden and low income in this region. While the Economic, Environmental, Social Fabrics (including the Health subfabric) were highly associated with Hispanic ethnic concentration, the overall HSI and the Crime subfabric were not. In addition, the Education, Health and Crime subfabrics were associated with African American racial composition, while Environment, Economic and Social Fabrics were not. Application of the HSI to Texas counties provides a fuller and more nuanced understanding of socioeconomic and environmental conditions, and increases awareness of the role played by environmental, economic, and social factors in observed health disparities by race/ethnicity and geographic region.
p. 1836-1845
Received: 16 March 2012; in revised form: 25 April 2012 / Accepted: 2 May 2012 / Published: 10 May 2012
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| Download PDF Full-text (140 KB) | Download XML Full-text Abstract: Many skin cancer screenings occur in non-traditional community settings, with the beach being an important setting due to beachgoers being at high risk for skin cancer. This study is a secondary analysis of data from a randomized trial of a skin cancer intervention in which participants (n = 312) had a full-body skin examination by a clinician and received a presumptive diagnosis (abnormal finding, no abnormal finding). Participants’ pursuit of follow-up was assessed post-intervention (n = 283). Analyses examined: (1) participant’s recall of screening results; and (2) whether cognitive and behavioral variables were associated with follow-up being as advised. Just 12% of participants (36/312) did not correctly recall the results of their skin examination. One-third (33%, 93/283) of participants’ follow-up was classified as being not as advised (recommend follow-up not pursued, unadvised follow-up pursued). Among participants whose follow-up was not as advised, 71% (66/93) did not seek recommended care. None of the measured behavioral and cognitive variables were significantly associated with recall of screening examination results or whether follow-up was as advised. Research is needed to determine what factors are associated with follow-up being as advised and to develop messages that increase receipt of advised follow-up care.
p. 1846-1858
Received: 27 February 2012; in revised form: 16 April 2012 / Accepted: 7 May 2012 / Published: 11 May 2012
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| Download PDF Full-text (191 KB) | Download XML Full-text Abstract: Scientific certainty regarding environmental toxin-related etiologies of breast cancer, particularly among women with genetic polymorphisms in estrogen metabolizing enzymes, is lacking. Fungicides have been recognized for their carcinogenic potential, yet there is a paucity of epidemiological studies examining the health risks of these agents. The association between agricultural fungicide exposure and breast cancer risk was examined in a secondary analysis of a province-wide breast cancer case-control study in Prince Edward Island (PEI) Canada. Specific objectives were: (1) to derive and examine the level of association between estimated fungicide exposures, and breast cancer risk among women in PEI; and (2) to assess the potential for gene-environment interactions between fungicide exposure and a CYP1A1 polymorphism in cases versus controls. After 1:3 matching of 207 cases to 621 controls by age, family history of breast cancer and menopausal status, fungicide exposure was not significantly associated with an increased risk of breast cancer (OR = 0.74; 95% CI: 0.46–1.17). Moreover, no statistically significant interactions between fungicide exposure and CYP1A1*2A were observed. Gene-environment interactions were identified. Though interpretations of findings are challenged by uncertainty of exposure assignment and small sample sizes, this study does provide grounds for further research.
p. 1859-1873
Received: 4 April 2012; in revised form: 28 April 2012 / Accepted: 30 April 2012 / Published: 11 May 2012
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| Download PDF Full-text (310 KB) | Download XML Full-text Abstract: In recent decades, high ambient ozone concentrations have become one of the major regional air quality issues in the Pearl River Delta (PRD) region. Non-methane hydrocarbons (NMHCs), as key precursors of ozone, were found to be the limiting factor in photochemical ozone formation for large areas in the PRD. For source apportioning of NMHCs as well as ozone pollution control strategies, it is necessary to obtain typical seasonal and diurnal patterns of NMHCs with a large pool of field data. To date, few studies have focused on seasonal and diurnal variations of NMHCs in urban areas of Guangzhou. This study explored the seasonal variations of most hydrocarbons concentrations with autumn maximum and spring minimum in Guangzhou. The diurnal variations of most anthropogenic NMHCs typically showed two-peak pattern with one at 8:00 in the morning and another at 20:00 in the evening, both corresponding to traffic rush hours in Guangzhou, whereas isoprene displayed a different bimodal diurnal curve. Propene, ethene, m , p -xylene and toluene were the four largest contributors to ozone formation in Guangzhou, based on the evaluation of individual NMHCs’ photochemical reactivity. Therefore, an effective strategy for controlling ozone pollution may be achieved by the reduction of vehicle emissions in Guangzhou.
p. 1874-1886
Received: 11 March 2012; in revised form: 20 April 2012 / Accepted: 23 April 2012 / Published: 16 May 2012
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| Download PDF Full-text (1158 KB) | Download XML Full-text Abstract: Heavy metal pollution in soil is becoming a widely concerning environmental problem in China. The aim of this study is to integrate multiple sources of data, namely total Cu and Pb contents, digital elevation model (DEM) data, remote sensing image and interpreted land-use data, for mapping the spatial distribution of total Cu and Pb contamination in top soil along the Le’an River and its branches. Combined with geographical analyses and watershed delineation, the source and transportation route of pollutants are identified. Regions at high risk of Cu or Pb pollution are suggested. Results reveal that topography is the major factor that controls the spatial distribution of Cu and Pb. Watershed delineation shows evidence that the streamflow resulting from rainfall is the major carrier of metal pollutants.
p. 1887-1907
Received: 6 February 2012; in revised form: 26 March 2012 / Accepted: 29 April 2012 / Published: 16 May 2012
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| Download PDF Full-text (1461 KB) | Download XML Full-text Abstract: Soil erosion has been recognized as one of the major threats to our environment and water quality worldwide, especially in China. To mitigate nonpoint source water quality problems caused by soil erosion, best management practices (BMPs) and/or conservation programs have been adopted. Watershed models, such as the Annualized Agricultural Non-Point Source Pollutant Loading model (AnnAGNPS), have been developed to aid in the evaluation of watershed response to watershed management practices. The model has been applied worldwide and proven to be a very effective tool in identifying the critical areas which had serious erosion, and in aiding in decision-making processes for adopting BMPs and/or conservation programs so that cost/benefit can be maximized and non-point source pollution control can be achieved in the most efficient way. The main goal of this study was to assess the characteristics of soil erosion, sediment and sediment delivery of a watershed so that effective conservation measures can be implemented. To achieve the overall objective of this study, all necessary data for the 4,184 km2 Daning River watershed in the Three-Gorge region of the Yangtze River of China were assembled. The model was calibrated using observed monthly runoff from 1998 to 1999 (Nash-Sutcliffe coefficient of efficiency of 0.94 and R 2 of 0.94) and validated using the observed monthly runoff from 2003 to 2005 (Nash-Sutcliffe coefficient of efficiency of 0.93 and R 2 of 0.93). Additionally, the model was validated using annual average sediment of 2000–2002 (relative error of −0.34) and 2003–2004 (relative error of 0.18) at Wuxi station. Post validation simulation showed that approximately 48% of the watershed was under the soil loss tolerance released by the Ministry of Water Resources of China (500 t·km−2 ·y−1 ). However, 8% of the watershed had soil erosion of exceeding 5,000 t·km−2 ·y−1 . Sloping areas and low coverage areas are the main source of soil loss in the watershed.
p. 1908-1926
Received: 27 March 2012; in revised form: 28 April 2012 / Accepted: 2 May 2012 / Published: 18 May 2012
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| Download PDF Full-text (192 KB) | Download XML Full-text Abstract: Rates of childhood and adult trauma are high among incarcerated persons. In addition to criminality, childhood trauma is associated with the risk for emotional disorders (e.g., depression and anxiety) and co-morbid conditions such as alcohol and drug abuse and antisocial behaviors in adulthood. This paper develops rates of childhood and adult trauma and examines the impact of age-of-onset and type-specific trauma on emotional problems and behavior for a sample of incarcerated males (N~4,000). Prevalence estimates for types of trauma were constructed by age at time of trauma, race and types of behavioral health treatment received while incarcerated. HLM models were used to explore the association between childhood and adult trauma and depression, anxiety, substance use, interpersonal problems, and aggression problems (each model estimated separately and controlling for age, gender, race, time incarcerated, and index offense). Rates of physical, sexual, and emotional trauma were higher in childhood than adulthood and ranged from 44.7% (physical trauma in childhood) to 4.5% (sexual trauma in adulthood). Trauma exposure was found to be strongly associated with a wide range of behavioral problems and clinical symptoms. Given the sheer numbers of incarcerated men and the strength of these associations, targeted intervention is critical.
p. 1927-1938
Received: 13 March 2012 / Accepted: 11 May 2012 / Published: 18 May 2012
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| Download PDF Full-text (87 KB) | Download XML Full-text Abstract: This paper reports the characteristics of suicides which occurred during the existential and the non-existential wars in Israel. It provides a first approximation of whether the suicide patterns in each war are consistent with the findings of Morselli and Durkheim, and whether their theoretical interpretations can serve as a preliminary guideline to explaining the Israeli case, which is characterized by short periods of war, social integration during some of the non-existential wars, and a sharp rise in post-war male suicide rates following all of the existential wars. Implications for further studies on the subject in Israel and elsewhere are discussed.
p. 1939-1953
Received: 21 March 2012; in revised form: 27 April 2012 / Accepted: 8 May 2012 / Published: 18 May 2012
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| Download PDF Full-text (429 KB) | Download XML Full-text | Abstract: Recent research has spotlighted the role of microRNAs (miRNAs) as critical epigenetic regulators of hematopoietic stem cell differentiation and leukemia development. Despite the recent advances in knowledge surrounding epigenetics and leukemia, the mechanisms underlying miRNAs’ influence on leukemia development have yet to be clearly elucidated. Our aim was to identify high ranking biological pathways altered at the gene expression level and under epigenetic control. Specifically, we set out to test the hypothesis that miRNAs dysregulated in acute myeloid leukemia (AML) converge on a common pathway that can influence signaling related to hematopoiesis and leukemia development. We identified genes altered in AML patients that are under common regulation of seven key miRNAs. By mapping these genes to a global interaction network, we identified the “AML Signalisome”. The AML Signalisome comprises 53 AML-associated molecules, and is enriched for proteins that play a role in the aryl hydrocarbon receptor (AhR) pathway, a major regulator of hematopoiesis. Furthermore, we show biological enrichment for hematopoiesis-related proteins within the AML Signalisome. These findings provide important insight into miRNA-regulated pathways in leukemia, and may help to prioritize targets for disease prevention and treatment.
p. 1954-1970
Received: 18 March 2012; in revised form: 17 April 2012 / Accepted: 19 April 2012 / Published: 21 May 2012
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| Download PDF Full-text (179 KB) | Download XML Full-text Abstract: We reviewed the adoption and implementation of smokefree policies in all Latin American and the Caribbean (LAC) countries. Significant progress has been achieved among LAC countries since the WHO Framework Convention on Tobacco Control (FCTC) was adopted in 2005. Both national and sub-national legislation have provided effective mechanisms to increase the fraction of the population protected from secondhand tobacco smoke. Civil society has actively promoted these policies and played a main role in enacting them and monitoring their enforcement. The tobacco industry, while continuing to oppose the approval and regulation of the laws at legislative and executive levels, has gone a step further by litigating against them in the Courts. As in the US and elsewhere, this litigation has failed to stop the legislation.
p. 1971-1983
Received: 26 March 2012 / Accepted: 11 April 2012 / Published: 22 May 2012
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| Download PDF Full-text (277 KB) | Download XML Full-text Abstract: Cumulative risk assessment has been proposed as an approach to evaluate the health risks associated with simultaneous exposure to multiple chemical and non-chemical stressors. Physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) models can allow for the inclusion and evaluation of multiple stressors, including non-chemical stressors, but studies have not leveraged PBPK/PD models to jointly consider these disparate exposures in a cumulative risk context. In this study, we focused on exposures to organophosphate (OP) pesticides for children in urban low-income environments, where these children would be simultaneously exposed to other pesticides (including pyrethroids) and non-chemical stressors that may modify the effects of these exposures (including diet). We developed a methodological framework to evaluate chemical and non-chemical stressor impacts on OPs, utilizing an existing PBPK/PD model for chlorpyrifos. We evaluated population-specific stressors that would influence OP doses or acetylcholinesterase (AChE) inhibition, the relevant PD outcome. We incorporated the impact of simultaneous exposure to pyrethroids and dietary factors on OP dose through the compartments of metabolism and PD outcome within the PBPK model, and simulated combinations of stressors across multiple exposure ranges and potential body weights. Our analyses demonstrated that both chemical and non-chemical stressors can influence the health implications of OP exposures, with up to 5-fold variability in AChE inhibition across combinations of stressor values for a given OP dose. We demonstrate an approach for modeling OP risks in the presence of other population-specific environmental stressors, providing insight about co-exposures and variability factors that most impact OP health risks and contribute to children’s cumulative health risk from pesticides. More generally, this framework can be used to inform cumulative risk assessment for any compound impacted by chemical and non-chemical stressors through metabolism or PD outcomes.
p. 1984-1996
Sameer Al Zenki , Husam Al Omirah , Suad Al Hooti , Nawal Al Hamad , Robert T. Jackson , Aravinda Rao , Nasser Al Jahmah , Ina'am Al Obaid , Jameela Al Ghanim , Mona Al Somaie , Sahar Zaghloul and Amani Al Othman
Received: 20 April 2012; in revised form: 4 May 2012 / Accepted: 15 May 2012 / Published: 23 May 2012
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| Download PDF Full-text (270 KB) | Download XML Full-text Abstract: The socio-economic development which followed the discovery of oil resources brought about considerable changes in the food habits and lifestyle of the Kuwaiti population. Excessive caloric intake and decreased energy expenditure due to a sedentary lifestyle have led to a rapid increase in obesity, diabetes and other non-communicable chronic diseases in the population. In this paper, we examine the prevalence of the Metabolic Syndrome (MetS) among Kuwaiti adults (≥20 years) using data from the first national nutrition survey conducted between July 2008 and November 2009. The prevalence of MetS was 37.7% in females and 34.2% in males by NCEP criteria, whereas the values were 40.1% in females and 41.7% in males according to IDF criteria. Prevalence of MetS increased with age and was higher in females than males. The high prevalence of the MetS in Kuwaiti adults warrants urgent public health measures to prevent morbidity and mortality due to cardiovascular complications in the future.
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