Open AccessReview
Animal-Assisted Interventions in the Classroom—A Systematic Review
Int. J. Environ. Res. Public Health 2017, 14(7), 669; doi:10.3390/ijerph14070669 (registering DOI) -
Abstract
The inclusion of animals in educational practice is becoming increasingly popular, but it is unclear how solid the evidence for this type of intervention is. The aim of this systematic review is to scrutinise the empirical research literature relating to animal-assisted interventions conducted
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The inclusion of animals in educational practice is becoming increasingly popular, but it is unclear how solid the evidence for this type of intervention is. The aim of this systematic review is to scrutinise the empirical research literature relating to animal-assisted interventions conducted in educational settings. The review included 25 papers; 21 from peer-reviewed journals and 4 obtained using grey literature databases. Most studies reported significant benefits of animal-assisted interventions in the school setting. Despite this, studies vary greatly in methods and design, in intervention types, measures, and sample sizes, and in the length of time exposed to an animal. Furthermore, a worrying lack of reference to risk assessment and animal welfare must be highlighted. Taken together, the results of this review show promising findings and emerging evidence suggestive of potential benefits related to animals in school settings. The review also indicates the need for a larger and more robust evidence base driven by thorough and strict protocols. The review further emphasises the need for safeguarding for all involved—welfare and safety are paramount. Full article
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Open AccessArticle
Evaluation of Legionella Air Contamination in Healthcare Facilities by Different Sampling Methods: An Italian Multicenter Study
Int. J. Environ. Res. Public Health 2017, 14(7), 670; doi:10.3390/ijerph14070670 (registering DOI) -
Abstract
Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in
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Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolis®μ) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolis®μ were also analyzed by real-time PCR. Legionella presence in the air and water was then compared by sequence-based typing (SBT) methods. Air contamination was found in four HF (36.4%) by at least one of the culturable methods. The culturable investigation by Coriolis®μ did not yield Legionella in any enrolled HF. However, molecular investigation using Coriolis®μ resulted in eight HF testing positive for Legionella in the air. Comparison of Legionella air and water contamination indicated that Legionella water concentration could be predictive of its presence in the air. Furthermore, a molecular study of 12 L. pneumophila strains confirmed a match between the Legionella strains from air and water samples by SBT for three out of four HF that tested positive for Legionella by at least one of the culturable methods. Overall, our study shows that Legionella air detection cannot replace water sampling because the absence of microorganisms from the air does not necessarily represent their absence from water; nevertheless, air sampling may provide useful information for risk assessment. The liquid impingement technique appears to have the greatest capacity for collecting airborne Legionella if combined with molecular investigations. Full article
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Open AccessArticle
Seasonal Differences in Determinants of Time Location Patterns in an Urban Population: A Large Population-Based Study in Korea
Int. J. Environ. Res. Public Health 2017, 14(7), 672; doi:10.3390/ijerph14070672 (registering DOI) -
Abstract
Time location patterns are a significant factor for exposure assessment models of air pollutants. Factors associated with time location patterns in urban populations are typically due to high air pollution levels in urban areas. The objective of this study was to determine the
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Time location patterns are a significant factor for exposure assessment models of air pollutants. Factors associated with time location patterns in urban populations are typically due to high air pollution levels in urban areas. The objective of this study was to determine the seasonal differences in time location patterns in two urban cities. A Time Use Survey of Korean Statistics (KOSTAT) was conducted in the summer, fall, and winter of 2014. Time location data from Seoul and Busan were collected, together with demographic information obtained by diaries and questionnaires. Determinants of the time spent at each location were analyzed by multiple linear regression and the stepwise method. Seoul and Busan participants had similar time location profiles over the three seasons. The time spent at own home, other locations, workplace/school and during walk were similar over the three seasons in both the Seoul and Busan participants. The most significant time location pattern factors were employment status, age, gender, monthly income, and spouse. Season affected the time spent at the workplace/school and other locations in the Seoul participants, but not in the Busan participants. The seasons affected each time location pattern of the urban population slightly differently, but overall there were few differences. Full article
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Open AccessArticle
Why Do Children Engage in Sedentary Behavior? Child- and Parent-Perceived Determinants
Int. J. Environ. Res. Public Health 2017, 14(7), 671; doi:10.3390/ijerph14070671 (registering DOI) -
Abstract
Todays children spend a large amount of their time sedentary. There is limited evidence on the determinants of sedentary behavior in children, and qualitative studies are especially lacking. Therefore, this study aimed to explore determinants of children’s sedentary behavior from the child- and
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Todays children spend a large amount of their time sedentary. There is limited evidence on the determinants of sedentary behavior in children, and qualitative studies are especially lacking. Therefore, this study aimed to explore determinants of children’s sedentary behavior from the child- and parent perspective. Qualitative data were collected during concept mapping sessions with four groups of 11–13 years old children (n = 38) and two online sessions with parents (n = 21). Children and parents generated sedentary behavior motives, sorted related motives, and rated their importance in influencing children’s sedentary time. Next, multidimensional scaling and hierarchical cluster analysis was performed to create clusters of motives resulting in a concept map. Finally, the researchers named the clusters in the concept map. Concept maps of children yielded eight to ten perceived determinants, and concept maps of parents six to seven. Children and parents identified six similar potential determinants, and both rated as important: Sitting because… “it is the norm (I have to)”, and “I can work/play better that way”. In addition, children rated “there is nobody to play with” as an important potential determinant for engaging in sedentary behavior. The most important child- and parent perceived determinants were related to the social/cultural and physical environment, indicating that these are promising targets for future interventions. Full article
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Open AccessArticle
Toxicity of Naphthalene and Benzene on Tribollium castaneum Herbst
Int. J. Environ. Res. Public Health 2017, 14(6), 667; doi:10.3390/ijerph14060667 -
Abstract
Naphthalene and benzene are widely-used volatile organic compounds. The aim of this research was to examine the toxicological effects of naphthalene and benzene against Tribolium castaneum as an animal model. Adult insects were exposed to these aromatic compounds to assess mortality after 4–48
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Naphthalene and benzene are widely-used volatile organic compounds. The aim of this research was to examine the toxicological effects of naphthalene and benzene against Tribolium castaneum as an animal model. Adult insects were exposed to these aromatic compounds to assess mortality after 4–48 h of exposure. The lethal concentration 50 (LC50) for naphthalene, naphthalin, and benzene were 63.6 µL/L, 20.0 µL/L, and 115.9 µL/L in air, respectively. Real-time polymerase chain reaction (PCR) analysis revealed expression changes in genes related to oxidative stress and metabolism [Glutathione S-Transferase (Gst), and Cytochrome P450 6BQ8 (Cyp6bq8)]; reproduction and metamorphosis [Hormone receptor in 39-like protein (Hr39), Ecdysone receptor: (Ecr), and Chitin synthase 2 (Chs2)]; and neurotransmission [Histamine-gated chloride channel 2 (Hiscl2)] in insects exposed for 4 h to 70.2 µL/L naphthalene. Adults exposed to benzene (80 µL/L; 4 h) overexpressed genes related to neurotransmission [GABA-gated anion channel (Rdl), Hiscl2, and GABA-gated ion channel (Grd)]; reproduction and metamorphosis [Ultraspiracle nuclear receptor (USP), Ecr; and Hr39]; and development (Chs2). The data presented here provides evidence that naphthalene and benzene inhalation are able to induce alterations on reproduction, development, metamorphosis, oxidative stress, metabolism, neurotransmission, and death of the insect. Full article
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Open AccessArticle
Antibiotic Concentrations Decrease during Wastewater Treatment but Persist at Low Levels in Reclaimed Water
Int. J. Environ. Res. Public Health 2017, 14(6), 668; doi:10.3390/ijerph14060668 -
Abstract
Reclaimed water has emerged as a potential irrigation solution to freshwater shortages. However, limited data exist on the persistence of antibiotics in reclaimed water used for irrigation. Therefore, we examined the fate of nine commonly-used antibiotics (ampicillin, azithromycin, ciprofloxacin, linezolid, oxacillin, oxolinic acid,
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Reclaimed water has emerged as a potential irrigation solution to freshwater shortages. However, limited data exist on the persistence of antibiotics in reclaimed water used for irrigation. Therefore, we examined the fate of nine commonly-used antibiotics (ampicillin, azithromycin, ciprofloxacin, linezolid, oxacillin, oxolinic acid, penicillin G, pipemidic acid, and tetracycline) in differentially treated wastewater and reclaimed water from two U.S. regions. We collected 72 samples from two Mid-Atlantic and two Midwest treatment plants, as well as one Mid-Atlantic spray irrigation site. Antibiotic concentrations were measured using liquid-chromatography- tandem mass spectrometry. Data were analyzed using Mann-Whitney-Wilcoxon tests and Kruskal Wallis tests. Overall, antibiotic concentrations in effluent samples were lower than that of influent samples. Mid-Atlantic plants had similar influent but lower effluent antibiotic concentrations compared to Midwest plants. Azithromycin was detected at the highest concentrations (of all antibiotics) in influent and effluent samples from both regions. For most antibiotics, transport from the treatment plant to the irrigation site resulted in no changes in antibiotic concentrations, and UV treatment at the irrigation site had no effect on antibiotic concentrations in reclaimed water. Our findings show that low-level antibiotic concentrations persist in reclaimed water used for irrigation; however, the public health implications are unclear at this time. Full article
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Open AccessFeature PaperArticle
The Fate of Pollutants in Porous Asphalt Pavements, Laboratory Experiments to Investigate Their Potential to Impact Environmental Health
Int. J. Environ. Res. Public Health 2017, 14(6), 666; doi:10.3390/ijerph14060666 -
Abstract
Pervious Paving Systems (PPS) are part of a sustainable approach to drainage in which excess surface water is encouraged to infiltrate through their structure, during which potentially toxic elements, such as metals and hydrocarbons are treated by biodegradation and physical entrapment and storage.
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Pervious Paving Systems (PPS) are part of a sustainable approach to drainage in which excess surface water is encouraged to infiltrate through their structure, during which potentially toxic elements, such as metals and hydrocarbons are treated by biodegradation and physical entrapment and storage. However, it is not known where in the PPS structure these contaminants accumulate, which has implications for environmental health, particularly during maintenance, as well as consequences for the recycling of material from the PPS at the end-of-life. A 1 m3 porous asphalt (PA) PPS test rig was monitored for 38 months after monthly additions of road sediment (RS) (367.5 g in total) and unused oil (430 mL in total), characteristic of urban loadings, were applied. Using a rainfall simulator, a typical UK rainfall rate of 15 mm/h was used to investigate its efficiency in dealing with contamination. Water quality of the effluent discharged from the rig was found to be suitable for discharge to most environments. On completion of the monitoring, a core was taken down through its surface, and samples of sediment and aggregate were taken. Analysis showed that most of the sediment remained in the surface course, with metal levels lower than the original RS, but higher than clean, unused aggregate or PA. However, even extrapolating these concentrations to 20 years’ worth of in-service use (the projected life of PPS) did not suggest their accumulation would present an environmental pollution risk when carrying out maintenance of the pavement and also indicates that the material could be recycled at end-of-life. Full article
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Open AccessArticle
Association between Air Pollution and Emergency Room Visits for Atrial Fibrillation
Int. J. Environ. Res. Public Health 2017, 14(6), 661; doi:10.3390/ijerph14060661 -
Abstract
Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a
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Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a 14 years’ time-series study to evaluate the association between the daily levels of air pollution (particulate matter, PM10 and PM2.5, and nitrogen dioxide, NO2) and the daily count of emergency accesses for AF (ICD-9 code: 427.31). We applied an over-dispersed conditional Poisson model to analyze the associations at different lags after controlling for time, influenza epidemics, holiday periods, temperature, and relative humidity. Additionally, we evaluated bi-pollutant models by including the other pollutant and the influence of several effect modifiers such as personal characteristics and pre-existing medical conditions. In the period of study, 79,892 individuals were admitted to the emergency departments of Rome hospitals because of AF (on average, 15.6 patients per day: min = 1, max = 36). Air pollution levels were associated with increased AF emergency visits within 24 h of exposure. Effect estimates ranged between 1.4% (0.7–2.3) for a 10 µg/m3 increase of PM10 to 3% (1.4–4.7) for a 10 µg/m3 increase of PM2.5 at lag 0–1 day. Those effects were higher in patients ≥75 years for all pollutants, male patients for PM10, and female patients for NO2. The presence of previous cardiovascular conditions, but not other effect modifiers, increase the pollution effects by 5–8% depending on the lag. This study found evidence that air pollution is associated with AF emergency visits in the short term. Full article
Open AccessArticle
Beyond Food Access: The Impact of Parent-, Home-, and Neighborhood-Level Factors on Children’s Diets
Int. J. Environ. Res. Public Health 2017, 14(6), 662; doi:10.3390/ijerph14060662 -
Abstract
Despite the growth in empirical research on neighborhood environmental characteristics and their influence on children’s diets, physical activity, and obesity, much remains to be learned, as few have examined the relationship between neighborhood food availability on dietary behavior in children, specifically. This analysis
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Despite the growth in empirical research on neighborhood environmental characteristics and their influence on children’s diets, physical activity, and obesity, much remains to be learned, as few have examined the relationship between neighborhood food availability on dietary behavior in children, specifically. This analysis utilized data from a community-based, cross-sectional sample of children (n = 199) that was collected in New Orleans, Louisiana, in 2010. This dataset was linked to food environment data to assess the impact of neighborhood food access as well as household and parent factors on children’s diets. We observed a negligible impact of the neighborhood food environment on children’s diets, except with respect to fast food, with children who had access to fast food within 500 m around their home significantly less likely (OR = 0.35, 95% CI: 0.1, 0.8) to consume vegetables. Key parental and household factors did play a role in diet, including receipt of public assistance and cooking meals at home. Children receiving public assistance were 2.5 times (95% CI: 1.1, 5.4) more likely to consume fruit more than twice per day compared with children not receiving public assistance. Children whose family cooked dinner at home more than 5 times per week had significantly more consumption of fruit (64% vs. 58%) and vegetables (55% vs. 39%), but less soda (27% vs. 43%). Findings highlight the need for future research that focuses on the dynamic and complex relationships between built and social factors in the communities and homes of children that impact their diet in order to develop multilevel prevention approaches that address childhood obesity. Full article
Open AccessArticle
Physical Fitness, Physical Activity, Sedentary Behavior, or Diet—What Are the Correlates of Obesity in Polish School Children?
Int. J. Environ. Res. Public Health 2017, 14(6), 664; doi:10.3390/ijerph14060664 -
Abstract
There is substantial evidence of rising prevalence of overweight and obesity and its co-morbidities among children in western-high income developed countries. In the European Union, the prevalence of overweight and obesity is increasing fastest among Polish children. Yet, there is paucity of evidence
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There is substantial evidence of rising prevalence of overweight and obesity and its co-morbidities among children in western-high income developed countries. In the European Union, the prevalence of overweight and obesity is increasing fastest among Polish children. Yet, there is paucity of evidence on the relationship of behavioral factors with body weight status of children in Poland. This study examined the association of obesity with physical fitness, physical activity, sedentary behavior and diet among Polish children. A total of 641 children (10–15 years) recruited from the Lower Silesia region of Poland participated in this cross-sectional study. Participants’ anthropometrics, physical fitness, physical activity, sedentary behavior and dietary intake were assessed. Outcome variables were weight categories (according to body mass index [BMI], waist-to-hip ratio [WHR], and percentage body fat [% BF]). The strongest negative correlation was found between VO2max and %BF (r = −0.39, p <0.05). Significant negative correlation was also found between VO2max and weight categories (r = −0.15). Results of the multinomial logit analysis showed that VO2max increased in groups of overweight, normal weight and underweight children by 13%, 26% and 19%, respectively as compared to the group of obese children. VO2max and weight and obesity indices were strongly correlated in both gender and age groups. Education and intervention programs to increase physical fitness (VO2max) through aerobic training are recommended for Physical Education teachers, parents and children in order to reduce the rate of overweight and obesity among children in the Lower Silesia region of Poland. Full article
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Open AccessArticle
Coverage and Influencing Determinants of Influenza Vaccination in Elderly Patients in a Country with a Poor Vaccination Implementation
Int. J. Environ. Res. Public Health 2017, 14(6), 665; doi:10.3390/ijerph14060665 -
Abstract
The seasonal influenza vaccination uptake of the elderly in Poland is one of the lowest in Europe. Objective: to assess the vaccination coverage and influencing determinants in patients ≥65 years of age. Methods: A cross-sectional study was conducted (November 2015–April 2016) among
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The seasonal influenza vaccination uptake of the elderly in Poland is one of the lowest in Europe. Objective: to assess the vaccination coverage and influencing determinants in patients ≥65 years of age. Methods: A cross-sectional study was conducted (November 2015–April 2016) among consecutive patients admitted to a municipal hospital located in the city of Szczecin, North-west Poland. Patients completed researcher-administered, anonymous questionnaires on socio- demographic data/factors related to the vaccination. Results: The response rate: 92.0%. Among 230 patients (79.6% women, median of age 69 years, range 65–89) who agreed to participate, 34.8% (95% Confidence Interval: 28.6–41.0%) were vaccinated. About 15.7% of respondents had not previously heard about the vaccination; 41.3% of those who stated they were vaccinated or planned on being vaccinated the following year, compared to 19.3% of respondents who stated they were not currently vaccinated (p < 0.001). A multivariable regression analysis revealed that patient factors, such as younger age (Odds Ratio, OR = 7.69), living in the urban area (OR = 7.69), having comorbidities (OR = 2.70), having a vaccinated family member (OR = 3.57), and being informed about vaccination (OR = 5.00) were each associated with greater odds of being immunized. Willingness for vaccination the next year was strongly associated (OR = 8.59) with vaccination status. Conclusions: The influenza vaccination uptake in the elderly population in Poland is disturbingly low. Improved education strategies are needed to increase the uptake. Vaccinated respondents are more likely to plan on being vaccinated the following year. Future interventions related to maximizing vaccination coverage should be more tailored, focusing especially on older patients living in rural areas. Full article
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Open AccessArticle
Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: Representativeness of the Monitoring Results in Fukushima, Japan
Int. J. Environ. Res. Public Health 2017, 14(6), 656; doi:10.3390/ijerph14060656 -
Abstract
Following Japan’s 2011 Fukushima nuclear incident, voluntary participation, rather than mandatory, was adopted as the default scenario for individual radiation monitoring. We evaluated the representativeness of the internal monitoring results from voluntary participants in Minamisoma City, which is located 10–40 km from the
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Following Japan’s 2011 Fukushima nuclear incident, voluntary participation, rather than mandatory, was adopted as the default scenario for individual radiation monitoring. We evaluated the representativeness of the internal monitoring results from voluntary participants in Minamisoma City, which is located 10–40 km from the Fukushima nuclear plant. Of approximately 70,000 individuals who were residing in Minamisoma City before the incident, a total of 19,263 residents (aged ≥21 years) participated in the monitoring from 1 October 2011 to 31 March 2015. Based on regression projection techniques with the available data obtained from the voluntary participants, the modeled probabilities of radiocesium (Cs) detection in October 2011 for Cs-137 and Cs-134 were 66.9% and 52.9%, respectively, which declined dramatically within a year following the incident. The rate of decline had stagnated since mid-2012, and the probability was close to zero after mid-2014. Sufficient agreement between the modeled probabilities of Cs detection (for the whole population) versus the measured Cs levels (for voluntary participants) was observed, except for Cs-134 in October 2011, indicating that the voluntary monitoring participant group was a good representative sample. Our findings affirmed the clinical importance of voluntary-based monitoring as a screening and dose-assessment tool in a post-nuclear incident. Our study informs societal decision-making regarding the long-term maintenance of the monitoring program under the current low exposure levels. Full article
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Open AccessFeature PaperArticle
Community Response to Multiple Sound Sources: Integrating Acoustic and Contextual Approaches in the Analysis
Int. J. Environ. Res. Public Health 2017, 14(6), 663; doi:10.3390/ijerph14060663 -
Abstract
Sufficient data refer to the relevant prevalence of sound exposure by mixed traffic sources in many nations. Furthermore, consideration of the potential effects of combined sound exposure is required in legal procedures such as environmental health impact assessments. Nevertheless, current practice still uses
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Sufficient data refer to the relevant prevalence of sound exposure by mixed traffic sources in many nations. Furthermore, consideration of the potential effects of combined sound exposure is required in legal procedures such as environmental health impact assessments. Nevertheless, current practice still uses single exposure response functions. It is silently assumed that those standard exposure-response curves accommodate also for mixed exposures—although some evidence from experimental and field studies casts doubt on this practice. The ALPNAP-study population (N = 1641) shows sufficient subgroups with combinations of rail-highway, highway-main road and rail-highway-main road sound exposure. In this paper we apply a few suggested approaches of the literature to investigate exposure-response curves and its major determinants in the case of exposure to multiple traffic sources. Highly/moderate annoyance and full scale mean annoyance served as outcome. The results show several limitations of the current approaches. Even facing the inherent methodological limitations (energy equivalent summation of sound, rating of overall annoyance) the consideration of main contextual factors jointly occurring with the sources (such as vibration, air pollution) or coping activities and judgments of the wider area soundscape increases the variance explanation from up to 8% (bivariate), up to 15% (base adjustments) up to 55% (full contextual model). The added predictors vary significantly, depending on the source combination. (e.g., significant vibration effects with main road/railway, not highway). Although no significant interactions were found, the observed additive effects are of public health importance. Especially in the case of a three source exposure situation the overall annoyance is already high at lower levels and the contribution of the acoustic indicators is small compared with the non-acoustic and contextual predictors. Noise mapping needs to go down to levels of 40 dBA,Lden to ensure the protection of quiet areas and prohibit the silent “filling up” of these areas with new sound sources. Eventually, to better predict the annoyance in the exposure range between 40 and 60 dBA and support the protection of quiet areas in city and rural areas in planning sound indicators need to be oriented at the noticeability of sound and consider other traffic related by-products (air quality, vibration, coping strain) in future studies and environmental impact assessments. Full article
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Open AccessArticle
Effects of Sulfate, Chloride, and Bicarbonate on Iron Stability in a PVC-U Drinking Pipe
Int. J. Environ. Res. Public Health 2017, 14(6), 660; doi:10.3390/ijerph14060660 -
Abstract
In order to describe iron stability in plastic pipes and to ensure the drinking water security, the influence factors and rules for iron adsorption and release were studied, dependent on the Unplasticized poly (vinyl chloride) (PVC-U) drinking pipes employed in this research. In
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In order to describe iron stability in plastic pipes and to ensure the drinking water security, the influence factors and rules for iron adsorption and release were studied, dependent on the Unplasticized poly (vinyl chloride) (PVC-U) drinking pipes employed in this research. In this paper, sulfate, chloride, and bicarbonate, as well as synthesized models, were chosen to investigate the iron stability on the inner wall of PVC-U drinking pipes. The existence of the three kinds of anions could significantly affect the process of iron adsorption, and a positive association was found between the level of anion concentration and the adsorption rate. However, the scaling formed on the inner surface of the pipes would be released into the water under certain conditions. The Larson Index (LI), used for a synthetic consideration of anion effects on iron stability, was selected to investigate the iron release under multi-factor conditions. Moreover, a well fitted linear model was established to gain a better understanding of iron release under multi-factor conditions. The simulation results demonstrated that the linear model was better fitted than the LI model for the prediction of iron release. Full article
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Open AccessArticle
Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study
Int. J. Environ. Res. Public Health 2017, 14(6), 655; doi:10.3390/ijerph14060655 -
Abstract
Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related
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Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS. Full article
Open AccessArticle
Level of Sedentary Behavior and Its Associated Factors among Saudi Women Working in Office-Based Jobs in Saudi Arabia
Int. J. Environ. Res. Public Health 2017, 14(6), 659; doi:10.3390/ijerph14060659 -
Abstract
Research in Saudi Arabia has revealed a shocking level of insufficiently physically active adults, particularly women. The risk of sedentary behavior will likely increase as the number of women with office-based jobs increases. The aim of this study is to determine the level
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Research in Saudi Arabia has revealed a shocking level of insufficiently physically active adults, particularly women. The risk of sedentary behavior will likely increase as the number of women with office-based jobs increases. The aim of this study is to determine the level of sedentary behavior, and its associated factors, among Saudi women working office-based jobs in the city of Riyadh. A cross-sectional study of 420 Saudi female employees at 8 office-based worksites were measured to determine body mass index and were given a self-administered survey to evaluate their level of physical activity and sedentary behavior. Median sitting time on work days was 690 min per day (interquartile range, IQR 541–870), with nearly half accumulated during work hours, and 575 min per day (IQR 360–780) on non-work days. Predictors of work day sitting time were level of education, number of children, and working in the private sector. Number of children, whether they were single, and whether they lived in a small home were found to predict non-work day sitting time. This study identifies Saudi women in office-based jobs as a high-risk group for sedentary behavior. There is a need to promote physical activity at worksites and reduce prolonged sitting. Full article
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Open AccessArticle
Paternal Risk Factors for Oral Clefts in Northern Africans, Southeast Asians, and Central Americans
Int. J. Environ. Res. Public Health 2017, 14(6), 657; doi:10.3390/ijerph14060657 -
Abstract
While several studies have investigated maternal exposures as risk factors for oral clefts, few have examined paternal factors. We conducted an international multi-centered case–control study to better understand paternal risk exposures for oral clefts (cases = 392 and controls = 234). Participants were
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While several studies have investigated maternal exposures as risk factors for oral clefts, few have examined paternal factors. We conducted an international multi-centered case–control study to better understand paternal risk exposures for oral clefts (cases = 392 and controls = 234). Participants were recruited from local hospitals and oral cleft repair surgical missions in Vietnam, the Philippines, Honduras, and Morocco. Questionnaires were administered to fathers and mothers separately to elicit risk factor and family history data. Associations between paternal exposures and risk of clefts were assessed using logistic regression adjusting for potential confounders. A father’s personal/family history of clefts was associated with significantly increased risk (adjusted OR: 4.77; 95% CI: 2.41–9.45). No other significant associations were identified for other suspected risk factors, including education (none/primary school v. university adjusted OR: 1.29; 95% CI: 0.74–2.24), advanced paternal age (5-year adjusted OR: 0.98; 95% CI: 0.84–1.16), or pre-pregnancy tobacco use (adjusted OR: 0.96; 95% CI: 0.67–1.37). Although sample size was limited, significantly decreased risks were observed for fathers with selected occupations. Further research is needed to investigate paternal environmental exposures as cleft risk factors. Full article
Open AccessArticle
Attachment Style Is Related to Quality of Life for Assistance Dog Owners
Int. J. Environ. Res. Public Health 2017, 14(6), 658; doi:10.3390/ijerph14060658 -
Abstract
Attachment styles have been shown to affect quality of life. Growing interest in the value of companion animals highlights that owning a dog can also affect quality of life, yet little research has explored the role of the attachment bond in affecting the
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Attachment styles have been shown to affect quality of life. Growing interest in the value of companion animals highlights that owning a dog can also affect quality of life, yet little research has explored the role of the attachment bond in affecting the relationship between dog ownership and quality of life. Given that the impact of dog ownership on quality of life may be greater for assistance dog owners than pet dog owners, we explored how anxious attachment and avoidance attachment styles to an assistance dog affected owner quality of life (n = 73). Regression analysis revealed that higher anxious attachment to the dog predicted enhanced quality of life. It is suggested that the unique, interdependent relationship between an individual and their assistance dog may mean that an anxious attachment style is not necessarily detrimental. Feelings that indicate attachment insecurity in other relationships may reflect more positive aspects of the assistance dog owner relationship, such as the level of support that the dog provides its owner. Full article
Open AccessArticle
Assessing Statistically Significant Heavy-Metal Concentrations in Abandoned Mine Areas via Hot Spot Analysis of Portable XRF Data
Int. J. Environ. Res. Public Health 2017, 14(6), 654; doi:10.3390/ijerph14060654 -
Abstract
To develop appropriate measures to prevent soil contamination in abandoned mining areas, an understanding of the spatial variation of the potentially toxic trace elements (PTEs) in the soil is necessary. For the purpose of effective soil sampling, this study uses hot spot analysis,
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To develop appropriate measures to prevent soil contamination in abandoned mining areas, an understanding of the spatial variation of the potentially toxic trace elements (PTEs) in the soil is necessary. For the purpose of effective soil sampling, this study uses hot spot analysis, which calculates a z-score based on the Getis-Ord Gi* statistic to identify a statistically significant hot spot sample. To constitute a statistically significant hot spot, a feature with a high value should also be surrounded by other features with high values. Using relatively cost- and time-effective portable X-ray fluorescence (PXRF) analysis, sufficient input data are acquired from the Busan abandoned mine and used for hot spot analysis. To calibrate the PXRF data, which have a relatively low accuracy, the PXRF analysis data are transformed using the inductively coupled plasma atomic emission spectrometry (ICP-AES) data. The transformed PXRF data of the Busan abandoned mine are classified into four groups according to their normalized content and z-scores: high content with a high z-score (HH), high content with a low z-score (HL), low content with a high z-score (LH), and low content with a low z-score (LL). The HL and LH cases may be due to measurement errors. Additional or complementary surveys are required for the areas surrounding these suspect samples or for significant hot spot areas. The soil sampling is conducted according to a four-phase procedure in which the hot spot analysis and proposed group classification method are employed to support the development of a sampling plan for the following phase. Overall, 30, 50, 80, and 100 samples are investigated and analyzed in phases 1–4, respectively. The method implemented in this case study may be utilized in the field for the assessment of statistically significant soil contamination and the identification of areas for which an additional survey is required. Full article
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Open AccessArticle
Association between Six CETP Polymorphisms and Metabolic Syndrome in Uyghur Adults from Xinjiang, China
Int. J. Environ. Res. Public Health 2017, 14(6), 653; doi:10.3390/ijerph14060653 -
Abstract
Objective: To explore the association between CETP gene polymorphisms and metabolic syndrome (MS), as well as the relationship between the CETP gene polymorphisms and each component of MS. Methods: A total of 571 individuals which were randomly selected from 5692 Uyghur adults were
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Objective: To explore the association between CETP gene polymorphisms and metabolic syndrome (MS), as well as the relationship between the CETP gene polymorphisms and each component of MS. Methods: A total of 571 individuals which were randomly selected from 5692 Uyghur adults were subdivided into two groups, including 280 patients with MS and 291 control subjects, using the group-matching method after matching for gender. We detected CETP polymorphisms (rs5882, rs1800775, rs3764261, rs12149545, rs711752, and rs708272) by using the Snapshot method. Results: (1) Significant differences were found involving the frequency distribution of genotypes and alleles of rs1800775, rs3764261, rs12149545, rs711752, and rs708272 between the control and MS groups (all p < 0.05). (2) rs1800775, rs3764261, rs12149545, rs711752, and rs708272 polymorphisms were significantly related to the risk of MS (all p < 0.05). (3) The rs1800775 polymorphism was associated with high fasting blood glucose levels and low high density lipoprotein cholesterol (HDL-C); rs3764261 and rs12149545 polymorphisms were associated with all components of MS except high blood pressure; rs711752 and rs708272 polymorphisms were associated with low HDL-C (all p < 0.05). (4) Complete linkage disequilibrium (LD) was identified for two pairs of single nucleotide polymorphisms (SNPs) (rs3764261 and rs12149545 (D’ = 1.000, r2 = 0.931), rs711752 and rs708272 (D’ = 1.000, r2 = 0.996)). (5) The A-G-G-G-C (p = 0.013, odds ratio [OR] = 0.622, 95% confidence interval [95% CI] = 0.427–0.906) and A-T-A-A-T (p < 0.001, OR = 0.519, 95% CI = 0.386–0.697) haplotypes were more frequent in the control group than in the case group. Conclusions: The rs1800775, rs3764261, rs12149545, rs711752, and rs708272 polymorphisms of CETP were associated with MS and its components among the Uyghur ethnic group. Complete LD was found between two pairs of SNPs (rs3764261 and rs12149545, rs711752, and rs708272). The A-G-G-G-C and A-T-A-A-T haplotypes might be protective factors for MS. Full article