Int. J. Environ. Res. Public Health2014, 11(11), 11065-11080; doi:10.3390/ijerph111111065 (registering DOI) - published 24 October 2014 Show/Hide Abstract
Abstract: The atmospheric concentrations and gas–particle partitioning of polychlorinated dibenzo-p-dioxins and furans (PCDDs/Fs) and polychlorinated biphenyls (PCBs) were investigated at two sites (Suwon and Ansan) in Gyeonggi-do, a heavily industrialized area of Korea, during the year 2010. The sum level (Σ17) of PCDDs/Fs and dioxin-like PCBs (dl-PCBs) in the ambient air at Suwon and Ansan ranged from 0.04 to 0.30 pg-TEQ·m−3 (geometric mean: 0.09 pg-TEQ·m−3) and 0.17 to 0.63 pg-TEQ·m−3 (geometric mean: 0.36 pg-TEQ·m−3), respectively. Moreover, the geometric mean concentrations of Σ180 PCBs at Suwon and Ansan were 233.6 pg·m−3 and 274.2 pg·m−3, respectively, and di-chlorinated biphenyls and tri-chlorinated biphenyls were the predominant homologs. Among the PCB congeners, 3,3'-dichlorobiphenyl (PCB-11) was the dominant species at both sites during all sampling periods, comprising up to 15.1% of Σ180 PCBs at Ansan and 24.6% at Suwon. We evaluated their gas-to-particle equilibriums by conducting regression between the particle–gas partition coefficient Kp (m3·ug−1) and the corresponding subcooled liquid vapor pressure (PL°). The slope (m) values for log–log plots of Kp vs. PL° were steeper in industrial areas owing to local source proximity. Moreover, owing to enhanced emissions from combustion-related sources at low temperatures, PCDD/Fs exhibited the largest deviation from the regression line of the particle–gas partition coefficient. Incinerators were found to be the primary emission source of atmospheric PCDDs/Fs, whereas re-evaporation from pre-existing environmental loads (e.g., storage areas or spilled soil and water bodies) was the dominant source for PCBs.
Int. J. Environ. Res. Public Health2014, 11(11), 11054-11064; doi:10.3390/ijerph111111054 (registering DOI) - published 24 October 2014 Show/Hide Abstract
Abstract: Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric.
Int. J. Environ. Res. Public Health2014, 11(11), 11028-11053; doi:10.3390/ijerph111111028 (registering DOI) - published 24 October 2014 Show/Hide Abstract
Abstract: This study identifies several characteristics of individuals who report their physical and/or mental health as being adversely affected by summertime heat and humidity, within the most disadvantaged neighbourhoods of the nine largest cities of Québec (Canada). The study is cross-sectional by stratified representative sample; 3485 people were interviewed in their residence. The prevalence of reported impacts was 46%, mostly physical health. Female gender and long-term medical leave are two impact risk indicators in people <65 years of age. Low income and air conditioning at home are risk indicators at all ages. Results for having ≥2 diagnoses of chronic diseases, particularly for people self-describing as in poor health (odds ratio, OR<65 = 5.6; OR≥65 = 4.2), and perceiving daily stress, are independent of age. The prevalence of reported heat-related health impacts is thus very high in those inner cities, with notable differences according to age, stress levels and long-term medical leave, previously unmentioned in the literature. Finally, the total number of pre-existing medical conditions seems to be a preponderant risk factor. This study complements the epidemiologic studies based on mortality or severe morbidity and shows that the heat-related burden of disease appears very important in those communities, affecting several subgroups differentially.
Int. J. Environ. Res. Public Health2014, 11(10), 11015-11027; doi:10.3390/ijerph111011015 - published 22 October 2014 Show/Hide Abstract
Abstract: Dental care is consistently reported as one of the primary medical needs of children with disabilities (IDC). The aim of the present study was to explore the influence of oral health behaviors on the caries experience in children with intellectual disabilities in Guangzhou, China. A cross-sectional study was carried out in 477 intellectually disabled children, 12 to 17 years old, who were randomly selected from special educational schools in Guangzhou. A self-administered parental questionnaire was used to collect data on socio-demographic characteristics and oral health behavior variables, and 450 valid questionnaires were returned. Multiple regression analysis was used to examine the factors associated with dental caries. The average age of those in the sample was 14.6 years (SD = 1.3), 68.4% of whom were male, and the caries prevalence rate was 53.5% (DMFT = 1.5 ± 2.0). The factors significantly affecting the development of dental caries in IDC included gender, the presence or absence of cerebral palsy, and the frequency of dental visits and toothbrushing. In conclusion, the presence of cerebral palsy contributed to an increase risk of caries experience in intellectually disabled children, while toothbrushing more than twice a day and routine dental visits were caries-protective factors. Oral health promotion action may lead to a reduction in dental caries levels in IDC.
Int. J. Environ. Res. Public Health2014, 11(10), 11004-11014; doi:10.3390/ijerph111011004 - published 21 October 2014 Show/Hide Abstract
Abstract: Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59%) had implemented screening programmes and 15 (56%) had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014). Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96%) considered screening among migrants useful, and 24 (92%) would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries.
Int. J. Environ. Res. Public Health2014, 11(10), 10991-11003; doi:10.3390/ijerph111010991 - published 21 October 2014 Show/Hide Abstract
Abstract: Radiation safety is an integral part of targeted radionuclide therapy. The aim of this work was to study the external dose rate and retained body activity as functions of time in differentiated thyroid carcinoma patients receiving 131I therapy. Seventy patients were stratified into two groups: the ablation group (A) and the follow-up group (FU). The patients’ external dose rate was measured, and simultaneously, their retained body radiation activity was monitored at various time points. The equations of the external dose rate and the retained body activity, described as a function of hours post administration, were fitted. Additionally, the release time for patients was calculated. The reduction in activity in the group receiving a second or subsequent treatment was more rapid than the group receiving only the initial treatment. Most important, an expeditious method was established to indirectly evaluate the retained body activity of patients by measuring the external dose rate with a portable radiation survey meter. By this method, the calculated external dose rate limits are 19.2, 8.85, 5.08 and 2.32 μSv·h−1 at 1, 1.5, 2 and 3 m, respectively, according to a patient’s released threshold level of retained body activity <400 MBq. This study is beneficial for radiation safety decision-making.