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Int. J. Environ. Res. Public Health, Volume 10, Issue 10 (October 2013) , Pages 4507-5256

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Open AccessArticle
Effect of the Environmental Pollutant Hexachlorobenzene (HCB) on the Neuronal Differentiation of Mouse Embryonic Stem Cells
Int. J. Environ. Res. Public Health 2013, 10(10), 5244-5256; https://doi.org/10.3390/ijerph10105244 - 21 Oct 2013
Cited by 9 | Viewed by 3307
Abstract
Exposure to persistent environmental pollutants may constitute an important factor on the onset of a number of neurological disorders such as autism, Parkinson’s disease, and Attention Deficit Disorder (ADD), which have also been linked to reduced GABAergic neuronal function. GABAergic neurons produce γ-aminobutyric [...] Read more.
Exposure to persistent environmental pollutants may constitute an important factor on the onset of a number of neurological disorders such as autism, Parkinson’s disease, and Attention Deficit Disorder (ADD), which have also been linked to reduced GABAergic neuronal function. GABAergic neurons produce γ-aminobutyric acid (GABA), which is the main inhibitory neurotransmitter in the brain. However, the lack of appropriate models has hindered the study of suspected environmental pollutants on GABAergic function. In this work, we have examined the effect of hexachlorobenzene (HCB), a persistent and bioaccumulative environmental pollutant, on the function and morphology of GABAergic neurons generated in vitro from mouse embryonic stem (ES) cells. We observed that: (1) treatment with 0.5 nM HCB did not affect cell viability, but affected the neuronal differentiation of ES cells; (2) HCB induced the production of reactive oxygen species (ROS); and (3) HCB repressed neurite outgrowth in GABAergic neurons, but this effect was reversed by the ROS scavenger N-acetylcysteine (NAC). Our study also revealed that HCB did not significantly interfere with the function of K+ ion channels in the neuronal soma, which indicates that this pollutant does not affect the maturation of the GABAergic neuronal soma. Our results suggest a mechanism by which environmental pollutants interfere with normal GABAergic neuronal function and may promote the onset of a number of neurological disorders such as autism and ADD. Full article
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Open AccessCommunication
Computing Power and Sample Size for Informational Odds Ratio
Int. J. Environ. Res. Public Health 2013, 10(10), 5239-5243; https://doi.org/10.3390/ijerph10105239 - 21 Oct 2013
Cited by 1 | Viewed by 2482
Abstract
The informational odds ratio (IOR) measures the post-exposure odds divided by the pre-exposure odds (i.e., information gained after knowing exposure status). A desirable property of an adjusted ratio estimate is collapsibility, wherein the combined crude ratio will not change after adjusting [...] Read more.
The informational odds ratio (IOR) measures the post-exposure odds divided by the pre-exposure odds (i.e., information gained after knowing exposure status). A desirable property of an adjusted ratio estimate is collapsibility, wherein the combined crude ratio will not change after adjusting for a variable that is not a confounder. Adjusted traditional odds ratios (TORs) are not collapsible. In contrast, Mantel-Haenszel adjusted IORs, analogous to relative risks (RRs) generally are collapsible. IORs are a useful measure of disease association in case-referent studies, especially when the disease is common in the exposed and/or unexposed groups. This paper outlines how to compute power and sample size in the simple case of unadjusted IORs. Full article
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Open AccessArticle
Green Synthesis of Silver Nanoparticles, Their Characterization, Application and Antibacterial Activity
Int. J. Environ. Res. Public Health 2013, 10(10), 5221-5238; https://doi.org/10.3390/ijerph10105221 - 21 Oct 2013
Cited by 85 | Viewed by 5715
Abstract
Our research focused on the production, characterization and application of silver nanoparticles (AgNPs), which can be utilized in biomedical research and environmental cleaning applications. We used an environmentally friendly extracellular biosynthetic technique for the production of the AgNPs. The reducing agents used to [...] Read more.
Our research focused on the production, characterization and application of silver nanoparticles (AgNPs), which can be utilized in biomedical research and environmental cleaning applications. We used an environmentally friendly extracellular biosynthetic technique for the production of the AgNPs. The reducing agents used to produce the nanoparticles were from aqueous extracts made from the leaves of various plants. Synthesis of colloidal AgNPs was monitored by UV-Visible spectroscopy. The UV-Visible spectrum showed a peak between 417 and 425 nm corresponding to the Plasmon absorbance of the AgNPs. The characterization of the AgNPs such as their size and shape was performed by Atom Force Microscopy (AFM), and Transmission Electron Microscopy (TEM) techniques which indicated a size range of 3 to 15 nm. The anti-bacterial activity of AgNPs was investigated at concentrations between 2 and 15 ppm for Gram-negative and Gram-positive bacteria. Staphylococcus aureus and Kocuria rhizophila, Bacillus thuringiensis (Gram-positive organisms); Escherichia coli, Pseudomonas aeruginosa, and Salmonella typhimurium (Gram-negative organisms) were exposed to AgNPs using Bioscreen C. The results indicated that AgNPs at a concentration of 2 and 4 ppm, inhibited bacterial growth. Preliminary evaluation of cytotoxicity of biosynthesized silver nanoparticles was accomplished using the InQ™ Cell Research System instrument with HEK 293 cells. This investigation demonstrated that silver nanoparticles with a concentration of 2 ppm and 4 ppm were not toxic for human healthy cells, but inhibit bacterial growth. Full article
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Open AccessArticle
The Kinetic Signature of Toxicity of Four Heavy Metals and Their Mixtures on MCF7 Breast Cancer Cell Line
Int. J. Environ. Res. Public Health 2013, 10(10), 5209-5220; https://doi.org/10.3390/ijerph10105209 - 21 Oct 2013
Cited by 5 | Viewed by 3110
Abstract
This study evaluated the kinetic signature of toxicity of four heavy metals known to cause severe health and environmental issues—cadmium (Cd), mercury (Hg) lead (Pb) arsenic (As)—and the mixture of all four metals (Mix) on MCF7 cancer cells, in the presence and absence [...] Read more.
This study evaluated the kinetic signature of toxicity of four heavy metals known to cause severe health and environmental issues—cadmium (Cd), mercury (Hg) lead (Pb) arsenic (As)—and the mixture of all four metals (Mix) on MCF7 cancer cells, in the presence and absence of the antioxidant glutathione (GSH). The study was carried out using real time cell electronic sensing (RT-CES). RT-CES monitors in real time the electrical impedance changes at the electrode/culture medium interface due to the number of adhered cells, which is used as an index of cell viability. Cells were seeded for 24 h before exposure to the metals and their mixtures. The results showed that in the presence and absence of cellular glutathione, arsenic was the most cytotoxic of all five treatments, inducing cell death after 5 h of exposure. Lead was the least cytotoxic in both scenarios. In the presence of cellular GSH, the cytotoxic trend was As > Cd > MIX > Hg > Pb, while in the absence of GSH, the cytotoxic trend was As > Hg > MIX > Cd > Pb. The findings from this study indicate the significance of glutathione-mediated toxicity of the metals examined—particularly for mercury—and may be clinically relevant for disorders such as autism spectrum disorder where decreased glutathione-based detoxification capacity is associated with increased mercury intoxication. Full article
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Open AccessArticle
Patients’ Acceptance towards a Web-Based Personal Health Record System: An Empirical Study in Taiwan
Int. J. Environ. Res. Public Health 2013, 10(10), 5191-5208; https://doi.org/10.3390/ijerph10105191 - 17 Oct 2013
Cited by 29 | Viewed by 3454
Abstract
The health care sector has become increasingly interested in developing personal health record (PHR) systems as an Internet-based telehealthcare implementation to improve the quality and decrease the cost of care. However, the factors that influence patients’ intention to use PHR systems remain unclear. [...] Read more.
The health care sector has become increasingly interested in developing personal health record (PHR) systems as an Internet-based telehealthcare implementation to improve the quality and decrease the cost of care. However, the factors that influence patients’ intention to use PHR systems remain unclear. Based on physicians’ therapeutic expertise, we implemented a web-based infertile PHR system and proposed an extended Technology Acceptance Model (TAM) that integrates the physician-patient relationship (PPR) construct into TAM’s original perceived ease of use (PEOU) and perceived usefulness (PU) constructs to explore which factors will influence the behavioral intentions (BI) of infertile patients to use the PHR. From ninety participants from a medical center, 50 valid responses to a self-rating questionnaire were collected, yielding a response rate of 55.56%. The partial least squares (PLS) technique was used to assess the causal relationships that were hypothesized in the extended model. The results indicate that infertile patients expressed a moderately high intention to use the PHR system. The PPR and PU of patients had significant effects on their BI to use PHR, whereas the PEOU indirectly affected the patients’ BI through the PU. This investigation confirms that PPR can have a critical role in shaping patients’ perceptions of the use of healthcare information technologies. Hence, we suggest that hospitals should promote the potential usefulness of PHR and improve the quality of the physician-patient relationship to increase patients’ intention of using PHR. Full article
(This article belongs to the Special Issue Advances in Telehealthcare)
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Open AccessArticle
Violence against Women and Gastroschisis: A Case-Control Study
Int. J. Environ. Res. Public Health 2013, 10(10), 5178-5190; https://doi.org/10.3390/ijerph10105178 - 17 Oct 2013
Cited by 4 | Viewed by 3233
Abstract
Background: Gastroschisis, a birth defect characterized by herniated fetal abdominal wall, occurs more commonly in infants born to teenage and young mothers. Ischemia of the vascular vitelline vessels is the likely mechanism of pathogenesis. Given that chronic stress and violence against women [...] Read more.
Background: Gastroschisis, a birth defect characterized by herniated fetal abdominal wall, occurs more commonly in infants born to teenage and young mothers. Ischemia of the vascular vitelline vessels is the likely mechanism of pathogenesis. Given that chronic stress and violence against women are risk factors for cardiovascular disease we explored whether these may represent risk factors for gastroschisis, when they occur during pregnancy. A case-control study was conducted, with 15 incident cases of children born with gastroschisis in the Region of Murcia, Spain, from December 2007 to June 2013. Forty concurrent controls were recruited at gestation weeks 20–24 or post-partum. All mothers of cases and controls completed a comprehensive, in-person, ‘green sheet’ questionnaire on environmental exposures. Results: Mothers of children with gastroschisis were younger, smoked more cigarettes per week relative to controls, were exposed to higher amounts of illegal drugs, and suffered from domestic violence more frequently than the controls. Multivariable logistic regression analysis highlights periconceptional ‘gender-related violence’ (OR: 16.6, 95% CI 2.7 to 101.7) and younger maternal age (OR 1.1, 95% CI 1.0–1.3). Conclusions: Violence against pregnant women is associated with birth defects, and should be studied in more depth as a cause-effect teratogenic. Psychosocial risk factors, including gender-based violence, are important for insuring the health and safety of the pregnant mother and the fetus. Full article
Open AccessArticle
Study on Association between Spatial Distribution of Metal Mines and Disease Mortality: A Case Study in Suxian District, South China
Int. J. Environ. Res. Public Health 2013, 10(10), 5163-5177; https://doi.org/10.3390/ijerph10105163 - 16 Oct 2013
Cited by 8 | Viewed by 3168
Abstract
Metal mines release toxic substances into the environment and can therefore negatively impact the health of residents in nearby regions. This paper sought to investigate whether there was excess disease mortality in populations in the vicinity of the mining area in Suxian District, [...] Read more.
Metal mines release toxic substances into the environment and can therefore negatively impact the health of residents in nearby regions. This paper sought to investigate whether there was excess disease mortality in populations in the vicinity of the mining area in Suxian District, South China. The spatial distribution of metal mining and related activities from 1985 to 2012, which was derived from remote sensing imagery, was overlapped with disease mortality data. Three hotspot areas with high disease mortality were identified around the Shizhuyuan mine sites, i.e., the Dengjiatang metal smelting sites, and the Xianxichong mine sites. Disease mortality decreased with the distance to the mining and smelting areas. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. The risk of dying according to disease mortality rates was analyzed within 7–25 km buffers. The results suggested that there was a close relationship between the risk of disease mortality and proximity to the Suxian District mining industries. These associations were dependent on the type and scale of mining activities, the area influenced by mining and so on. Full article
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Open AccessArticle
Comparison of the Cytotoxic Potential of Cigarette Smoke and Electronic Cigarette Vapour Extract on Cultured Myocardial Cells
Int. J. Environ. Res. Public Health 2013, 10(10), 5146-5162; https://doi.org/10.3390/ijerph10105146 - 16 Oct 2013
Cited by 109 | Viewed by 27146
Abstract
Background: Electronic cigarettes (ECs) have been marketed as an alternative-to-smoking habit. Besides chemical studies of the content of EC liquids or vapour, little research has been conducted on their in vitro effects. Smoking is an important risk factor for cardiovascular disease and cigarette [...] Read more.
Background: Electronic cigarettes (ECs) have been marketed as an alternative-to-smoking habit. Besides chemical studies of the content of EC liquids or vapour, little research has been conducted on their in vitro effects. Smoking is an important risk factor for cardiovascular disease and cigarette smoke (CS) has well-established cytotoxic effects on myocardial cells. The purpose of this study was to evaluate the cytotoxic potential of the vapour of 20 EC liquid samples and a “base” liquid sample (50% glycerol and 50% propylene glycol, with no nicotine or flavourings) on cultured myocardial cells. Included were 4 samples produced by using cured tobacco leaves in order to extract the tobacco flavour. Methods: Cytotoxicity was tested according to the ISO 10993-5 standard. By activating an EC device at 3.7 volts (6.2 watts—all samples, including the “base” liquid) and at 4.5 volts (9.2 watts—four randomly selected samples), 200 mg of liquid evaporated and was extracted in 20 mL of culture medium. Cigarette smoke (CS) extract from three tobacco cigarettes was produced according to ISO 3308 method (2 s puffs of 35 mL volume, one puff every 60 s). The extracts, undiluted (100%) and in four dilutions (50%, 25%, 12.5%, and 6.25%), were applied to myocardial cells (H9c2); percent-viability was measured after 24 h incubation. According to ISO 10993-5, viability of <70% was considered cytotoxic. Results: CS extract was cytotoxic at extract concentrations >6.25% (viability: 76.9 ± 2.0% at 6.25%, 38.2 ± 0.5% at 12.5%, 3.1 ± 0.2% at 25%, 5.2 ± 0.8% at 50%, and 3.9 ± 0.2% at 100% extract concentration). Three EC extracts (produced by tobacco leaves) were cytotoxic at 100% and 50% extract concentrations (viability range: 2.2%–39.1% and 7.4%–66.9% respectively) and one (“Cinnamon-Cookies” flavour) was cytotoxic at 100% concentration only (viability: 64.8 ± 2.5%). Inhibitory concentration 50 was >3 times lower in CS extract compared to the worst-performing EC vapour extract. For EC extracts produced by high-voltage and energy, viability was reduced but no sample was cytotoxic according to ISO 10993-5 definition. Vapour produced by the “base” liquid was not cytotoxic at any extract concentration. Cell survival was not associated with nicotine concentration of EC liquids. Conclusions: This study indicates that some EC samples have cytotoxic properties on cultured cardiomyoblasts, associated with the production process and materials used in flavourings. However, all EC vapour extracts were significantly less cytotoxic compared to CS extract. Full article
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Open AccessArticle
The Measurement of Dry Deposition and Surface Runoff to Quantify Urban Road Pollution in Taipei, Taiwan
Int. J. Environ. Res. Public Health 2013, 10(10), 5130-5145; https://doi.org/10.3390/ijerph10105130 - 16 Oct 2013
Cited by 9 | Viewed by 3054
Abstract
Pollutants deposited on road surfaces and distributed in the environment are a source of nonpoint pollution. Field data are traditionally hard to collect from roads because of constant traffic. In this study, in cooperation with the traffic administration, the dry deposition on and [...] Read more.
Pollutants deposited on road surfaces and distributed in the environment are a source of nonpoint pollution. Field data are traditionally hard to collect from roads because of constant traffic. In this study, in cooperation with the traffic administration, the dry deposition on and road runoff from urban roads was measured in Taipei City and New Taipei City, Taiwan. The results showed that the dry deposition is 2.01–5.14 g/m2·day and 78–87% of these solids are in the 75–300 µm size range. The heavy metals in the dry deposited particles are mainly Fe, Zn, and Na, with average concentrations of 34,978, 1,519 and 1,502 ppm, respectively. Elevated express roads show the highest heavy metal concentrations. Not only the number of vehicles, but also the speed of the traffic should be considered as factors that influence road pollution, as high speeds may accelerate vehicle wear and deposit more heavy metals on road surfaces. In addition to dry deposition, the runoff and water quality was analyzed every five minutes during the first two hours of storm events to capture the properties of the first flush road runoff. The sample mean concentration (SMC) from three roads demonstrated that the first flush runoff had a high pollution content, notably for suspended solid (SS), chemical oxygen demand (COD), oil and grease, Pb, and Zn. Regular sweeping and onsite water treatment facilities are suggested to minimize the pollution from urban roads. Full article
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Open AccessReview
Molecular Epidemiology and Evolution of West Nile Virus in North America
Int. J. Environ. Res. Public Health 2013, 10(10), 5111-5129; https://doi.org/10.3390/ijerph10105111 - 16 Oct 2013
Cited by 31 | Viewed by 3781
Abstract
West Nile virus (WNV) was introduced to New York in 1999 and rapidly spread throughout North America and into parts of Central and South America. Displacement of the original New York (NY99) genotype by the North America/West Nile 2002 (NA/WN02) genotype occurred in [...] Read more.
West Nile virus (WNV) was introduced to New York in 1999 and rapidly spread throughout North America and into parts of Central and South America. Displacement of the original New York (NY99) genotype by the North America/West Nile 2002 (NA/WN02) genotype occurred in 2002 with subsequent identification of a novel genotype in 2003 in isolates collected from the southwestern Unites States region (SW/WN03 genotype). Both genotypes co-circulate to date. Subsequent WNV surveillance studies have confirmed additional genotypes in the United States that have become extinct due to lack of a selective advantage or stochastic effect; however, the dynamic emergence, displacement, and extinction of multiple WNV genotypes in the US from 1999–2012 indicates the continued evolution of WNV in North America. Full article
(This article belongs to the Special Issue Epidemiology of West Nile Virus)
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Open AccessArticle
Characterization of a Bioflocculant Produced by a Consortium of Halomonas sp. Okoh and Micrococcus sp. Leo
Int. J. Environ. Res. Public Health 2013, 10(10), 5097-5110; https://doi.org/10.3390/ijerph10105097 - 16 Oct 2013
Cited by 31 | Viewed by 2672
Abstract
The physicochemical and flocculating properties of a bioflocculant produced by a bacterial consortium composed of Halomonas sp. Okoh and Micrococcus sp. Leo were investigated. The purified bioflocculant was cation and pH dependent, and optimally flocculated kaolin clay suspension at a dosage of 0.1 [...] Read more.
The physicochemical and flocculating properties of a bioflocculant produced by a bacterial consortium composed of Halomonas sp. Okoh and Micrococcus sp. Leo were investigated. The purified bioflocculant was cation and pH dependent, and optimally flocculated kaolin clay suspension at a dosage of 0.1 mg/mL. The flocculating activity of the bioflocculant was stimulated in the presence of Ca2+, Mn2+, Al3+ and had a wide pH range of 2–10, with the highest flocculating activity of 86% at pH 8. The bioflocculant was thermostable and retained more than 70% of its flocculating activity after being heated at 80 °C for 30 min. Thermogravimetric analyses revealed a partial thermal decomposition of the biofloculant at 400 °C. The infrared spectrum showed the presence of hydroxyl, carboxyl and amino moieties as functional groups. The bioflocculant produced by the bacterial consortium appears to hold promising alternative to inorganic and synthetic organic flocculants that are widely used in wastewater treatment. Full article
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Open AccessArticle
Longitudinal Influences of Neighbourhood Built and Social Environment on Children’s Weight Status
Int. J. Environ. Res. Public Health 2013, 10(10), 5083-5096; https://doi.org/10.3390/ijerph10105083 - 15 Oct 2013
Cited by 25 | Viewed by 3600
Abstract
The objective was to examine longitudinal 4-year-relationships between neighbourhood social environment and children’s body mass index-standard deviation score (BMI-SDS) taking into account the built environment. Furthermore, we have analysed the influence of potential interactions between the social environment and family/social data on children’s [...] Read more.
The objective was to examine longitudinal 4-year-relationships between neighbourhood social environment and children’s body mass index-standard deviation score (BMI-SDS) taking into account the built environment. Furthermore, we have analysed the influence of potential interactions between the social environment and family/social data on children’s BMI-SDS. Between 2006–2008 and 2010–2012, anthropometric measurements were conducted among 485 children (age at baseline: 6.1 (5.8–6.4)). Socio-demographic characteristics and perception of residential environment were reported by parents. Geographic Information Systems were used to examine street length, number of food outlets and distance to the nearest playground and park/green space within an 800 m Euclidian buffer of each participant address point. Additional data on neighbourhood characteristics (e.g., traffic density, walkability, crime rates) were obtained from the State Capital of Kiel, Germany. In a multivariate model, walkability, street type, socioeconomic status of the district and perceived frequency of passing trucks/busses were associated with BMI-SDS over 4 years, but only neighbourhood SES had an effect on change in BMI-SDS. However, familial/social factors rather than neighbourhood environment (especially social environment) had an impact on children’s BMI-SDS over 4 years. Thus, social inequalities in childhood overweight are only partially explained by social neighbourhood environment. Full article
(This article belongs to the Special Issue Inequalities in Health)
Open AccessArticle
Psychological Distress, Related Work Attendance, and Productivity Loss in Small-to-Medium Enterprise Owner/Managers
Int. J. Environ. Res. Public Health 2013, 10(10), 5062-5082; https://doi.org/10.3390/ijerph10105062 - 15 Oct 2013
Cited by 41 | Viewed by 3906
Abstract
Owner/managers of small-to-medium enterprises (SMEs) are an under-researched population in terms of psychological distress and the associated health and economic consequences. Using baseline data from the evaluation of the Business in Mind program, a mental health promotion intervention amongst SME owner/managers, this study [...] Read more.
Owner/managers of small-to-medium enterprises (SMEs) are an under-researched population in terms of psychological distress and the associated health and economic consequences. Using baseline data from the evaluation of the Business in Mind program, a mental health promotion intervention amongst SME owner/managers, this study investigated: (i) prevalence of high/very high psychological distress, past-month sickness absenteeism and presenteeism days in SME owner/managers; (ii) associated, self-reported lost productivity; and (iii) associations between work, non-work and business-specific factors and work attendance behaviours. In our sample of 217 SME owner/managers 36.8% reported high/very high psychological distress. Of this group 38.7% reported past-month absenteeism, 82.5% reported past-month presenteeism, and those reporting presenteeism were 50% less productive as than usual. Negative binomial regression was used to demonstrate the independent effects of socio-demographic, work-related wellbeing and health-related factors, as well as various individual and business characteristics on continuous measures of absenteeism and presenteeism days. Health-related factors (self-rated health and treatment) were the strongest correlates of higher presenteeism days (p < 0.05). Work-related wellbeing factors (job tension and job satisfaction) were the strongest correlates of higher absenteeism days (p < 0.05). Higher educational attainment, treatment and neuroticism were also correlated with more absenteeism days. SME-specific information about the occurrence of psychological distress, work attendance behaviour, and the variables that influence these decisions, are needed for the development of guidelines for managing psychological distress within this sector. Full article
(This article belongs to the Special Issue Job Stress and Health)
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Open AccessReview
The Natural History of IgE-Mediated Food Allergy: Can Skin Prick Tests and Serum-Specific IgE Predict the Resolution of Food Allergy?
Int. J. Environ. Res. Public Health 2013, 10(10), 5039-5061; https://doi.org/10.3390/ijerph10105039 - 15 Oct 2013
Cited by 19 | Viewed by 4344
Abstract
IgE-mediated food allergy is a transient condition for some children, however there are few indices to predict when and in whom food allergy will resolve. Skin prick test (SPT) and serum-specific IgE levels (sIgE) are usually monitored in the management of food allergy [...] Read more.
IgE-mediated food allergy is a transient condition for some children, however there are few indices to predict when and in whom food allergy will resolve. Skin prick test (SPT) and serum-specific IgE levels (sIgE) are usually monitored in the management of food allergy and are used to predict the development of tolerance or persistence of food allergy. The aim of this article is to review the published literature that investigated the predictive value of SPT and sIgE in development of tolerance in children with a previous diagnosis of peanut, egg and milk allergy. A systematic search identified twenty-six studies, of which most reported SPT or sIgE thresholds which predicted persistent or resolved allergy. However, results were inconsistent between studies. Previous research was hampered by several limitations including the absence of gold standard test to diagnose food allergy or tolerance, biased samples in retrospective audits and lack of systematic protocols for triggering re-challenges. There is a need for population-based, prospective studies that use the gold standard oral food challenge (OFC) to diagnose food allergy at baseline and follow-up to develop SPT and sIgE thresholds that predict the course of food allergy. Full article
(This article belongs to the Special Issue Food Allergy, Genes and Environment)
Open AccessArticle
Depressive Symptoms and Its Associated Factors in 13-Year-Old Urban Adolescents
Int. J. Environ. Res. Public Health 2013, 10(10), 5026-5038; https://doi.org/10.3390/ijerph10105026 - 14 Oct 2013
Cited by 10 | Viewed by 3053
Abstract
The available estimates reveal that 20–50% of adolescents report depressive symptoms, being one of the most prevalent health problems in adolescence. The aim of this study was to assess the prevalence of depressive symptoms in a community sample of 13-year-old adolescents and identify [...] Read more.
The available estimates reveal that 20–50% of adolescents report depressive symptoms, being one of the most prevalent health problems in adolescence. The aim of this study was to assess the prevalence of depressive symptoms in a community sample of 13-year-old adolescents and identify associated features. Thirteen year-old adolescents attending private and public schools in Porto (n = 1,988, 52.2% females) were evaluated from October 2003 to June 2004 and completed a questionnaire including health behaviors and the Beck Depression Inventory II. A questionnaire on parents’ socio-demographics and clinical characteristics was sent home. Data were analyzed separately by sex. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. The prevalence of depressive symptoms was 18.8% in girls and 7.6% in boys (p < 0.001). Boys with a family history of depression and girls with smoking habits had a significantly increased risk of depressive symptoms (OR = 2.18, 95%CI 1.00–4.71; OR = 2.34, 95%CI 1.46–3.76). Menarche at an early age significantly increased the risk of depressive symptoms. The characteristics most strongly associated with depressive symptoms were family history of depression among boys, tobacco consumption and an early age at menarche among girls. The high prevalence of depressive symptoms early in adolescence calls for the awareness of public health professionals. Full article
Open AccessArticle
Spatially Interpolated Disease Prevalence Estimation Using Collateral Indicators of Morbidity and Ecological Risk
Int. J. Environ. Res. Public Health 2013, 10(10), 5011-5025; https://doi.org/10.3390/ijerph10105011 - 14 Oct 2013
Cited by 3 | Viewed by 2692
Abstract
This paper considers estimation of disease prevalence for small areas (neighbourhoods) when the available observations on prevalence are for an alternative partition of a region, such as service areas. Interpolation to neighbourhoods uses a kernel method extended to take account of two types [...] Read more.
This paper considers estimation of disease prevalence for small areas (neighbourhoods) when the available observations on prevalence are for an alternative partition of a region, such as service areas. Interpolation to neighbourhoods uses a kernel method extended to take account of two types of collateral information. The first is morbidity and service use data, such as hospital admissions, observed for neighbourhoods. Variations in morbidity and service use are expected to reflect prevalence. The second type of collateral information is ecological risk factors (e.g., pollution indices) that are expected to explain variability in prevalence in service areas, but are typically observed only for neighbourhoods. An application involves estimating neighbourhood asthma prevalence in a London health region involving 562 neighbourhoods and 189 service (primary care) areas. Full article
(This article belongs to the Special Issue Spatial Epidemiology)
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Open AccessArticle
Improving the Psychosocial Work Environment at Multi-Ethnic Workplaces: A Multi-Component Intervention Strategy in the Cleaning Industry
Int. J. Environ. Res. Public Health 2013, 10(10), 4996-5010; https://doi.org/10.3390/ijerph10104996 - 14 Oct 2013
Cited by 5 | Viewed by 3254
Abstract
Global labour migration has increased in recent years and immigrant workers are often recruited into low status and low paid jobs such as cleaning. Research in a Danish context shows that immigrants working in the cleaning industry often form social networks based on [...] Read more.
Global labour migration has increased in recent years and immigrant workers are often recruited into low status and low paid jobs such as cleaning. Research in a Danish context shows that immigrants working in the cleaning industry often form social networks based on shared languages and backgrounds, and that conflict between different ethnic groups may occur. This paper evaluates the impact of a multi-component intervention on the psychosocial work environment at a multi-ethnic Danish workplace in the cleaning sector. The intervention included Danish lessons, vocational training courses, and activities to improve collaboration across different groups of cleaners. Interviews about the outcome of the intervention were conducted with the cleaners and their supervisor. The Copenhagen Psychosocial Questionnaire was used as a supplement to the interviews. The results suggest that the psychosocial work environment had improved after the intervention. According to the interviews with the cleaners, the intervention had led to improved communication, trust, and collaboration. These findings are supported by the questionnaire where social support from supervisor and colleagues, social community, trust, and teamwork seem to have improved together with meaning of work, rewards, and emotional demands. The design of the intervention may provide inspiration for future psychosocial work environment interventions at multi-ethnic work places. Full article
(This article belongs to the Special Issue Occupational Health)
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Open AccessArticle
Respiratory Disease Related Mortality and Morbidity on an Island of Greece Exposed to Perlite and Bentonite Mining Dust
Int. J. Environ. Res. Public Health 2013, 10(10), 4982-4995; https://doi.org/10.3390/ijerph10104982 - 14 Oct 2013
Cited by 8 | Viewed by 2552
Abstract
A morbidity and mortality study took place, focused on Milos Island, where perlite and bentonite mining sites are located. Official data concerning number and cause of deaths, regarding specific respiratory diseases and the total of respiratory diseases, for both Milos Island and the [...] Read more.
A morbidity and mortality study took place, focused on Milos Island, where perlite and bentonite mining sites are located. Official data concerning number and cause of deaths, regarding specific respiratory diseases and the total of respiratory diseases, for both Milos Island and the Cyclades Prefecture were used. Standardized Mortality Ratios (SMRs) were computed, adjusted specifically for age, gender and calendar year. Tests of linear trend were performed. By means of a predefined questionnaire, the morbidity rates of specific respiratory diseases in Milos, were compared to those of the municipality of Oinofita, an industrial region. Chi-square analysis was used and the confounding factors of age, gender and smoking were taken into account, by estimating binary logistic regression models. The SMRs for Pneumonia and Chronic Obstructive Pulmonary Disease (COPD) were found elevated for both genders, although they did not reach statistical significance. For the total of respiratory diseases, a statistically significant SMR was identified regarding the decade 1989–1998. The morbidity study revealed elevated and statistically significant Odds Ratios (ORs), associated with allergic rhinitis, pneumonia, COPD and bronchiectasis. An elevated OR was also identified for asthma. After controlling for age, gender and smoking, the ORs were statistically significant and towards the same direction. Full article
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Open AccessArticle
Spatial Distribution of Underweight, Overweight and Obesity among Women and Children: Results from the 2011 Uganda Demographic and Health Survey
Int. J. Environ. Res. Public Health 2013, 10(10), 4967-4981; https://doi.org/10.3390/ijerph10104967 - 11 Oct 2013
Cited by 12 | Viewed by 3965
Abstract
While undernutrition and infectious diseases are still persistent in developing countries, overweight, obesity, and associated comorbidities have become more prevalent. Uganda, a developing sub-Saharan African country, is currently experiencing the public health paradox of undernutrition and overnutrition. We utilized the 2011 Uganda Demographic [...] Read more.
While undernutrition and infectious diseases are still persistent in developing countries, overweight, obesity, and associated comorbidities have become more prevalent. Uganda, a developing sub-Saharan African country, is currently experiencing the public health paradox of undernutrition and overnutrition. We utilized the 2011 Uganda Demographic and Health Survey (DHS) to examine risk factors and hot spots for underweight, overweight, and obesity among adult females (N = 2,420) and their children (N = 1,099) using ordinary least squares and multinomial logit regression and the ArcGIS Getis-Ord Gi* statistic. Overweight and obese women were significantly more likely to have overweight children, and overweight was correlated with being in the highest wealth class (OR = 2.94, 95% CI = 1.99–4.35), and residing in an urban (OR = 1.76, 95% CI = 1.34–2.29) but not a conflict prone (OR = 0.48, 95% CI = 0.29–0.78) area. Underweight clustered significantly in the Northern and Northeastern regions, while overweight females and children clustered in the Southeast. We demonstrate that the DHS can be used to assess geographic clustering and burden of disease, thereby allowing for targeted programs and policies. Further, we pinpoint specific regions and population groups in Uganda for targeted preventive measures and treatment to reduce the burden of overweight and chronic diseases in Uganda. Full article
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Open AccessArticle
“We Made the Rule, We Have to Stick to It”: Towards Effective Management of Environmental Tobacco Smoke in Remote Australian Aboriginal Communities
Int. J. Environ. Res. Public Health 2013, 10(10), 4944-4966; https://doi.org/10.3390/ijerph10104944 - 11 Oct 2013
Cited by 10 | Viewed by 3131
Abstract
Smoking prevalence in remote Australian Aboriginal communities remains extraordinarily high, with rates reported of up to 82%. Widespread exposure to environmental tobacco smoke (ETS) is exacerbated by overcrowded housing. Implementation of existing smoke-free policies is challenged by the normalization of smoking and a [...] Read more.
Smoking prevalence in remote Australian Aboriginal communities remains extraordinarily high, with rates reported of up to 82%. Widespread exposure to environmental tobacco smoke (ETS) is exacerbated by overcrowded housing. Implementation of existing smoke-free policies is challenged by the normalization of smoking and a lack of appropriate regulation resources. This paper celebrates a grassroots approach to control of environmental tobacco smoke (ETS) in these settings. We report on selected findings from a tobacco intervention study in Arnhem Land, Northern Territory in 2007–2012. In community-level tobacco use surveys at baseline (n = 400 ≥ 16 years), participants reported concern about the constant exposure of non-smokers to tobacco smoke. Suggestions for action included restricting smoking in private and public spaces. We selected three case studies illustrating management of ETS from observational data during the study’s intervention phase. Using a critical realist approach, the context and mechanisms that contributed to specific strategies, or outcomes, were examined in order to develop a hypothesis regarding more effective management of ETS in these environments. Our results suggest that in discrete, disadvantaged communities, enhanced local ownership of smoke-free policies and development of implementation strategies at the grassroots level that acknowledge and incorporate cultural contexts can contribute to more effective management of ETS. Full article
(This article belongs to the Special Issue Tobacco Control in Vulnerable Population Groups)
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Open AccessArticle
Heterogeneous Risk Perceptions: The Case of Poultry Meat Purchase Intentions in Finland
Int. J. Environ. Res. Public Health 2013, 10(10), 4925-4943; https://doi.org/10.3390/ijerph10104925 - 11 Oct 2013
Viewed by 2566
Abstract
This study focused on the heterogeneity of consumer reactions, measured through poultry meat purchase intentions, when facing three cases of risk. The heterogeneity was analysed by latent class logistic regression that included all three risk cases. Approximately 60% of the respondents belonged to [...] Read more.
This study focused on the heterogeneity of consumer reactions, measured through poultry meat purchase intentions, when facing three cases of risk. The heterogeneity was analysed by latent class logistic regression that included all three risk cases. Approximately 60% of the respondents belonged to the group of production risk avoiders, in which the intention to purchase risk food was significantly lower than in the second group of risk neutrals. In addition to socio-demographic variables, the purchase intentions were statistically associated with several attitude-based variables. We highlighted some policy implications of the heterogeneity. Overall, the study demonstrated that risk matters to consumers, not all risk is equal, and consumer types react somewhat differently to different types of risk. Full article
(This article belongs to the Special Issue Food Safety and Public Health)
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Open AccessArticle
Stress, Health and Well-Being: The Mediating Role of Employee and Organizational Commitment
Int. J. Environ. Res. Public Health 2013, 10(10), 4907-4924; https://doi.org/10.3390/ijerph10104907 - 11 Oct 2013
Cited by 14 | Viewed by 5122
Abstract
This study investigates the mediating impact of organizational commitment on the relationship between organizational stressors and employee health and well-being. Data were collected from 401 operator level employees working in business process outsourcing organizations (BPOs) based in New Delhi, India. In this research [...] Read more.
This study investigates the mediating impact of organizational commitment on the relationship between organizational stressors and employee health and well-being. Data were collected from 401 operator level employees working in business process outsourcing organizations (BPOs) based in New Delhi, India. In this research several dimensions from ASSET, which is an organizational stress screening tool, were used to measure employee perceptions of stressors, their commitment to the organization, their perception of the organization’s commitment to them, and their health and well-being. Data were analyzed using structural equation modeling on AMOS software. Results of the mediation analysis highlight both employee commitment to their organization and their perceptions of the organization’s commitment to them mediate the impact of stressors on physical health and psychological well-being. All indices of the model fit were found to be above standard norms. Implications are discussed with the view to improving standards of health and well-being within the call center industry, which is a sector that has reported higher turnover rates and poor working conditions among its employees internationally. Full article
(This article belongs to the Special Issue Job Stress and Health)
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Open AccessArticle
Drunken Environments: A Survey of Bartenders Working in Pubs, Bars and Nightclubs
Int. J. Environ. Res. Public Health 2013, 10(10), 4896-4906; https://doi.org/10.3390/ijerph10104896 - 11 Oct 2013
Cited by 14 | Viewed by 3124
Abstract
There is evidence that bartenders play a key role in respect of the health and safety of patrons in nightlife environments. However, little is known of how bartenders themselves are affected by the environments in which they work, especially with regard to their [...] Read more.
There is evidence that bartenders play a key role in respect of the health and safety of patrons in nightlife environments. However, little is known of how bartenders themselves are affected by the environments in which they work, especially with regard to their exposure to violence, pressure to drink and stress. We used a cross-sectional survey to assess the experiences of bartenders (n = 424) working in pubs, bars and nightclubs in Denmark. 71% of the respondents reported drinking while working, 6% reported using other drugs than alcohol at work, and 33% reported drinking even when they did not feel like it because of pressure to drink at work. Verbal assaults and threats were common and associated with higher levels of perceived stress. Bartenders’ work environment poses a risk for the development of alcohol use disorders. The fact that many bartenders consume significant quantities of alcohol during their working hours may pose a risk not only to their own safety, but also to that of their colleagues and patrons. Full article
Open AccessReview
European Surveillance for West Nile Virus in Mosquito Populations
Int. J. Environ. Res. Public Health 2013, 10(10), 4869-4895; https://doi.org/10.3390/ijerph10104869 - 11 Oct 2013
Cited by 74 | Viewed by 7438
Abstract
A wide range of arthropod-borne viruses threaten both human and animal health either through their presence in Europe or through risk of introduction. Prominent among these is West Nile virus (WNV), primarily an avian virus, which has caused multiple outbreaks associated with human [...] Read more.
A wide range of arthropod-borne viruses threaten both human and animal health either through their presence in Europe or through risk of introduction. Prominent among these is West Nile virus (WNV), primarily an avian virus, which has caused multiple outbreaks associated with human and equine mortality. Endemic outbreaks of West Nile fever have been reported in Italy, Greece, France, Romania, Hungary, Russia and Spain, with further spread expected. Most outbreaks in Western Europe have been due to infection with WNV Lineage 1. In Eastern Europe WNV Lineage 2 has been responsible for human and bird mortality, particularly in Greece, which has experienced extensive outbreaks over three consecutive years. Italy has experienced co-circulation with both virus lineages. The ability to manage this threat in a cost-effective way is dependent on early detection. Targeted surveillance for pathogens within mosquito populations offers the ability to detect viruses prior to their emergence in livestock, equine species or human populations. In addition, it can establish a baseline of mosquito-borne virus activity and allow monitoring of change to this over time. Early detection offers the opportunity to raise disease awareness, initiate vector control and preventative vaccination, now available for horses, and encourage personal protection against mosquito bites. This would have major benefits through financial savings and reduction in equid morbidity/mortality. However, effective surveillance that predicts virus outbreaks is challenged by a range of factors including limited resources, variation in mosquito capture rates (too few or too many), difficulties in mosquito identification, often reliant on specialist entomologists, and the sensitive, rapid detection of viruses in mosquito pools. Surveillance for WNV and other arboviruses within mosquito populations varies between European countries in the extent and focus of the surveillance. This study reviews the current status of WNV in mosquito populations across Europe and how this is informing our understanding of virus epidemiology. Key findings such as detection of virus, presence of vector species and invasive mosquito species are summarized, and some of the difficulties encountered when applying a cost-effective surveillance programme are highlighted. Full article
(This article belongs to the Special Issue Epidemiology of West Nile Virus)
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Open AccessArticle
Community Perceptions of Air Pollution and Related Health Risks in Nairobi Slums
Int. J. Environ. Res. Public Health 2013, 10(10), 4851-4868; https://doi.org/10.3390/ijerph10104851 - 11 Oct 2013
Cited by 31 | Viewed by 5510
Abstract
Air pollution is among the leading global risks for mortality and responsible for increasing risk for chronic diseases. Community perceptions on exposure are critical in determining people’s response and acceptance of related policies. Therefore, understanding people’ perception is critical in informing the design [...] Read more.
Air pollution is among the leading global risks for mortality and responsible for increasing risk for chronic diseases. Community perceptions on exposure are critical in determining people’s response and acceptance of related policies. Therefore, understanding people’ perception is critical in informing the design of appropriate intervention measures. The aim of this paper was to establish levels and associations between perceived pollution and health risk perception among slum residents. A cross-sectional study of 5,317 individuals aged 35+ years was conducted in two slums of Nairobi. Association of perceived score and individual characteristics was assessed using linear regression. Spatial variation in the perceived levels was determined through hot spot analysis using ArcGIS. The average perceived air pollution level was higher among residents in Viwandani compared to those in Korogocho. Perceived air pollution level was positively associated with perceived health risks. The majority of respondents were exposed to air pollution in their place of work with 66% exposed to at least two sources of air pollution. Less than 20% of the respondents in both areas mentioned sources related to indoor pollution. The perceived air pollution level and related health risks in the study community were low among the residents indicating the need for promoting awareness on air pollution sources and related health risks. Full article
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Open AccessReview
Estimating the Public Health Impact of Setting Targets at the European Level for the Reduction of Zoonotic Salmonella in Certain Poultry Populations
Int. J. Environ. Res. Public Health 2013, 10(10), 4836-4850; https://doi.org/10.3390/ijerph10104836 - 11 Oct 2013
Cited by 10 | Viewed by 2690
Abstract
In the European Union (EU), targets are being set for the reduction of certain zoonotic Salmonella serovars in different animal populations, including poultry populations, within the framework of Regulation (EC) No. 2160/2003 on the control of zoonoses. For a three-year transitional period, the [...] Read more.
In the European Union (EU), targets are being set for the reduction of certain zoonotic Salmonella serovars in different animal populations, including poultry populations, within the framework of Regulation (EC) No. 2160/2003 on the control of zoonoses. For a three-year transitional period, the EU targets were to cover only Salmonella Enteritidis and S. Typhimurium (and in addition S. Hadar, S. Infantis and S. Virchow for breeding flocks of Gallus gallus). Before the end of that transitional period, the revision of the EU targets was to be considered, including the potentially addition of other serovars with public health significance to the permanent EU targets. This review article aims at providing an overview of the assessments carried out by the Scientific Panel on Biological Hazards of the European Food Safety Authority in the field of setting targets for Salmonella in poultry populations (breeding flocks of Gallus gallus, laying flocks of Gallus gallus, broiler flocks of Gallus gallus and flocks of breeding and fattening turkeys) and their impact in subsequent changes in EU legislation. Full article
(This article belongs to the Special Issue Food Safety and Public Health)
Open AccessReview
Domestic Water Service Delivery Indicators and Frameworks for Monitoring, Evaluation, Policy and Planning: A Review
Int. J. Environ. Res. Public Health 2013, 10(10), 4812-4835; https://doi.org/10.3390/ijerph10104812 - 11 Oct 2013
Cited by 42 | Viewed by 7166
Abstract
Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating [...] Read more.
Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator—service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled. Full article
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Open AccessReview
Smoking Behaviour and Mental Health Disorders—Mutual Influences and Implications for Therapy
Int. J. Environ. Res. Public Health 2013, 10(10), 4790-4811; https://doi.org/10.3390/ijerph10104790 - 10 Oct 2013
Cited by 23 | Viewed by 3926
Abstract
Tobacco use is strongly associated with a variety of psychiatric disorders. Smokers are more likely than non-smokers to meet current criteria for mental health conditions, such as mood disorders, anxiety disorders and psychosis. Evidence also suggest that smokers with psychiatric disorders may have [...] Read more.
Tobacco use is strongly associated with a variety of psychiatric disorders. Smokers are more likely than non-smokers to meet current criteria for mental health conditions, such as mood disorders, anxiety disorders and psychosis. Evidence also suggest that smokers with psychiatric disorders may have more difficulty quitting, offering at least a partial explanation for why smoking rates are higher in this population. The mechanisms linking mental health conditions and cigarette smoking are complex and likely differ across each of the various disorders. The most commonly held view is that patients with mental health conditions smoke in an effort to regulate the symptoms associated with their disorder. However some recent evidence suggests that quitting smoking may actually improve mental health symptoms. This is particularly true if the tobacco cessation intervention is integrated into the context of ongoing mental health treatment. In this paper we reviewed and summarized the most relevant knowledge about the relationship between tobacco use and dependence and psychiatric disorders. We also reviewed the most effective smoking cessation strategies available for patients with psychiatric comorbidity and the impact of smoking behavior on psychiatric medication. Full article
(This article belongs to the Special Issue Tobacco Control in Vulnerable Population Groups)
Open AccessArticle
Detection of Human Impacts by an Adaptive Energy-Based Anisotropic Algorithm
Int. J. Environ. Res. Public Health 2013, 10(10), 4767-4789; https://doi.org/10.3390/ijerph10104767 - 10 Oct 2013
Cited by 1 | Viewed by 2573
Abstract
Boosted by health consequences and the cost of falls in the elderly, this work develops and tests a novel algorithm and methodology to detect human impacts that will act as triggers of a two-layer fall monitor. The two main requirements demanded by socio-healthcare [...] Read more.
Boosted by health consequences and the cost of falls in the elderly, this work develops and tests a novel algorithm and methodology to detect human impacts that will act as triggers of a two-layer fall monitor. The two main requirements demanded by socio-healthcare providers—unobtrusiveness and reliability—defined the objectives of the research. We have demonstrated that a very agile, adaptive, and energy-based anisotropic algorithm can provide 100% sensitivity and 78% specificity, in the task of detecting impacts under demanding laboratory conditions. The algorithm works together with an unsupervised real-time learning technique that addresses the adaptive capability, and this is also presented. The work demonstrates the robustness and reliability of our new algorithm, which will be the basis of a smart falling monitor. This is shown in this work to underline the relevance of the results. Full article
(This article belongs to the Special Issue Advances in Telehealthcare)
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Open AccessArticle
An Upscaling Method for Cover-Management Factor and Its Application in the Loess Plateau of China
Int. J. Environ. Res. Public Health 2013, 10(10), 4752-4766; https://doi.org/10.3390/ijerph10104752 - 09 Oct 2013
Cited by 12 | Viewed by 2932
Abstract
The cover-management factor (C-factor) is important for studying soil erosion. In addition, it is important to use sampling plot data to estimate the regional C-factor when assessing erosion and soil conservation. Here, the loess hill and gully region in Ansai County, China, was [...] Read more.
The cover-management factor (C-factor) is important for studying soil erosion. In addition, it is important to use sampling plot data to estimate the regional C-factor when assessing erosion and soil conservation. Here, the loess hill and gully region in Ansai County, China, was studied to determine a method for computing the C-factor. This C-factor is used in the Universal Soil Loss Equation (USLE) at a regional scale. After upscaling the slope-scale computational equation, the C-factor for Ansai County was calculated by using the soil loss ratio, precipitation and land use/cover type. The multi-year mean C-factor for Ansai County was 0.36. The C-factor values were greater in the eastern region of the county than in the western region. In addition, the lowest C-factor values were found in the southern region of the county near its southern border. These spatial differences were consistent with the spatial distribution of the soil loess ratios across areas with different land uses. Additional research is needed to determine the effects of seasonal vegetation growth changes on the C-factor, and the C-factor upscaling uncertainties at a regional scale. Full article
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