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Int. J. Environ. Res. Public Health, Volume 11, Issue 6 (June 2014) , Pages 5567-6611

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Open AccessArticle
Nature-Based Stress Management Course for Individuals at Risk of Adverse Health Effects from Work-Related Stress—Effects on Stress Related Symptoms, Workability and Sick Leave
Int. J. Environ. Res. Public Health 2014, 11(6), 6586-6611; https://doi.org/10.3390/ijerph110606586 - 23 Jun 2014
Cited by 14 | Viewed by 5019
Abstract
Sick leave due to stress-related disorders is increasing in Sweden after a period of decrease. To avoid that individuals living under heavy stress develop more severe stress-related disorders, different stress management interventions are offered. Self-assessed health, burnout-scores and well-being are commonly used as [...] Read more.
Sick leave due to stress-related disorders is increasing in Sweden after a period of decrease. To avoid that individuals living under heavy stress develop more severe stress-related disorders, different stress management interventions are offered. Self-assessed health, burnout-scores and well-being are commonly used as outcome measures. Few studies have used sick-leave to compare effects of stress interventions. A new approach is to use nature and garden in a multimodal stress management context. This study aimed to explore effects on burnout, work ability, stress-related health symptoms, and sick leave for 33 women participating in a 12-weeks nature based stress management course and to investigate how the nature/garden activities were experienced. A mixed method approach was used. Measures were taken at course start and three follow-ups. Results showed decreased burnout-scores and long-term sick leaves, and increased work ability; furthermore less stress-related symptoms were reported. Tools and strategies to better handle stress were achieved and were widely at use at all follow-ups. The garden and nature content played an important role for stress relief and for tools and strategies to develop. The results from this study points to beneficial effects of using garden activities and natural environments in a stress management intervention. Full article
(This article belongs to the Special Issue Health Benefits of Nature)
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Open AccessArticle
Identifying Determinants of Oncomelania hupensis Habitats and Assessing the Effects of Environmental Control Strategies in the Plain Regions with the Waterway Network of China at the Microscale
Int. J. Environ. Res. Public Health 2014, 11(6), 6571-6585; https://doi.org/10.3390/ijerph110606571 - 23 Jun 2014
Cited by 10 | Viewed by 2432
Abstract
This study aims to identify the landscape ecological determinants related to Oncomelania hupensis distribution, map the potential high risk of O. hupensis habitats at the microscale, and assess the effects of two environmental control strategies. Sampling was performed on 242 snail sites and [...] Read more.
This study aims to identify the landscape ecological determinants related to Oncomelania hupensis distribution, map the potential high risk of O. hupensis habitats at the microscale, and assess the effects of two environmental control strategies. Sampling was performed on 242 snail sites and 726 non-snail sites throughout Qianjiang City, Hubei Province, China. An integrated approach of landscape pattern analysis coupled with multiple logistic regression modeling was applied to investigate the effects of environmental factors on snail habitats. The risk probability of snail habitats positively correlated with patch fractal dimension (FD), paddy farm land proportion, and wetness index but inversely correlated with categorized normalized difference vegetation index (NDVI) and elevation. These findings indicate that FD can identify irregular features (e.g., irrigation ditches) in plain regions and that a moderate NDVI increases the microscale risk probability. Basing on the observed determinants, we predicted a map showing high-risk areas of snail habitats and simulated the effects of conduit hardening and paddy farming land rotation to dry farming land. The two approaches were confirmed effective for snail control. These findings provide an empirical basis for health professionals in local schistosomiasis control stations to identify priority areas and promising environmental control strategies for snail control and prevention. Full article
(This article belongs to the Special Issue Environmental Determinants of Infectious Disease Transmission)
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Open AccessArticle
The Role of Open Space in Urban Neighbourhoods for Health-Related Lifestyle
Int. J. Environ. Res. Public Health 2014, 11(6), 6547-6570; https://doi.org/10.3390/ijerph110606547 - 23 Jun 2014
Cited by 12 | Viewed by 3795
Abstract
The research reported in this paper addresses the relationship between quality of open space and health related lifestyle in urban residential areas. The research was performed in the residential developments in Ljubljana, Slovenia, dating from the time of political and economic changes in [...] Read more.
The research reported in this paper addresses the relationship between quality of open space and health related lifestyle in urban residential areas. The research was performed in the residential developments in Ljubljana, Slovenia, dating from the time of political and economic changes in the early nineties. Compared to the older neighborhoods, these are typically single-use residential areas, with small open spaces and poor landscape design. The research is concerned with the quality of life in these areas, especially from the perspective of the vulnerable users, like the elderly and children. Both depend on easily accessible green areas in close proximity to their homes. The hypothesis is that the poor open space quality affects their health-related behavior and their perceived health status. The research has three methodological phases: (1) a comparison between urban residential areas by criteria describing their physical characteristics; (2) behavior observation and mapping and (3) a resident opinion survey. The results confirm differences between open spaces of the selected residential areas as well as their relation with outdoor activities: a lack of outdoor programs correlates with poor variety of outdoor activities, limited to transition type, less time spent outdoors and lower satisfaction with their home environment. The survey also disclosed a strong influence of a set of socio-economic variables such as education and economic status on physical activity and self-perceived health status of people. The results therefore confirm the hypothesis especially for less affluent and educated; i.e., vulnerable groups. Full article
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Open AccessReview
Impact of the 2008 Economic and Financial Crisis on Child Health: A Systematic Review
Int. J. Environ. Res. Public Health 2014, 11(6), 6528-6546; https://doi.org/10.3390/ijerph110606528 - 23 Jun 2014
Cited by 53 | Viewed by 6212
Abstract
The aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health [...] Read more.
The aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health outcomes on children, published since 2007 and related to the 2008 economic crisis were included. Two reviewers independently assessed studies for inclusion. Data were synthesised as a narrative review. Five hundred and six titles and abstracts were reviewed, from which 22 studies were included. The risk of bias for quantitative studies was mixed while qualitative studies showed low risk of bias. An excess of 28,000–50,000 infant deaths in 2009 was estimated in sub-Saharan African countries, and increased infant mortality in Greece was reported. Increased price of foods was related to worsening nutrition habits in disadvantaged families worldwide. An increase in violence against children was reported in the U.S., and inequalities in health-related quality of life appeared in some countries. Most studies suggest that the economic crisis has harmed children’s health, and disproportionately affected the most vulnerable groups. There is an urgent need for further studies to monitor the child health effects of the global recession and to inform appropriate public policy responses. Full article
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Open AccessArticle
Field Survey of Health Perception and Complaints of Pennsylvania Residents in the Marcellus Shale Region
Int. J. Environ. Res. Public Health 2014, 11(6), 6517-6527; https://doi.org/10.3390/ijerph110606517 - 20 Jun 2014
Cited by 15 | Viewed by 3863
Abstract
Pennsylvania Marcellus Shale region residents have reported medical symptoms they believe are related to nearby Unconventional Natural Gas Development (UNGD). Associations between medical symptoms and UNGD have been minimally explored. The objective of this descriptive study is to explore whether shale region Pennsylvania [...] Read more.
Pennsylvania Marcellus Shale region residents have reported medical symptoms they believe are related to nearby Unconventional Natural Gas Development (UNGD). Associations between medical symptoms and UNGD have been minimally explored. The objective of this descriptive study is to explore whether shale region Pennsylvania residents perceive UNGD as a health concern and whether they attribute health symptoms to UNGD exposures. A questionnaire was administered to adult volunteers with medical complaints in a primary-care medical office in a county where UNGD was present. Participants were asked whether they were concerned about health effects from UNGD, and whether they attributed current symptoms to UNGD or to some other environmental exposure. There were 72 respondents; 22% perceived UNGD as a health concern and 13% attributed medical symptoms to UNGD exposures. Overall, 42% attributed one or more of their medical symptoms to environmental causes, of which UNGD was the most frequent. A medical record review conducted on six participants who attributed their medical symptoms to UNGD revealed that only one of these records documented both the symptoms in question and the attribution to UNGD. The results of this pilot study suggest that there is substantial concern about adverse health effects of UNGD among Pennsylvania Marcellus Shale residents, and that these concerns may not be adequately represented in medical records. Further efforts to determine the relationship between UNGD and health are recommended in order to address community concerns. Full article
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Open AccessArticle
Interaction of Intercellular Adhesion Molecule 1 (ICAM1) Polymorphisms and Environmental Tobacco Smoke on Childhood Asthma
Int. J. Environ. Res. Public Health 2014, 11(6), 6504-6516; https://doi.org/10.3390/ijerph110606504 - 20 Jun 2014
Cited by 3 | Viewed by 2250
Abstract
Asthma is a chronic disease that is particularly common in children. The association between polymorphisms of the gene encoding intercellular adhesion molecule 1 (ICAM1) and gene-environment interactions with childhood asthma has not been fully investigated. A cross-sectional study was undertaken to investigate these [...] Read more.
Asthma is a chronic disease that is particularly common in children. The association between polymorphisms of the gene encoding intercellular adhesion molecule 1 (ICAM1) and gene-environment interactions with childhood asthma has not been fully investigated. A cross-sectional study was undertaken to investigate these associations among children in Taiwan. The effects of two functional single-nucleotide polymorphisms (SNPs) of ICAM1, rs5491 (K56M) and rs5498 (K469E), and exposure to environmental tobacco smoke (ETS) were studied. Two hundred and eighteen asthmatic and 877 nonasthmatic children were recruited from elementary schools. It was found that the genetic effect of each SNP was modified by the other SNP and by exposure to ETS. The risk of asthma was higher for children carrying the rs5491 AT or TT genotypes and the rs5498 GG genotype (odds ratio = 1.68, 95% confidence interval 1.09–2.59) than for those with the rs5491 AA and rs5498 AA or AG genotypes (the reference group). The risk for the other two combinations of genotypes did not differ significantly from that of the reference group (p of interaction = 0.0063). The two studied ICAM1 SNPs were associated with childhood asthma among children exposed to ETS, but not among those without ETS exposure (p of interaction = 0.05 and 0.01 for rs5491 and rs5498, respectively). Both ICAM1 and ETS, and interactions between these two factors are likely to be involved in the development of asthma in childhood. Full article
(This article belongs to the Special Issue Genetic Impact on the Development of Allergic Disease)
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Open AccessCommentary
Mobile Health in Maternal and Newborn Care: Fuzzy Logic
Int. J. Environ. Res. Public Health 2014, 11(6), 6494-6503; https://doi.org/10.3390/ijerph110606494 - 20 Jun 2014
Cited by 4 | Viewed by 2742
Abstract
Whether mHealth improves maternal and newborn health outcomes remains uncertain as the response is perhaps not true or false but lies somewhere in between when considering unintended harmful consequences. Fuzzy logic, a mathematical approach to computing, extends the traditional binary “true or false” [...] Read more.
Whether mHealth improves maternal and newborn health outcomes remains uncertain as the response is perhaps not true or false but lies somewhere in between when considering unintended harmful consequences. Fuzzy logic, a mathematical approach to computing, extends the traditional binary “true or false” (one or zero) to exemplify this notion of partial truths that lies between completely true and false. The commentary explores health, socio-ecological and environmental consequences–positive, neutral or negative. Of particular significance is the negative influence of mHealth on maternal care-behaviors, which can increase stress reactivity and vulnerability to stress-induced illness across the lifespan of the child and establish pathways for intergenerational transmission of behaviors. A mHealth “fingerprinting” approach is essential to monitor psychosocial, economic, cultural, environmental and physical impact of mHealth intervention and make evidence-informed decision(s) about use of mHealth in maternal and newborn care. Full article
Open AccessArticle
Prevalence of Self-Reported Shaking and Smothering and Their Associations with Co-Sleeping among 4-Month-Old Infants in Japan
Int. J. Environ. Res. Public Health 2014, 11(6), 6485-6493; https://doi.org/10.3390/ijerph110606485 - 20 Jun 2014
Cited by 10 | Viewed by 2241
Abstract
Few studies have investigated the prevalence of shaking and smothering and whether they are associated with co-sleeping. In Japan, co-sleeping is common during infancy and early childhood. This study investigates the prevalence of shaking and smothering and their associations with co-sleeping among 4-month-old [...] Read more.
Few studies have investigated the prevalence of shaking and smothering and whether they are associated with co-sleeping. In Japan, co-sleeping is common during infancy and early childhood. This study investigates the prevalence of shaking and smothering and their associations with co-sleeping among 4-month-old infants in Japan. A questionnaire was administered to mothers who participated in a 4-month health checkup program in Kamagaya City in Japan (n = 1307; valid response rate, 82%). The questionnaire investigated the frequency of self-reported shaking and smothering during the past one month, co-sleeping status, and living arrangements with grandparents, in addition to traditional risk factors such as stress due to crying. Associations between co-sleeping and self-reported shaking or smothering were analyzed using multiple logistic regression. The prevalence of self-reported shaking and smothering at least one time during the past one month was 3.4% (95% confidence interval (CI), 2.4%–4.3%) and 2.4% (95% CI, 1.5%–3.2%), respectively. Co-sleeping was marginally associated with the amount of crying and not associated with stress due to crying. Further, co-sleeping was not associated with either self-reported shaking or smothering, although stress due to crying showed strong association with shaking and smothering. Co-sleeping was not a risk factor for shaking and smothering. Full article
Open AccessArticle
Differences in Birthweight Outcomes: A Longitudinal Study Based on Siblings
Int. J. Environ. Res. Public Health 2014, 11(6), 6472-6484; https://doi.org/10.3390/ijerph110606472 - 20 Jun 2014
Cited by 7 | Viewed by 2231
Abstract
Objectives: We investigate the differences in birthweight between first- and second-borns, evaluating the impact of changes in pregnancy (e.g., gestational age), demographic (e.g., age), and social (e.g., education level, marital status) maternal characteristics. Data and Methods: All analyses are performed on data collected [...] Read more.
Objectives: We investigate the differences in birthweight between first- and second-borns, evaluating the impact of changes in pregnancy (e.g., gestational age), demographic (e.g., age), and social (e.g., education level, marital status) maternal characteristics. Data and Methods: All analyses are performed on data collected in Umbria (Italy) taking into account a set of 792 women who delivered twice from 2005 to 2008. Firstly, we use a univariate paired t-test for the comparison between weights of first- and second-borns; Secondly, we use linear and nonlinear regression approaches in order to: (i) evaluate the effect of demographic and social maternal characteristics and (ii) predict the odds-ratio of low and high birthweight infants, respectively. Results: We find that the birthweight of second-borns is significantly higher than that of first-borns. Statistically significant effects are related with a longer gestational age, an increased number of visits during the pregnancy, and the gender of infants. On the other hand, we do not observe any significant effect related with mother’s age and with other characteristics of interest. Full article
Open AccessDiscussion
The Case in Favor of E-Cigarettes for Tobacco Harm Reduction
Int. J. Environ. Res. Public Health 2014, 11(6), 6459-6471; https://doi.org/10.3390/ijerph110606459 - 20 Jun 2014
Cited by 20 | Viewed by 11518
Abstract
A carefully structured Tobacco Harm Reduction (THR) initiative, with e-cigarettes as a prominent THR modality, added to current tobacco control programming, is the most feasible policy option likely to substantially reduce tobacco-attributable illness and death in the United States over the next 20 [...] Read more.
A carefully structured Tobacco Harm Reduction (THR) initiative, with e-cigarettes as a prominent THR modality, added to current tobacco control programming, is the most feasible policy option likely to substantially reduce tobacco-attributable illness and death in the United States over the next 20 years. E-cigarettes and related vapor products are the most promising harm reduction modalities because of their acceptability to smokers. There are about 46 million smokers in the United States, and an estimated 480,000 deaths per year attributed to cigarette smoking. These numbers have been essentially stable since 2004. Currently recommended pharmaceutical smoking cessation protocols fail in about 90% of smokers who use them as directed, even under the best of study conditions, when results are measured at six to twelve months. E-cigarettes have not been attractive to non-smoking teens or adults. Limited numbers non-smokers have experimented with them, but hardly any have continued their use. The vast majority of e-cigarette use is by current smokers using them to cut down or quit cigarettes. E-cigarettes, even when used in no-smoking areas, pose no discernable risk to bystanders. Finally, addition of a THR component to current tobacco control programming will likely reduce costs by reducing the need for counseling and drugs. Full article
(This article belongs to the Special Issue Electronic Cigarettes as a Tool in Tobacco Harm Reduction)
Open AccessArticle
Building Resilience against Climate Effects—A Novel Framework to Facilitate Climate Readiness in Public Health Agencies
Int. J. Environ. Res. Public Health 2014, 11(6), 6433-6458; https://doi.org/10.3390/ijerph110606433 - 20 Jun 2014
Cited by 23 | Viewed by 6012
Abstract
Climate change is anticipated to have several adverse health impacts. Managing these risks to public health requires an iterative approach. As with many risk management strategies related to climate change, using modeling to project impacts, engaging a wide range of stakeholders, and regularly [...] Read more.
Climate change is anticipated to have several adverse health impacts. Managing these risks to public health requires an iterative approach. As with many risk management strategies related to climate change, using modeling to project impacts, engaging a wide range of stakeholders, and regularly updating models and risk management plans with new information—hallmarks of adaptive management—are considered central tenets of effective public health adaptation. The Centers for Disease Control and Prevention has developed a framework, entitled Building Resilience Against Climate Effects, or BRACE, to facilitate this process for public health agencies. Its five steps are laid out here. Following the steps laid out in BRACE will enable an agency to use the best available science to project likely climate change health impacts in a given jurisdiction and prioritize interventions. Adopting BRACE will also reinforce public health’s established commitment to evidence-based practice and institutional learning, both of which will be central to successfully engaging the significant new challenges that climate change presents. Full article
(This article belongs to the Special Issue Climate Change and Human Health)
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Open AccessArticle
Environmental Factors and Multiple Sclerosis Severity: A Descriptive Study
Int. J. Environ. Res. Public Health 2014, 11(6), 6417-6432; https://doi.org/10.3390/ijerph110606417 - 19 Jun 2014
Cited by 26 | Viewed by 2963
Abstract
Growing evidence suggests that environmental factors play a key role in the onset of multiple sclerosis (MS). This study was conducted to examine whether environmental factors may also be associated with the evolution of the disease. We collected data on smoking habits, sunlight [...] Read more.
Growing evidence suggests that environmental factors play a key role in the onset of multiple sclerosis (MS). This study was conducted to examine whether environmental factors may also be associated with the evolution of the disease. We collected data on smoking habits, sunlight exposure and diet (particularly consumption of vitamin D-rich foods) from a sample of 131 MS patients. We also measured their serum vitamin D concentration. The clinical impact of MS was quantified using the Multiple Sclerosis Severity Score (MSSS); MS was considered “severe” in patients with MSSS ≥ 6, and “mild” in patients with MSSS ≤ 1. The results showed a strong association between serum vitamin D concentration and both sunlight exposure (26.4 ± 11.9 ng/mL vs. 16.5 ± 12.1 ng/mL, p = 0.0004) and a fish-rich diet (23.5 ± 12.1 ng/mL vs. 16.1 ± 12.4 ng/mL, p = 0.005). Patients reporting frequent sunlight exposure had a lower MSSS (2.6 ± 2.4 h vs. 4.6 ± 2.6 h, p < 0.001). The mild MS patients reported much more frequent sunlight exposure (75% mild MS vs. 25% severe MS p = 0.004, Chi square test). A higher serum vitamin D concentration determined a lower risk of developing severe MS, adjusted for sunlight exposure (OR = 0.92 for one unit increase in vitamin D, 95% CI: 0.86–0.97, p = 0.005). A stronger inverse association emerged between frequent sunlight exposure and the risk of severe MS (OR = 0.26, 95% CI: 0.09–0.71, p = 0.009). Our data show that an appropriate diet and adequate expose to sunlight are associated with less aggressive MS. Full article
Open AccessArticle
Humidity and Gravimetric Equivalency Adjustments for Nephelometer-Based Particulate Matter Measurements of Emissions from Solid Biomass Fuel Use in Cookstoves
Int. J. Environ. Res. Public Health 2014, 11(6), 6400-6416; https://doi.org/10.3390/ijerph110606400 - 19 Jun 2014
Cited by 16 | Viewed by 3166
Abstract
Great uncertainty exists around indoor biomass burning exposure-disease relationships due to lack of detailed exposure data in large health outcome studies. Passive nephelometers can be used to estimate high particulate matter (PM) concentrations during cooking in low resource environments. Since passive nephelometers do [...] Read more.
Great uncertainty exists around indoor biomass burning exposure-disease relationships due to lack of detailed exposure data in large health outcome studies. Passive nephelometers can be used to estimate high particulate matter (PM) concentrations during cooking in low resource environments. Since passive nephelometers do not have a collection filter they are not subject to sampler overload. Nephelometric concentration readings can be biased due to particle growth in high humid environments and differences in compositional and size dependent aerosol characteristics. This paper explores relative humidity (RH) and gravimetric equivalency adjustment approaches to be used for the pDR-1000 used to assess indoor PM concentrations for a cookstove intervention trial in Nepal. Three approaches to humidity adjustment performed equivalently (similar root mean squared error). For gravimetric conversion, the new linear regression equation with log-transformed variables performed better than the traditional linear equation. In addition, gravimetric conversion equations utilizing a spline or quadratic term were examined. We propose a humidity adjustment equation encompassing the entire RH range instead of adjusting for RH above an arbitrary 60% threshold. Furthermore, we propose new integrated RH and gravimetric conversion methods because they have one response variable (gravimetric PM2.5 concentration), do not contain an RH threshold, and is straightforward. Full article
(This article belongs to the Special Issue Air Pollution Modeling)
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Open AccessArticle
Evaluating the Impact of Environmental Temperature on Global Highly Pathogenic Avian Influenza (HPAI) H5N1 Outbreaks in Domestic Poultry
Int. J. Environ. Res. Public Health 2014, 11(6), 6388-6399; https://doi.org/10.3390/ijerph110606388 - 19 Jun 2014
Cited by 5 | Viewed by 2495
Abstract
The emergence and spread of highly pathogenic avian influenza (HPAI) A virus subtype H5N1 in Asia, Europe and Africa has had an enormously socioeconomic impact and presents an important threat to human health because of its efficient animal-to-human transmission. Many factors contribute to [...] Read more.
The emergence and spread of highly pathogenic avian influenza (HPAI) A virus subtype H5N1 in Asia, Europe and Africa has had an enormously socioeconomic impact and presents an important threat to human health because of its efficient animal-to-human transmission. Many factors contribute to the occurrence and transmission of HPAI H5N1 virus, but the role of environmental temperature remains poorly understood. Based on an approach of integrating a Bayesian Cox proportional hazards model and a Besag-York-Mollié (BYM) model, we examined the specific impact of environmental temperature on HPAI H5N1 outbreaks in domestic poultry around the globe during the period from 1 December 2003 to 31 December 2009. The results showed that higher environmental temperature was a significant risk factor for earlier occurrence of HPAI H5N1 outbreaks in domestic poultry, especially for a temperature of 25 °C. Its impact varied with epidemic waves (EWs), and the magnitude of the impact tended to increase over EWs. Full article
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Open AccessArticle
The Role of Civic Engagement for Men’s Health and Well Being in Norway—A Contribution to Public Health
Int. J. Environ. Res. Public Health 2014, 11(6), 6375-6387; https://doi.org/10.3390/ijerph110606375 - 18 Jun 2014
Cited by 3 | Viewed by 2832
Abstract
Objectives: Using the example of older men volunteering on teams that restore historic ships, this article examines the effects of volunteering on the well-being of older adults. We consider particularly how volunteering impacts levels of social engagement and explore how the men’s [...] Read more.
Objectives: Using the example of older men volunteering on teams that restore historic ships, this article examines the effects of volunteering on the well-being of older adults. We consider particularly how volunteering impacts levels of social engagement and explore how the men’s reminiscences as they bond with their fellows in highly skilled work helps integrate their life experiences. Methods: Data are based on 14 in-depth interviews with volunteers working on historic vessels in Norway. Self-rated health, functional dependency, and well-being measures were collected using semi-structured questionnaire. Results: Volunteering in a context of skilled, group-bonded, culturally prestigious activity adds considerably to social capital among elderly men in Norway. Respondents explain their involvement in terms of prior relationships and current social benefits. They spoke of the value of maintaining past personal connections to a particular ship, shipping company, or local community. These were reinforced by current social benefits, such as the experience of companionship, unity, and the feeling of making an important contribution to the society. The group dynamics and strong collective aspect of these voluntary associations maintains internal cohesion, and members only leave when forced by increasing age, poor health, or insufficient financial resources. Conclusions: This article illuminates a case study of gender-specific engagement of older adults in volunteer roles returning high benefits both to participants and society, and adds knowledge to public-health programs and policies in the volunteer- and cultural-heritage sector. Full article
Open AccessArticle
Health Risk Assessment of Ambient Air Concentrations of Benzene, Toluene and Xylene (BTX) in Service Station Environments
Int. J. Environ. Res. Public Health 2014, 11(6), 6354-6374; https://doi.org/10.3390/ijerph110606354 - 18 Jun 2014
Cited by 33 | Viewed by 3442
Abstract
A comprehensive evaluation of the adverse health effects of human exposures to BTX from service station emissions was carried out using BTX exposure data from the scientific literature. The data was grouped into different scenarios based on activity, location and occupation and plotted [...] Read more.
A comprehensive evaluation of the adverse health effects of human exposures to BTX from service station emissions was carried out using BTX exposure data from the scientific literature. The data was grouped into different scenarios based on activity, location and occupation and plotted as Cumulative Probability Distributions (CPD) plots. Health risk was evaluated for each scenario using the Hazard Quotient (HQ) at 50% (CEXP50) and 95% (CEXP95) exposure levels. HQ50 and HQ95 > 1 were obtained with benzene in the scenario for service station attendants and mechanics repairing petrol dispensing pumps indicating a possible health risk. The risk was minimized for service stations using vapour recovery systems which greatly reduced the benzene exposure levels. HQ50 and HQ95 < 1 were obtained for all other scenarios with benzene suggesting minimal risk for most of the exposed population. However, HQ50 and HQ95 < 1 was also found with toluene and xylene for all scenarios, suggesting minimal health risk. The lifetime excess Cancer Risk (CR) and Overall Risk Probability for cancer on exposure to benzene was calculated for all Scenarios and this was higher amongst service station attendants than any other scenario. Full article
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Open AccessArticle
Validation of a Framework for Measuring Hospital Disaster Resilience Using Factor Analysis
Int. J. Environ. Res. Public Health 2014, 11(6), 6335-6353; https://doi.org/10.3390/ijerph110606335 - 18 Jun 2014
Cited by 11 | Viewed by 2992
Abstract
Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This [...] Read more.
Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies. Full article
(This article belongs to the Special Issue Preparedness and Emergency Response)
Open AccessReview
Exploring Childhood Lead Exposure through GIS: A Review of the Recent Literature
Int. J. Environ. Res. Public Health 2014, 11(6), 6314-6334; https://doi.org/10.3390/ijerph110606314 - 18 Jun 2014
Cited by 21 | Viewed by 3162
Abstract
Childhood exposure to lead remains a critical health control problem in the US. Integration of Geographic Information Systems (GIS) into childhood lead exposure studies significantly enhanced identifying lead hazards in the environment and determining at risk children. Research indicates that the toxic threshold [...] Read more.
Childhood exposure to lead remains a critical health control problem in the US. Integration of Geographic Information Systems (GIS) into childhood lead exposure studies significantly enhanced identifying lead hazards in the environment and determining at risk children. Research indicates that the toxic threshold for lead exposure was updated three times in the last four decades: 60 to 30 micrograms per deciliter (µg/dL) in 1975, 25 µg/dL in 1985, and 10 µb/dL in 1991. These changes revealed the extent of lead poisoning. By 2012 it was evident that no safe blood lead threshold for the adverse effects of lead on children had been identified and the Center for Disease Control (CDC) currently uses a reference value of 5 µg/dL. Review of the recent literature on GIS-based studies suggests that numerous environmental risk factors might be critical for lead exposure. New GIS-based studies are used in surveillance data management, risk analysis, lead exposure visualization, and community intervention strategies where geographically-targeted, specific intervention measures are taken. Full article
Open AccessArticle
Evaluating Determinants of Environmental Risk Perception for Risk Management in Contaminated Sites
Int. J. Environ. Res. Public Health 2014, 11(6), 6291-6313; https://doi.org/10.3390/ijerph110606291 - 16 Jun 2014
Cited by 16 | Viewed by 4892
Abstract
Understanding the differences in the risk judgments of residents of industrial communities potentially provides insights into how to develop appropriate risk communication strategies. This study aimed to explore citizens’ fundamental understanding of risk-related judgments and to identify the factors contributing to perceived risks. [...] Read more.
Understanding the differences in the risk judgments of residents of industrial communities potentially provides insights into how to develop appropriate risk communication strategies. This study aimed to explore citizens’ fundamental understanding of risk-related judgments and to identify the factors contributing to perceived risks. An exploratory model was created to investigate the public’s risk judgments. In this model, the relationship between laypeople’s perceived risks and the factors related to the physical nature of risks (such as perceived probability of environmental contamination, probability of receiving impacts, and severity of catastrophic consequences) were examined by means of multiple regression analysis. Psychological factors, such as the ability to control the risks, concerns, experiences, and perceived benefits of industrial development were also included in the analysis. The Maptaphut industrial area in Rayong Province, Thailand was selected as a case study. A survey of 181 residents of communities experiencing different levels of hazardous gas contamination revealed rational risk judgments by inhabitants of high-risk and moderate-risk communities, based on their perceived probability of contamination, probability of receiving impacts, and perceived catastrophic consequences. However, risks assessed by people in low-risk communities could not be rationally explained and were influenced by their collective experiences. Full article
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Open AccessArticle
Microbial Community Structures and Dynamics in the O3/BAC Drinking Water Treatment Process
Int. J. Environ. Res. Public Health 2014, 11(6), 6281-6290; https://doi.org/10.3390/ijerph110606281 - 16 Jun 2014
Cited by 11 | Viewed by 2449
Abstract
Effectiveness of drinking water treatment, in particular pathogen control during the water treatment process, is always a major public health concern. In this investigation, the application of PCR-DGGE technology to the analysis of microbial community structures and dynamics in the drinking water treatment [...] Read more.
Effectiveness of drinking water treatment, in particular pathogen control during the water treatment process, is always a major public health concern. In this investigation, the application of PCR-DGGE technology to the analysis of microbial community structures and dynamics in the drinking water treatment process revealed several dominant microbial populations including: α-Proteobacteria, β-Proteobacteria, γ-Proteobacteria, Bacteroidetes, Actinobacteria Firmicutes and Cyanobacteria. α-Proteobacteria and β-Proteobacteria were the dominant bacteria during the whole process. Bacteroidetes and Firmicutes were the dominant bacteria before and after treatment, respectively. Firmicutes showed season-dependent changes in population dynamics. Importantly, γ-Proteobacteria, which is a class of medically important bacteria, was well controlled by the O3/biological activated carbon (BAC) treatment, resulting in improved effluent water bio-safety. Full article
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Open AccessArticle
Protecting Health from Climate Change in the WHO European Region
Int. J. Environ. Res. Public Health 2014, 11(6), 6265-6280; https://doi.org/10.3390/ijerph110606265 - 16 Jun 2014
Cited by 11 | Viewed by 3083
Abstract
“How far are we in implementing climate change and health action in the WHO European Region?” This was the question addressed to representatives of WHO European Member States of the working group on health in climate change (HIC). Twenty-two Member States provided answers [...] Read more.
“How far are we in implementing climate change and health action in the WHO European Region?” This was the question addressed to representatives of WHO European Member States of the working group on health in climate change (HIC). Twenty-two Member States provided answers to a comprehensive questionnaire that focused around eight thematic areas (Governance; Vulnerability, impact and adaptation (health) assessments; Adaptation strategies and action plans; Climate change mitigation; Strengthening health systems; Raising awareness and building capacity; Greening health services; and Sharing best practices). Strong areas of development are climate change vulnerability and impact assessments, as well as strengthening health systems and awareness raising. Areas where implementation would benefit from further action are the development of National Health Adaptation Plans, greening health systems, sharing best practice and reducing greenhouse gas emissions in other sectors. At the Parma Conference in 2010, the European Ministerial Commitment to Act on climate change and health and the European Regional Framework for Action to protect health from climate change were endorsed by fifty three European Member States. The results of this questionnaire are the most comprehensive assessment so far of the progress made by WHO European Member States to protecting public health from climate change since the agreements in Parma and the World Health Assembly Resolution in 2008. Full article
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Open AccessArticle
The Deployment of Carbon Monoxide Wireless Sensor Network (CO-WSN) for Ambient Air Monitoring
Int. J. Environ. Res. Public Health 2014, 11(6), 6246-6264; https://doi.org/10.3390/ijerph110606246 - 16 Jun 2014
Cited by 9 | Viewed by 2462
Abstract
Wireless sensor networks are becoming increasingly important as an alternative solution for environment monitoring because they can reduce cost and complexity. Also, they can improve reliability and data availability in places where traditional monitoring methods are difficult to site. In this study, a [...] Read more.
Wireless sensor networks are becoming increasingly important as an alternative solution for environment monitoring because they can reduce cost and complexity. Also, they can improve reliability and data availability in places where traditional monitoring methods are difficult to site. In this study, a carbon monoxide wireless sensor network (CO-WSN) was developed to measure carbon monoxide concentrations at a major traffic intersection near the University of Cincinnati main campus. The system has been deployed over two weeks during Fall 2010, and Summer 2011–2012, traffic data was also recorded by using a manual traffic counter and a video camcorder to characterize vehicles at the intersection 24 h, particularly, during the morning and evening peak hour periods. According to the field test results, the 1 hr-average CO concentrations were found to range from 0.1–1.0 ppm which is lower than the National Ambient Air Quality Standards (NAAQS) 35 ppm on a one-hour averaging period. During rush hour periods, the traffic volume at the intersection varied from 2,067 to 3,076 vehicles per hour with 97% being passenger vehicles. Furthermore, the traffic volume based on a 1-h average showed good correlation (R2 = 0.87) with the 1-h average CO-WSN concentrations for morning and evening peak time periods whereas CO-WSN results provided a moderate correlation (R2 = 0.42) with 24 hours traffic volume due to fluctuated changes of meteorological conditions. It is concluded that the performance and the reliability of wireless ambient air monitoring networks can be used as an alternative method for real time air monitoring. Full article
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Open AccessArticle
Patients’ Perspective of the Design of Provider-Patients Electronic Communication Services
Int. J. Environ. Res. Public Health 2014, 11(6), 6231-6245; https://doi.org/10.3390/ijerph110606231 - 12 Jun 2014
Cited by 2 | Viewed by 2216
Abstract
Information Delivery is one the most important tasks in healthcare practice. This article discusses patient’s tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also [...] Read more.
Information Delivery is one the most important tasks in healthcare practice. This article discusses patient’s tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also described. The architecture and the methodology for the healthcare service portal are set out in the proposed system design. Full article
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Open AccessArticle
A Study of Handling Cytotoxic Drugs and Risk of Birth Defects in Offspring of Female Veterinarians
Int. J. Environ. Res. Public Health 2014, 11(6), 6216-6230; https://doi.org/10.3390/ijerph110606216 - 12 Jun 2014
Cited by 4 | Viewed by 3064
Abstract
We examined the association of occupational exposure to handling cytotoxic drugs at work with risk of birth defects among a cohort of female veterinarians. This study is a follow up survey of 321 female participants (633 pregnancies) who participated in the Health Risks [...] Read more.
We examined the association of occupational exposure to handling cytotoxic drugs at work with risk of birth defects among a cohort of female veterinarians. This study is a follow up survey of 321 female participants (633 pregnancies) who participated in the Health Risks of Australian Veterinarian project. Data on pregnancies and exposure during each pregnancy was obtained by self-administered mailed questionnaire. Female veterinarians handling cytotoxic drugs during their pregnancy had a two-fold increased risk of birth defects in their offspring (RR = 2.08, 95% CI (1.05–4.15)). Results were consistent in subgroup analysis of those who graduated during the period of 1961 to 1980 (RR = 5.04, 95% CI (1.81, 14.03) and in those working specifically in small and large animal practice. There was no increased risk in the subgroup that graduated after 1980. Women with unplanned pregnancies were more likely to handle cytotoxic drugs on a daily basis (RR = 1.86, 95% CI, 1.00–3.48) and had a higher increased risk of birth defects than those who planned their pregnancies in recent graduates and in those who worked specifically in small animal practice (RR = 2.53, 95% CI, 1.18–5.42). This study suggests that the adverse effects of handling cytotoxic drugs in pregnant women may include an increased risk of birth defects. Pregnancy intention status is an important health behavior and should be considered in prenatal programs. Full article
Open AccessArticle
Dietary Phthalate Exposure in Pregnant Women and the Impact of Consumer Practices
Int. J. Environ. Res. Public Health 2014, 11(6), 6193-6215; https://doi.org/10.3390/ijerph110606193 - 12 Jun 2014
Cited by 27 | Viewed by 2850
Abstract
Phthalates are ubiquitous endocrine-disrupting chemicals that are contaminants in food and contribute to significant dietary exposures. We examined associations between reported consumption of specific foods and beverages and first trimester urinary phthalate metabolite concentrations in 656 pregnant women within a multicenter cohort study, [...] Read more.
Phthalates are ubiquitous endocrine-disrupting chemicals that are contaminants in food and contribute to significant dietary exposures. We examined associations between reported consumption of specific foods and beverages and first trimester urinary phthalate metabolite concentrations in 656 pregnant women within a multicenter cohort study, The Infant Development and Environment Study (TIDES), using multivariate regression analysis. We also examined whether reported use of ecofriendly and chemical-free products was associated with lower phthalate biomarker levels in comparison to not following such practices. Consumption of one additional serving of dairy per week was associated with decreases of 1% in the sum of di-2-ethylhexyl phthalate (DEHP) metabolite levels (95% CI: −2.0, −0.2). Further, participants who reported sometimes eating homegrown food had monoisobutyl phthalate (MiBP) levels that were 16.6% lower (95% CI: −29.5, −1.3) in comparison to participants in the rarely/never category. In contrast to rarely/never eating frozen fruits and vegetables, participants who reported sometimes following this practice had monobenzyl phthalate (MBzP) levels that were 21% higher (95% CI: 3.3, 41.7) than rarely/ever respondents. Future study on prenatal dietary phthalate exposure and the role of consumer product choices in reducing such exposure is needed. Full article
Open AccessArticle
Engaging with Peri-Urban Woodlands in England: The Contribution to People’s Health and Well-Being and Implications for Future Management
Int. J. Environ. Res. Public Health 2014, 11(6), 6171-6192; https://doi.org/10.3390/ijerph110606171 - 12 Jun 2014
Cited by 11 | Viewed by 3297
Abstract
In this paper we engage with debates concerning people and their contact with the natural environment as part of everyday life drawing on Irwin’s ideas of co-construction and Gibson’s theory of affordances. We focus on peri-urban woodlands in England as important places where [...] Read more.
In this paper we engage with debates concerning people and their contact with the natural environment as part of everyday life drawing on Irwin’s ideas of co-construction and Gibson’s theory of affordances. We focus on peri-urban woodlands in England as important places where people can interact with nature for health and well-being. Qualitative data were collected in situ via walks in the woods, focus group discussions and photo elicitation, with a sample of 49 people. These methods provide rich data on the wide range of meanings associated with woodlands that can have a perceived impact on people’s health and well-being. The findings link to contemporary debates about health, well-being and ecosystem services. We explore the inter-play between attributes of the physical environment and the range of facilities provided to enable access, social interactions and the benefits people attribute to their woodland experiences. We conclude that peri-urban woodlands can clearly contribute to self-reported health and well-being in multiple ways, and that organized activities can be important for those who face barriers to accessing woodlands. A strong message emerging from the research is the opportunity afforded by woodlands for social connections with others, as well as the provision of a range of sensory benefits and opportunities to observe and enjoy seasonal change in woodlands. Mental restoration via connection with nature also emerged as important, confirming previous research. Full article
(This article belongs to the Special Issue Health Benefits of Nature)
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Open AccessArticle
Quality of Water and Antibiotic Resistance of Escherichia coli from Water Sources of Hilly Tribal Villages with and without Integrated Watershed Management—A One Year Prospective Study
Int. J. Environ. Res. Public Health 2014, 11(6), 6156-6170; https://doi.org/10.3390/ijerph110606156 - 12 Jun 2014
Cited by 6 | Viewed by 2625
Abstract
In many hilly tribal areas of the world, water scarcity is a major problem and diarrhoea is common. Poor quality of water also affects the environment. An integrated watershed management programme (IWMP) aims to increase availability of water and to improve life conditions. [...] Read more.
In many hilly tribal areas of the world, water scarcity is a major problem and diarrhoea is common. Poor quality of water also affects the environment. An integrated watershed management programme (IWMP) aims to increase availability of water and to improve life conditions. Globally, there is a lack of information on water contamination, occurrence of diarrhoea and antibiotic resistance, a serious global concern, in relation to IWMP in hilly tribal areas. Therefore, a prospective observational study was conducted during 2011–2012 in six villages in a hilly tribal belt of India, three with and three without implementation of an IWMP, to explore quality of water, diarrhoeal cases in the community and antibiotic resistance of Escherichia coli from water sources. The results showed that physico-chemical quality of water was within limits of safe consumption in all samples. The odds of coliform contamination in water samples was 2.3 times higher in non-watershed management villages (NWMV) compared to integrated watershed management villages (IWMV) (95% CI 0.8–6.45, p = 0.081). The number of diarrhoeal cases (18/663 vs. 42/639, p < 0.05) was lower in IWMV as compared to NWMV. Overall E. coli isolates showed high susceptibility to antibiotics. Resistance to a wider range of antibiotics was observed in NWMV. Full article
Open AccessArticle
Parity, Age at First Birth, and Risk of Death from Asthma: Evidence from a Cohort in Taiwan
Int. J. Environ. Res. Public Health 2014, 11(6), 6147-6155; https://doi.org/10.3390/ijerph110606147 - 11 Jun 2014
Cited by 3 | Viewed by 2153
Abstract
This study was undertaken to examine whether there is an association between age at first birth and parity and risk of asthma death. The study cohort consisted of 1,292,462 women in Taiwan who had a first live birth between 1 January 1978 and [...] Read more.
This study was undertaken to examine whether there is an association between age at first birth and parity and risk of asthma death. The study cohort consisted of 1,292,462 women in Taiwan who had a first live birth between 1 January 1978 and 31 December 1987. We tracked each woman from the date of their first childbirth to 31 December 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate hazard ratios of death from asthma associated with parity and age at first birth. A trend of increasing risk of asthma death was seen with increasing age at first birth. The adjusted hazard ratio was 0.75 (95% confidence interval (CI) = 0.53–1.08) among women with two live births and 0.53 (95% CI = 0.36–0.78) among those with three or more births, compared with women who had one live birth. There was a significant decreasing trend in adjusted hazard ratios of asthma death with increasing parity. This study is the first to provide evidences to support an association between reproductive factors (parity and early age at first birth) and the risk of asthma death. Full article
Open AccessReview
Genetic Epidemiology and Preventive Healthcare in Multiethnic Societies: The Hemoglobinopathies
Int. J. Environ. Res. Public Health 2014, 11(6), 6136-6146; https://doi.org/10.3390/ijerph110606136 - 11 Jun 2014
Cited by 18 | Viewed by 2729 | Correction
Abstract
Healthy carriers of severe Hemoglobinopathies are usually asymptomatic and only efficiently detected through screening campaigns. Based upon epidemiological data, screenings have been offered for decades to populations of endemic Southern Europe for primary prevention of Thalassemia Major, while for many populations of the [...] Read more.
Healthy carriers of severe Hemoglobinopathies are usually asymptomatic and only efficiently detected through screening campaigns. Based upon epidemiological data, screenings have been offered for decades to populations of endemic Southern Europe for primary prevention of Thalassemia Major, while for many populations of the highly endemic African and Asian countries prevention for Sickle Cell Disease and Thalassemia Major is mainly unavailable. The massive migrations of the last decades have brought many healthy carriers of these diseases to live and reproduce in non-endemic immigration areas changing the epidemiological pattern of the local recessive diseases and bringing an urgent need for treatment and primary prevention in welfare countries. Nonetheless, no screening for an informed reproductive choice is actively offered by the healthcare systems of most of these welfare countries. As a consequence more children affected with severe Hemoglobinopathies are born today in the immigration countries of Northern Europe than in the endemic Southern European area. Following the Mediterranean example, some countries like the UK and The Netherlands have been offering early pregnancy carrier screening at different levels and/or in specific areas but more accessible measures need to be taken at the national level in all immigration countries. Identification of carriers using simple and inexpensive methods should be included in the Rhesus and infectious diseases screening which is offered early in pregnancy in most developed countries. This would allow identification of couples at risk in time for an informed choice and for prenatal diagnosis if required before the first affected child is born. Full article
(This article belongs to the Special Issue Genetic Epidemiology)
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Open AccessArticle
Water Quality of a Reservoir and Its Major Tributary Located in East-Central Mexico
Int. J. Environ. Res. Public Health 2014, 11(6), 6119-6135; https://doi.org/10.3390/ijerph110606119 - 10 Jun 2014
Cited by 8 | Viewed by 2368
Abstract
A reservoir with ecological and economic importance and its major tributary, localized in east-central Mexico, were studied. The aim of this work was to know the physicochemical water characteristics of both water bodies and to contrast these by their different uses, and also [...] Read more.
A reservoir with ecological and economic importance and its major tributary, localized in east-central Mexico, were studied. The aim of this work was to know the physicochemical water characteristics of both water bodies and to contrast these by their different uses, and also estimate overall water quality using a Water Quality Index (WQI). Water samples from the reservoir and the tributary were obtained in different climatic seasons. In the tributary, anoxic and hypoxic conditions and high levels of organic matter, orthophosphate, and ammonium showed that this is strongly impacted by wastewater discharges and that the water is not suitable for different uses; independently of the season, the WQI showed “poor” quality (34.4–47.2). In contrast, in the reservoir a better water quality was determined; the WQI in the sampling months ranged from 72.1–76.6 (“good” quality), and spatially, this was from 66.5–79.5 (“fair” and “good” quality). Full article
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