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Int. J. Environ. Res. Public Health, Volume 12, Issue 5 (May 2015) , Pages 4481-5684

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Open AccessReview
Triclosan: Current Status, Occurrence, Environmental Risks and Bioaccumulation Potential
Int. J. Environ. Res. Public Health 2015, 12(5), 5657-5684; https://doi.org/10.3390/ijerph120505657 - 22 May 2015
Cited by 135 | Viewed by 9280
Abstract
Triclosan (TCS) is a multi-purpose antimicrobial agent used as a common ingredient in everyday household personal care and consumer products. The expanded use of TCS provides a number of pathways for the compound to enter the environment and it has been detected in [...] Read more.
Triclosan (TCS) is a multi-purpose antimicrobial agent used as a common ingredient in everyday household personal care and consumer products. The expanded use of TCS provides a number of pathways for the compound to enter the environment and it has been detected in sewage treatment plant effluents; surface; ground and drinking water. The physico-chemical properties indicate the bioaccumulation and persistence potential of TCS in the environment. Hence, there is an increasing concern about the presence of TCS in the environment and its potential negative effects on human and animal health. Nevertheless, scarce monitoring data could be one reason for not prioritizing TCS as emerging contaminant. Conventional water and wastewater treatment processes are unable to completely remove the TCS and even form toxic intermediates. Considering the worldwide application of personal care products containing TCS and inefficient removal and its toxic effects on aquatic organisms, the compound should be considered on the priority list of emerging contaminants and its utilization in all products should be regulated. Full article
(This article belongs to the Special Issue Emerging Contaminants in the Environment)
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Open AccessArticle
Development of an RF-EMF Exposure Surrogate for Epidemiologic Research
Int. J. Environ. Res. Public Health 2015, 12(5), 5634-5656; https://doi.org/10.3390/ijerph120505634 - 22 May 2015
Cited by 23 | Viewed by 2656
Abstract
Exposure assessment is a crucial part in studying potential effects of RF-EMF. Using data from the HERMES study on adolescents, we developed an integrative exposure surrogate combining near-field and far-field RF-EMF exposure in a single brain and whole-body exposure measure. Contributions from far-field [...] Read more.
Exposure assessment is a crucial part in studying potential effects of RF-EMF. Using data from the HERMES study on adolescents, we developed an integrative exposure surrogate combining near-field and far-field RF-EMF exposure in a single brain and whole-body exposure measure. Contributions from far-field sources were modelled by propagation modelling and multivariable regression modelling using personal measurements. Contributions from near-field sources were assessed from both, questionnaires and mobile phone operator records. Mean cumulative brain and whole-body doses were 1559.7 mJ/kg and 339.9 mJ/kg per day, respectively. 98.4% of the brain dose originated from near-field sources, mainly from GSM mobile phone calls (93.1%) and from DECT phone calls (4.8%). Main contributors to the whole-body dose were GSM mobile phone calls (69.0%), use of computer, laptop and tablet connected to WLAN (12.2%) and data traffic on the mobile phone via WLAN (6.5%). The exposure from mobile phone base stations contributed 1.8% to the whole-body dose, while uplink exposure from other people’s mobile phones contributed 3.6%. In conclusion, the proposed approach is considered useful to combine near-field and far-field exposure to an integrative exposure surrogate for exposure assessment in epidemiologic studies. However, substantial uncertainties remain about exposure contributions from various near-field and far-field sources. Full article
(This article belongs to the Special Issue Electromagnetic Fields and Health)
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Open AccessArticle
Estimation of Arsenic Intake from Drinking Water and Food (Raw and Cooked) in a Rural Village of Northern Chile. Urine as a Biomarker of Recent Exposure
Int. J. Environ. Res. Public Health 2015, 12(5), 5614-5633; https://doi.org/10.3390/ijerph120505614 - 22 May 2015
Cited by 13 | Viewed by 2863
Abstract
The aim of this study was to estimate both the contribution of drinking water and food (raw and cooked) to the total (t-As) and inorganic (i-As) arsenic intake and the exposure of inhabitants of Socaire, a rural village in Chile´s Antofagasta Region, by [...] Read more.
The aim of this study was to estimate both the contribution of drinking water and food (raw and cooked) to the total (t-As) and inorganic (i-As) arsenic intake and the exposure of inhabitants of Socaire, a rural village in Chile´s Antofagasta Region, by using urine as biomarker. The i-As intake from food and water was estimated using samples collected between November 2008 and September 2009. A 24-hour dietary recall questionnaire was given to 20 participants. Drinking water, food (raw and cooked) and urine samples were collected directly from the homes where the interviewees lived. The percentage of i-As/t-As in the drinking water that contributed to the total intake was variable (26.8–92.9). Cereals and vegetables are the food groups that contain higher concentrations of i-As. All of the participants interviewed exceeded the reference intake FAO/OMS (149.8 µg∙i-As·day−1) by approximately nine times. The concentration of t-As in urine in each individual ranged from 78 to 459 ng·mL−1. Estimated As intake from drinking water and food was not associated with total urinary As concentration. The results show that both drinking water and food substantially contribute to i-As intake and an increased exposure risk to adult residents in contaminated areas. Full article
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Open AccessArticle
Season of Birth, Sex and Sleep Timing Preferences
Int. J. Environ. Res. Public Health 2015, 12(5), 5603-5613; https://doi.org/10.3390/ijerph120505603 - 22 May 2015
Viewed by 2554
Abstract
Objective: To evaluate whether the season of birth and sex are associated with preferences for bedtime among Chinese adults. Methods: A national population-based study on sleep preferences was conducted among Chinese in 2008. A questionnaire was used to collect information on [...] Read more.
Objective: To evaluate whether the season of birth and sex are associated with preferences for bedtime among Chinese adults. Methods: A national population-based study on sleep preferences was conducted among Chinese in 2008. A questionnaire was used to collect information on the sleep time of Chinese adults. Analysis of covariance was used to examine the relationship between season of birth and preferences for bedtime. Two sets of potential confounders were used in the adjusted models. Model 1 adjusted for age. Model 2 additionally adjusted for area, occupation, education level, smoking, and drinking. Participants and Measurements: The questionnaire was administered to a sample of 3959 Chinese adults. Results: Men had a higher delayed mean sleep onset and offset time (22:38 and 6:32) than women (22:18 and 6:25). Men also slept for a shorter duration compared to women (7 h 54 min vs. 8 h 7 min). Women born in fall had the latest sleep onset time sleep offset time (22:23/6:30), compared to their counterparts born in winter. These associations were attenuated by additional adjustments of more confounders. Conclusions: There were significant differences in sleep timing preferences between men and women. Season of birth was not associated with sleep timing in Chinese adults. Full article
Open AccessArticle
Modeling Flows and Concentrations of Nine Engineered Nanomaterials in the Danish Environment
Int. J. Environ. Res. Public Health 2015, 12(5), 5581-5602; https://doi.org/10.3390/ijerph120505581 - 22 May 2015
Cited by 87 | Viewed by 3281
Abstract
Predictions of environmental concentrations of engineered nanomaterials (ENM) are needed for their environmental risk assessment. Because analytical data on ENM-concentrations in the environment are not yet available, exposure modeling represents the only source of information on ENM exposure in the environment. This work [...] Read more.
Predictions of environmental concentrations of engineered nanomaterials (ENM) are needed for their environmental risk assessment. Because analytical data on ENM-concentrations in the environment are not yet available, exposure modeling represents the only source of information on ENM exposure in the environment. This work provides material flow data and environmental concentrations of nine ENM in Denmark. It represents the first study that distinguishes between photostable TiO2 (as used in sunscreens) and photocatalytic TiO2 (as used in self-cleaning surfaces). It also provides first exposure estimates for quantum dots, carbon black and CuCO3. Other ENM that are covered are ZnO, Ag, CNT and CeO2. The modeling is based for all ENM on probability distributions of production, use, environmental release and transfer between compartments, always considering the complete life-cycle of products containing the ENM. The magnitude of flows and concentrations of the various ENM depends on the one hand on the production volume but also on the type of products they are used in and the life-cycles of these products and their potential for release. The results reveal that in aquatic systems the highest concentrations are expected for carbon black and photostable TiO2, followed by CuCO3 (under the assumption that the use as wood preservative becomes important). In sludge-treated soil highest concentrations are expected for CeO2 and TiO2. Transformation during water treatments results in extremely low concentrations of ZnO and Ag in the environment. The results of this study provide valuable environmental exposure information for future risk assessments of these ENM. Full article
(This article belongs to the Special Issue Environmental Fate and Effect of Nanoparticles and Nanomaterials)
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Open AccessArticle
Do Neighborhood Characteristics in Amsterdam Influence Adiposity at Preschool Age?
Int. J. Environ. Res. Public Health 2015, 12(5), 5561-5580; https://doi.org/10.3390/ijerph120505561 - 22 May 2015
Cited by 5 | Viewed by 2187
Abstract
Background: Neighborhood characteristics may contribute to adiposity in young children, but results in the current literature are inconsistent. This study aimed to investigate whether objective (socioeconomic status (SES)) and subjective (perceived safety, satisfaction with green spaces and perceived physical disorder) neighborhood characteristics directly [...] Read more.
Background: Neighborhood characteristics may contribute to adiposity in young children, but results in the current literature are inconsistent. This study aimed to investigate whether objective (socioeconomic status (SES)) and subjective (perceived safety, satisfaction with green spaces and perceived physical disorder) neighborhood characteristics directly influence child adiposity (as measured by BMI, percent body fat (%BF) and waist-to-height ratio (WHtR)). Methods: Data on child BMI, %BF and WHtR were obtained from the Amsterdam Born Children and their Development cohort at 5–6 years of age. Three thousand four hundred and sixty nine (3469) children were included in the analyses. Mixed models, using random intercepts for postal code area to account for neighborhood clustering effects, were used to analyze the relationships of interest. Results: Associations were observed for both perceived safety and neighborhood SES with %BF after adjustment for maternal education and ethnicity. All relationships were eliminated with the inclusion of individual covariates and parental BMI into the models. Conclusions: In general, child adiposity at age 5–6 years was not independently associated with neighborhood characteristics, although a small relationship between child %BF and both neighborhood SES and perceived safety cannot be ruled out. At this young age, familial and individual factors probably play a more important role in influencing child adiposity than neighborhood characteristics. Full article
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Open AccessArticle
The Impact of Hurricane Katrina on Students’ Behavioral Disorder: A Difference-in-Difference Analysis
Int. J. Environ. Res. Public Health 2015, 12(5), 5540-5560; https://doi.org/10.3390/ijerph120505540 - 22 May 2015
Cited by 2 | Viewed by 2262
Abstract
Objective: The objective of this paper is to examine the impact of Hurricane Katrina on displaced students’ behavioral disorder. Methods: First, we determine displaced students’ likelihood of discipline infraction each year relative to non-evacuees using all K12 student records of the [...] Read more.
Objective: The objective of this paper is to examine the impact of Hurricane Katrina on displaced students’ behavioral disorder. Methods: First, we determine displaced students’ likelihood of discipline infraction each year relative to non-evacuees using all K12 student records of the U.S. state of Louisiana during the period of 2000–2008. Second, we investigate the impact of hurricane on evacuee students’ in-school behavior in a difference-in-difference framework. The quasi-experimental nature of the hurricane makes this framework appropriate with the advantage that the problem of endogeneity is of least concern and the causal effect of interest can be reasonably identified. Results: Preliminary analysis demonstrates a sharp increase in displaced students’ relative likelihood of discipline infraction around 2005 when the hurricane occurred. Further, formal difference-in-difference analysis confirms the results. To be specific, post Katrina, displaced students’ relative likelihood of any discipline infraction has increased by 7.3% whereas the increase in the relative likelihood for status offense, offense against person, offense against property and serious crime is 4%, 1.5%, 3.8% and 2.1%, respectively. Conclusion: When disasters occur, as was the case with Hurricane Katrina, in addition to assistance for adult evacuees, governments, in cooperation with schools, should also provide aid and assistance to displaced children to support their mental health and in-school behavior. Full article
(This article belongs to the Section Health Economics)
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Open AccessArticle
The Physical Activity Levels and Sedentary Behaviors of Latino Children in London (Ontario, Canada)
Int. J. Environ. Res. Public Health 2015, 12(5), 5528-5539; https://doi.org/10.3390/ijerph120505528 - 22 May 2015
Cited by 4 | Viewed by 2324
Abstract
Objective: To assess the physical activity and sedentary behaviors of a sample of Latino children in London, Ontario, Canada. Methods: Seventy-four Latino children (54.1% male; mean age = 11.4) completed self-report questionnaires related to physical activity and sedentary behaviors. A subset of children [...] Read more.
Objective: To assess the physical activity and sedentary behaviors of a sample of Latino children in London, Ontario, Canada. Methods: Seventy-four Latino children (54.1% male; mean age = 11.4) completed self-report questionnaires related to physical activity and sedentary behaviors. A subset of children (n = 64) wore Actical (Mini Mitter, Respironics) accelerometers for a maximum of four days. Results: Latino children self-reported moderate levels of physical activity (i.e., mean score of 2.8 on 5-point scale). Accelerometer data revealed that children spent an average of 50.0 min in moderate-to-vigorous physical activity (MVPA; 59.2 min on weekdays and 50.6 min on weekend days) and were sedentary for an average of 8.4 h (508.0 min) per day (533.5 min on weekdays and 497.7 min on weekend days). Children reported spending an average of 3.8 h (228 min) daily in front of screens—1.7 h (102 min) watching television, 1.2 h (72 min) on the computer, and 0.9 h (54 min) playing video games. Conclusions: This feasibility project provided a preliminary account of objectively measured daily physical activity and sedentary time among a sample of Latino children in Canada, as well as insight into the challenge of measuring these behaviors. Sedentary behavior reduction techniques should be explored and implemented in this young population, along with strategies to promote adherence to accelerometer protocols. Full article
Open AccessArticle
Detection of Emerging and Re-Emerging Pathogens in Surface Waters Close to an Urban Area
Int. J. Environ. Res. Public Health 2015, 12(5), 5505-5527; https://doi.org/10.3390/ijerph120505505 - 22 May 2015
Cited by 23 | Viewed by 3059 | Correction
Abstract
Current knowledge about the spread of pathogens in aquatic environments is scarce probably because bacteria, viruses, algae and their toxins tend to occur at low concentrations in water, making them very difficult to measure directly. The purpose of this study was the development [...] Read more.
Current knowledge about the spread of pathogens in aquatic environments is scarce probably because bacteria, viruses, algae and their toxins tend to occur at low concentrations in water, making them very difficult to measure directly. The purpose of this study was the development and validation of tools to detect pathogens in freshwater systems close to an urban area. In order to evaluate anthropogenic impacts on water microbiological quality, a phylogenetic microarray was developed in the context of the EU project µAQUA to detect simultaneously numerous pathogens and applied to samples from two different locations close to an urban area located upstream and downstream of Rome in the Tiber River. Furthermore, human enteric viruses were also detected. Fifty liters of water were collected and concentrated using a hollow-fiber ultrafiltration approach. The resultant concentrate was further size-fractionated through a series of decreasing pore size filters. RNA was extracted from pooled filters and hybridized to the newly designed microarray to detect pathogenic bacteria, protozoa and toxic cyanobacteria. Diatoms as indicators of the water quality status, were also included in the microarray to evaluate water quality. The microarray results gave positive signals for bacteria, diatoms, cyanobacteria and protozoa. Cross validation of the microarray was performed using standard microbiological methods for the bacteria. The presence of oral-fecal transmitted human enteric-viruses were detected using q-PCR. Significant concentrations of Salmonella, Clostridium, Campylobacter and Staphylococcus as well as Hepatitis E Virus (HEV), noroviruses GI (NoGGI) and GII (NoGII) and human adenovirus 41 (ADV 41) were found in the Mezzocammino site, whereas lower concentrations of other bacteria and only the ADV41 virus was recovered at the Castel Giubileo site. This study revealed that the pollution level in the Tiber River was considerably higher downstream rather than upstream of Rome and the downstream location was contaminated by emerging and re-emerging pathogens. Full article
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Open AccessArticle
Molecular Tools for the Selective Detection of Nine Diatom Species Biomarkers of Various Water Quality Levels
Int. J. Environ. Res. Public Health 2015, 12(5), 5485-5504; https://doi.org/10.3390/ijerph120505485 - 22 May 2015
Cited by 3 | Viewed by 2416
Abstract
Our understanding of the composition of diatom communities and their response to environmental changes is currently limited by laborious taxonomic identification procedures. Advances in molecular technologies are expected to contribute more efficient, robust and sensitive tools for the detection of these ecologically relevant [...] Read more.
Our understanding of the composition of diatom communities and their response to environmental changes is currently limited by laborious taxonomic identification procedures. Advances in molecular technologies are expected to contribute more efficient, robust and sensitive tools for the detection of these ecologically relevant microorganisms. There is a need to explore and test phylogenetic markers as an alternative to the use of rRNA genes, whose limited sequence divergence does not allow the accurate discrimination of diatoms at the species level. In this work, nine diatom species belonging to eight genera, isolated from epylithic environmental samples collected in central Italy, were chosen to implement a panel of diatoms covering the full range of ecological status of freshwaters. The procedure described in this work relies on the PCR amplification of specific regions in two conserved diatom genes, elongation factor 1-a (eEF1-a) and silicic acid transporter (SIT), as a first step to narrow down the complexity of the targets, followed by microarray hybridization experiments. Oligonucleotide probes with the potential to discriminate closely related species were designed taking into account the genetic polymorphisms found in target genes. These probes were tested, refined and validated on a small-scale prototype DNA chip. Overall, we obtained 17 highly specific probes targeting eEF1-a and SIT, along with 19 probes having lower discriminatory power recognizing at the same time two or three species. This basic array was validated in a laboratory setting and is ready for tests with crude environmental samples eventually to be scaled-up to include a larger panel of diatoms. Its possible use for the simultaneous detection of diatoms selected from the classes of water quality identified by the European Water Framework Directive is discussed. Full article
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Open AccessCorrection
Correction: Maachia, L.; et al. Assessment of the Petrochemical Industry Pollution on Skikda Bay, Algeria. Int. J. Environ. Res. Public Health 2005, 2, 463–468
Int. J. Environ. Res. Public Health 2015, 12(5), 5483-5484; https://doi.org/10.3390/ijerph120505483 - 21 May 2015
Viewed by 1596
Abstract
We wish to make the following changes to the published article [1], agreed upon by all authors: Leila Maachia has been added as co-author. [...] Full article
Open AccessArticle
Introducing Simple Detection of Bioavailable Arsenic at Rafaela (Santa Fe Province, Argentina) Using the ARSOlux Biosensor
Int. J. Environ. Res. Public Health 2015, 12(5), 5465-5482; https://doi.org/10.3390/ijerph120505465 - 21 May 2015
Cited by 7 | Viewed by 2931
Abstract
Numerous articles have reported the occurrence of arsenic in drinking water in Argentina, and the resulting health effects in severely affected regions of the country. Arsenic in drinking water in Argentina is largely naturally occurring due to elevated background content of the metalloid [...] Read more.
Numerous articles have reported the occurrence of arsenic in drinking water in Argentina, and the resulting health effects in severely affected regions of the country. Arsenic in drinking water in Argentina is largely naturally occurring due to elevated background content of the metalloid in volcanic sediments, although, in some regions, mining can contribute. While the origin of arsenic release has been discussed extensively, the problem of drinking water contamination has not yet been solved. One key step in progress towards mitigation of problems related with the consumption of As-containing water is the availability of simple detection tools. A chemical test kit and the ARSOlux biosensor were evaluated as simple analytical tools for field measurements of arsenic in the groundwater of Rafaela (Santa Fe, Argentina), and the results were compared with ICP-MS and HPLC-ICP-MS measurements. A survey of the groundwater chemistry was performed to evaluate possible interferences with the field tests. The results showed that the ARSOlux biosensor performed better than the chemical field test, that the predominant species of arsenic in the study area was arsenate and that arsenic concentration in the studied samples had a positive correlation with fluoride and vanadium, and a negative one with calcium and iron. Full article
(This article belongs to the Special Issue Arsenic in Drinking Water: Current Perspectives and Future Directions)
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Open AccessArticle
Gateway Effects: Why the Cited Evidence Does Not Support Their Existence for Low-Risk Tobacco Products (and What Evidence Would)
Int. J. Environ. Res. Public Health 2015, 12(5), 5439-5464; https://doi.org/10.3390/ijerph120505439 - 21 May 2015
Cited by 11 | Viewed by 5952
Abstract
It is often claimed that low-risk drugs still create harm because of “gateway effects”, in which they cause the use of a high-risk alternative. Such claims are popular among opponents of tobacco harm reduction, claiming that low-risk tobacco products (e.g., e-cigarettes, smokeless tobacco) [...] Read more.
It is often claimed that low-risk drugs still create harm because of “gateway effects”, in which they cause the use of a high-risk alternative. Such claims are popular among opponents of tobacco harm reduction, claiming that low-risk tobacco products (e.g., e-cigarettes, smokeless tobacco) cause people to start smoking, sometimes backed by empirical studies that ostensibly support the claim. However, these studies consistently ignore the obvious alternative causal pathways, particularly that observed associations might represent causation in the opposite direction (smoking causes people to seek low-risk alternatives) or confounding (the same individual characteristics increase the chance of using any tobacco product). Due to these complications, any useful analysis must deal with simultaneity and confounding by common cause. In practice, existing analyses seem almost as if they were designed to provide teaching examples about drawing simplistic and unsupported causal conclusions from observed associations. The present analysis examines what evidence and research strategies would be needed to empirically detect such a gateway effect, if there were one, explaining key methodological concepts including causation and confounding, examining the logic of the claim, identifying potentially useful data, and debunking common fallacies on both sides of the argument, as well as presenting an extended example of proper empirical testing. The analysis demonstrates that none of the empirical studies to date that are purported to show a gateway effect from tobacco harm reduction products actually does so. The observations and approaches can be generalized to other cases where observed association of individual characteristics in cross-sectional data could result from any of several causal relationships. Full article
(This article belongs to the Special Issue Methodological Innovations and Reflections-1)
Open AccessArticle
Spatial-Temporal Variations of Chlorophyll-a in the Adjacent Sea Area of the Yangtze River Estuary Influenced by Yangtze River Discharge
Int. J. Environ. Res. Public Health 2015, 12(5), 5420-5438; https://doi.org/10.3390/ijerph120505420 - 20 May 2015
Cited by 16 | Viewed by 2334
Abstract
Carrying abundant nutrition, terrigenous freshwater has a great impact on the spatial and temporal heterogeneity of phytoplankton in coastal waters. The present study analyzed the spatial-temporal variations of Chlorophyll-a (Chl-a) concentration under the influence of discharge from the Yangtze River, based on remotely [...] Read more.
Carrying abundant nutrition, terrigenous freshwater has a great impact on the spatial and temporal heterogeneity of phytoplankton in coastal waters. The present study analyzed the spatial-temporal variations of Chlorophyll-a (Chl-a) concentration under the influence of discharge from the Yangtze River, based on remotely sensed Chl-a concentrations. The study area was initially zoned to quantitatively investigate the spatial variation patterns of Chl-a. Then, the temporal variation of Chl-a in each zone was simulated by a sinusoidal curve model. The results showed that in the inshore waters, the terrigenous discharge was the predominant driving force determining the pattern of Chl-a, which brings the risk of red tide disasters; while in the open sea areas, Chl-a was mainly affected by meteorological factors. Furthermore, a diversity of spatial and temporal variations of Chl-a existed based on the degree of influences from discharge. The diluted water extended from inshore to the east of Jeju Island. This process affected the Chl-a concentration flowing through the area, and had a potential impact on the marine environment. The Chl-a from September to November showed an obvious response to the discharge from July to September with a lag of 1 to 2 months. Full article
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Open AccessArticle
Estimating the Dietary Intake of Breastfeeding Preterm Infants
Int. J. Environ. Res. Public Health 2015, 12(5), 5408-5419; https://doi.org/10.3390/ijerph120505408 - 20 May 2015
Cited by 1 | Viewed by 2217
Abstract
Aim: To determine how accurately the daily prescribed feed volume (mL/day) estimates the actual intake of breastfeeding preterm infants and to characterise the volume taken during a breastfeed at differing gestational and postmenstrual ages. Methods: A cross sectional study was conducted on preterm [...] Read more.
Aim: To determine how accurately the daily prescribed feed volume (mL/day) estimates the actual intake of breastfeeding preterm infants and to characterise the volume taken during a breastfeed at differing gestational and postmenstrual ages. Methods: A cross sectional study was conducted on preterm infants born <37 weeks gestation from two Australian neonatal units. To determine the volume taken in a 24-h period infants were weighed before and after each breastfeed. This volume was added to the charted intake to determine the total intake and then compared to the prescribed feed volume. Bland Altman analyses were used to assess the level of agreement between the two methods. Results: Fifty six infants were studied on 206 breastfeeding occasions. There was a small bias (27 mLs/day) but large 95% limits of agreement (–76 to 130 mL/day). The volume taken during a single breastfeed ranged from 0 to 101 mL (median 23 mL, IQR 9 to 31 mL) and was greater in more mature infants. Conclusions: Using the prescribed feed volume to estimate total intake has limited clinical utility for the individual infant, however the relatively small bias means that it may be useful within a population or for comparison between groups in which population means are compared. There was a large variation in volume taken during a breastfeed across all gestational and postmenstrual ages. Full article
(This article belongs to the Special Issue Breastfeeding and Infant Health)
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Open AccessAddendum
Addendum: Brousse, G.; et al. Alcohol Risk Reduction in France: A Modernised Approach Related to Alcohol Misuse Disorders. Int. J. Environ. Res. Public Health 2014, 11, 11664-11675
Int. J. Environ. Res. Public Health 2015, 12(5), 5406-5407; https://doi.org/10.3390/ijerph120505406 - 20 May 2015
Viewed by 1765
Abstract
The author would like to update “Conflicts of Interest” section of their previous publication [1] as follows:Conflicts of Interest Georges Brousse has received sponsorship to attend scientific meetings, speaker honoraria, and consultancy fees from Lundbeck and Merck-Lipha. Patrick Bendimerad received honoraria and [...] Read more.
The author would like to update “Conflicts of Interest” section of their previous publication [1] as follows:Conflicts of Interest Georges Brousse has received sponsorship to attend scientific meetings, speaker honoraria, and consultancy fees from Lundbeck and Merck-Lipha. Patrick Bendimerad received honoraria and travel reimbursements for conferences and consultancy by Lundbeck Laboratory and participated as a coinvestigator.in the multicenter investigational drug studies of Lundbeck. [...] Full article
Open AccessArticle
Comparative Cytotoxicity Study of Silver Nanoparticles (AgNPs) in a Variety of Rainbow Trout Cell Lines (RTL-W1, RTH-149, RTG-2) and Primary Hepatocytes
Int. J. Environ. Res. Public Health 2015, 12(5), 5386-5405; https://doi.org/10.3390/ijerph120505386 - 20 May 2015
Cited by 27 | Viewed by 3381
Abstract
Among all classes of nanomaterials, silver nanoparticles (AgNPs) have potentially an important ecotoxicological impact, especially in freshwater environments. Fish are particularly susceptible to the toxic effects of silver ions and, with knowledge gaps regarding the contribution of dissolution and unique particle effects to [...] Read more.
Among all classes of nanomaterials, silver nanoparticles (AgNPs) have potentially an important ecotoxicological impact, especially in freshwater environments. Fish are particularly susceptible to the toxic effects of silver ions and, with knowledge gaps regarding the contribution of dissolution and unique particle effects to AgNP toxicity, they represent a group of vulnerable organisms. Using cell lines (RTL-W1, RTH-149, RTG-2) and primary hepatocytes of rainbow trout (Oncorhynchus mykiss) as in vitro test systems, we assessed the cytotoxicity of the representative AgNP, NM-300K, and AgNO3 as an Ag+ ion source. Lack of AgNP interference with the cytotoxicity assays (AlamarBlue, CFDA-AM, NRU assay) and their simultaneous application point to the compatibility and usefulness of such a battery of assays. The RTH-149 and RTL-W1 liver cell lines exhibited similar sensitivity as primary hepatocytes towards AgNP toxicity. Leibovitz’s L-15 culture medium composition (high amino acid content) had an important influence on the behaviour and toxicity of AgNPs towards the RTL-W1 cell line. The obtained results demonstrate that, with careful consideration, such an in vitro approach can provide valuable toxicological data to be used in an integrated testing strategy for NM-300K risk assessment. Full article
(This article belongs to the Special Issue Environmental Fate and Effect of Nanoparticles and Nanomaterials)
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Open AccessArticle
Ethnic Differences in the Prevalence of High Homocysteine Levels Among Low-Income Rural Kazakh and Uyghur Adults in Far Western China and Its Implications for Preventive Public Health
Int. J. Environ. Res. Public Health 2015, 12(5), 5373-5385; https://doi.org/10.3390/ijerph120505373 - 19 May 2015
Cited by 6 | Viewed by 2207
Abstract
Objective: Homocysteine (Hcy) is a relevant biomarker of vascular disease: serum Hcy concentrations will increase the risk of systolic hypertension, whereas hyperhomocysteinemia (HHcy) has a synergistic effect with hypertension and increases the risk of cardiovascular disease. However, information has primarily been gathered [...] Read more.
Objective: Homocysteine (Hcy) is a relevant biomarker of vascular disease: serum Hcy concentrations will increase the risk of systolic hypertension, whereas hyperhomocysteinemia (HHcy) has a synergistic effect with hypertension and increases the risk of cardiovascular disease. However, information has primarily been gathered from high-income and urban settings, and little is known regarding low-income rural settings. This study focused on a low-income rural and nomadic minority residing in far western China. Hcy levels were tested, and the prevalences of HHcy and H-type hypertension were investigated in this population. Methods: This study used a stratified cluster random sampling method, selecting 2,180 individuals as subjects from Kazakh and Uyghur inhabitants (≥25 years old) of 18 villages in Xinjiang, China, which is approximately 4407 km from the capital, Beijing. Hcy levels were determined using a double reagent enzymatic cycling method. HHcy (Hcy > 10 μmol/L) was defined by the criteria of the American Heart Association. Results: The Kazakh geometrical mean of Hcy was 13.34 μmol/L, and the Uyghur mean was 13.75 μmol/L; the mean values were higher in males than in females of both ethnicities (15.99 μmol/L vs. 11.63 μmol/L; 15.71 μmol/L vs. 11.91 μmol/L, respectively, p < 0.01). The serum levels of Hcy increased with increasing age in both ethnicities, and except for Kazakh individuals >65 years old, Hcy serum levels were higher in males than in females in all age groups of both ethnicities, with a p value less than 0.01. The Kazakh prevalence of HHcy was 80.0%, and the Uyghur prevalence was 78.2%; the male prevalence was higher than that in females for both ethnicities (93.5% vs. 69.6%; 90.8% vs. 64.6%, respectively, p < 0.05). Among the Kazakh, the prevalence of hypertension was 35.1%, and the prevalence was higher in males than in females (44.3% vs. 28.1%, p < 0.001); 87.6% of the Kazakh individuals had H-type hypertension, and the prevalence was higher in males than in females (95.0% vs. 80.0%, p < 0.05). In Uyghur, the prevalence of hypertension was 30.6%, and the prevalence was higher in males than in females (37.9% vs. 22.8%, p < 0.001); 88.0% of the Uyghur individuals had H-type hypertension, and the prevalence was higher in males than in females (93.9% vs. 79.1%, p < 0.05). Conclusions: HHcy was found to be common among the Kazakh and Uyghur. The prevalences of HHcy and H-type hypertension were high among both ethnicities and differed depending on gender and age. Community interventions should be conducted to improve public health conditions among the Kazakh and Uyghur in Xinjiang. Full article
Open AccessArticle
Traffic, Air Pollution, Minority and Socio-Economic Status: Addressing Inequities in Exposure and Risk
Int. J. Environ. Res. Public Health 2015, 12(5), 5355-5372; https://doi.org/10.3390/ijerph120505355 - 19 May 2015
Cited by 23 | Viewed by 4417
Abstract
Higher levels of nearby traffic increase exposure to air pollution and adversely affect health outcomes. Populations with lower socio-economic status (SES) are particularly vulnerable to stressors like air pollution. We investigated cumulative exposures and risks from traffic and from MNRiskS-modeled air pollution in [...] Read more.
Higher levels of nearby traffic increase exposure to air pollution and adversely affect health outcomes. Populations with lower socio-economic status (SES) are particularly vulnerable to stressors like air pollution. We investigated cumulative exposures and risks from traffic and from MNRiskS-modeled air pollution in multiple source categories across demographic groups. Exposures and risks, especially from on-road sources, were higher than the mean for minorities and low SES populations and lower than the mean for white and high SES populations. Owning multiple vehicles and driving alone were linked to lower household exposures and risks. Those not owning a vehicle and walking or using transit had higher household exposures and risks. These results confirm for our study location that populations on the lower end of the socio-economic spectrum and minorities are disproportionately exposed to traffic and air pollution and at higher risk for adverse health outcomes. A major source of disparities appears to be the transportation infrastructure. Those outside the urban core had lower risks but drove more, while those living nearer the urban core tended to drive less but had higher exposures and risks from on-road sources. We suggest policy considerations for addressing these inequities. Full article
(This article belongs to the Special Issue Transport Impacts on Public Health)
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Open AccessArticle
Radio Hazard Safety Assessment for Marine Ship Transmitters: Measurements Using a New Data Collection Method and Comparison with ICNIRP and ARPANSA Limits
Int. J. Environ. Res. Public Health 2015, 12(5), 5338-5354; https://doi.org/10.3390/ijerph120505338 - 19 May 2015
Cited by 2 | Viewed by 2458
Abstract
We investigated the levels of radio frequency electromagnetic fields (RF EMFs) emitted from marine ship transmitters. In this study, we recorded the radio frequency (RF) electric field (EF) levels emitted from transmitters from a marine vessel focusing on the areas normally occupied by [...] Read more.
We investigated the levels of radio frequency electromagnetic fields (RF EMFs) emitted from marine ship transmitters. In this study, we recorded the radio frequency (RF) electric field (EF) levels emitted from transmitters from a marine vessel focusing on the areas normally occupied by crew members and passengers. Previous studies considered radiation hazard safety assessment for marine vessels with a limited number of transmitters, such as very high-frequency (VHF) transceivers, radar and communication transmitters. In our investigation, EF levels from seven radio transmitters were measured, including: VHF, medium frequency/high frequency (MF/HF), satellite communication (Sat-Com C), AISnavigation, radar X-band and radar S-band. Measurements were carried out in a 40 m-long, three-level ship (upper deck, bridge deck and bridge roof) at 12 different locations. We developed a new data-collection protocol and performed it under 11 different scenarios to observe and measure the radiation emissions from all of the transmitters. In total, 528 EF field measurements were collected and averaged over all three levels of the marine ship with RF transmitters: the measured electric fields were the lowest on the upper deck (0.82–0.86 V/m), the highest on the bridge roof (2.15–3.70 V/m) and in between on the bridge deck (0.47–1.15 V/m). The measured EF levels were then assessed for compliance with the occupational and general public reference levels of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) guidelines and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) standards. The ICNIRP and the ARPANSA limits for the general public were exceeded on the bridge roof; nevertheless, the occupational limits were respected everywhere. The measured EF levels, hence, complied with the ICNIRP guidelines and the ARPANSA standards. In this paper, we provide a new data collection model for future surveys, which could be conducted with larger samples to verify our observations. Furthermore, this new method could be useful as a reference for researchers and industry professionals without direct access to the necessary equipment. Full article
(This article belongs to the Special Issue Electromagnetic Fields and Health)
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Open AccessArticle
Elevated Serum Bisphenol A Level in Patients with Dilated Cardiomyopathy
Int. J. Environ. Res. Public Health 2015, 12(5), 5329-5337; https://doi.org/10.3390/ijerph120505329 - 19 May 2015
Cited by 5 | Viewed by 2517
Abstract
background: This study aimed to determine serum Bisphenol A (BPA) concentrations in patients with dilated cardiomyopathy (DCM) as well as the association between serum BPA and several hormonal parameters in DCM patients compared with a healthy control group. Materials and methods: Eighty-eight DCM [...] Read more.
background: This study aimed to determine serum Bisphenol A (BPA) concentrations in patients with dilated cardiomyopathy (DCM) as well as the association between serum BPA and several hormonal parameters in DCM patients compared with a healthy control group. Materials and methods: Eighty-eight DCM patients and 88 age- and gender-matched healthy controls were included. Serum BPA levels and several hormonal parameters (including total testosterone (T), sex hormone-binding globulin (SHBG) and estradiol (E2) were measured by using corresponding ELISA Kits. The free androgen index (FAI) was calculated by the formula: total T in nmol/L × 100/SHBG in nmol/L. Results: BPA levels in the total DCM group were significantly higher compared with that in the controls (6.9 ± 2.7 ng/mL vs. 3.8 ± 1.9 ng/mL, p < 0.001). Significant difference was also observed in SHBG and FAI between DCM patients and controls, (76.9 ± 30.9 nM/L vs. 41.0 ± 15.6 nM/L and 2.9 ± 3.5 vs.5.3 ± 2.6, respectively, both of p < 0.001). Similar trends were observed in the male and female subgroup. Mean T level was lower in DCM group than in control group (540.8 ± 186.0 pg/mL vs. 656.3 ± 112.9 pg/mL, p < 0.001). Linear regression analysis has shown that increasing serum BPA levels were statistically significantly associated with increased SHBG levels. However, no statistical difference was noted for E2. Conclusion: Our findings firstly demonstrated that BPA exposure increased in DCM patients compared with that in healthy controls, while FAI and T levels decreased. SHBG presented a positive association with BPA. It is concluded that hormone disorder induced by BPA exposure might be an environmental factor in the pathology of DCM. Full article
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Open AccessArticle
Adult Psychotic Symptoms, Their Associated Risk Factors and Changes in Prevalence in Men and Women Over a Decade in a Poor Rural District of Kenya
Int. J. Environ. Res. Public Health 2015, 12(5), 5310-5328; https://doi.org/10.3390/ijerph120505310 - 19 May 2015
Cited by 6 | Viewed by 2230
Abstract
There have been no repeat surveys of psychotic symptoms in Kenya or indeed subSaharan Africa. A mental health epidemiological survey was therefore conducted in a demographic surveillance site of a Kenyan household population in 2013 to test the hypothesis that the prevalence of [...] Read more.
There have been no repeat surveys of psychotic symptoms in Kenya or indeed subSaharan Africa. A mental health epidemiological survey was therefore conducted in a demographic surveillance site of a Kenyan household population in 2013 to test the hypothesis that the prevalence of psychotic symptoms would be similar to that found in an earlier sample drawn from the same sample frame in 2004, using the same overall methodology and instruments. This 2013 study found that the prevalence of one or more psychotic symptoms was 13.9% with one or more symptoms and 3.8% with two or more symptoms, while the 2004 study had found that the prevalence of single psychotic symptoms in rural Kenya was 8% of the adult population, but only 0.6% had two symptoms and none had three or more psychotic symptoms. This change was accounted for by a striking increase in psychotic symptoms in women (17.8% in 2013 compared with 6.9% in 2004, p < 0.001), whereas there was no significant change in men (10.6% in 2013 compared with 9.4% in 2004, p = 0.582). Potential reasons for this increase in rate of psychotic symptoms in women are explored. Full article
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Open AccessArticle
Principles Relevant to Health Research among Indigenous Communities
Int. J. Environ. Res. Public Health 2015, 12(5), 5304-5309; https://doi.org/10.3390/ijerph120505304 - 19 May 2015
Cited by 6 | Viewed by 2008
Abstract
Research within Indigenous communities has been criticised for lacking community engagement, for being exploitative, and for poorly explaining the processes of research. To address these concerns, and to ensure ‘best practice’, Jamieson, et al. (2012) recently published a summary of principles outlined [...] Read more.
Research within Indigenous communities has been criticised for lacking community engagement, for being exploitative, and for poorly explaining the processes of research. To address these concerns, and to ensure ‘best practice’, Jamieson, et al. (2012) recently published a summary of principles outlined by the NHMRC (2003) in “one short, accessible document”. Here we expand on Jamieson et al.’s paper, which while commendable, lacks emphasis on the contribution that communities themselves can make to the research process and how culturally appropriate engagement, can allow this contribution to be assured, specifically with respect to engagement with remote communities. Engagement started before the research proposal is put forward, and continued after the research is completed, has integrity. We emphasise the value of narratives, of understanding cultural and customary behaviours and leadership, the importance of cultural legitimacy, and of the need for time, not just to allow for delays, but to ensure genuine participatory engagement from all members of the community. We also challenge researchers to consider the outcomes of their research, on the basis that increasing clinical evidence does not always result in better outcomes for the community involved. Full article
Open AccessArticle
The Negative Affect Hypothesis of Noise Sensitivity
Int. J. Environ. Res. Public Health 2015, 12(5), 5284-5303; https://doi.org/10.3390/ijerph120505284 - 18 May 2015
Cited by 9 | Viewed by 2242
Abstract
Some studies indicate that noise sensitivity is explained by negative affect, a dispositional tendency to negatively evaluate situations and the self. Individuals high in such traits may report a greater sensitivity to other sensory stimuli, such as smell, bright light and pain. However, [...] Read more.
Some studies indicate that noise sensitivity is explained by negative affect, a dispositional tendency to negatively evaluate situations and the self. Individuals high in such traits may report a greater sensitivity to other sensory stimuli, such as smell, bright light and pain. However, research investigating the relationship between noise sensitivity and sensitivity to stimuli associated with other sensory modalities has not always supported the notion of a common underlying trait, such as negative affect, driving them. Additionally, other explanations of noise sensitivity based on cognitive processes have existed in the clinical literature for over 50 years. Here, we report on secondary analyses of pre-existing laboratory (n = 74) and epidemiological (n = 1005) data focusing on the relationship between noise sensitivity to and annoyance with a variety of olfactory-related stimuli. In the first study a correlational design examined the relationships between noise sensitivity, noise annoyance, and perceptual ratings of 16 odors. The second study sought differences between mean noise and air pollution annoyance scores across noise sensitivity categories. Results from both analyses failed to support the notion that, by itself, negative affectivity explains sensitivity to noise. Full article
(This article belongs to the Special Issue Sound and Health related Quality of Life)
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Open AccessReview
Heat Waves and Morbidity: Current Knowledge and Further Direction-A Comprehensive Literature Review
Int. J. Environ. Res. Public Health 2015, 12(5), 5256-5283; https://doi.org/10.3390/ijerph120505256 - 18 May 2015
Cited by 71 | Viewed by 3578
Abstract
In the past few decades, several devastating heat wave events have significantly challenged public health. As these events are projected to increase in both severity and frequency in the future, it is important to assess the relationship between heat waves and the health [...] Read more.
In the past few decades, several devastating heat wave events have significantly challenged public health. As these events are projected to increase in both severity and frequency in the future, it is important to assess the relationship between heat waves and the health indicators that can be used in the early warning systems to guide the public health response. Yet there is a knowledge gap in the impact of heat waves on morbidity. In this study, a comprehensive review was conducted to assess the relationship between heat waves and different morbidity indicators, and to identify the vulnerable populations. The PubMed and ScienceDirect database were used to retrieve published literature in English from 1985 to 2014 on the relationship between heat waves and morbidity, and the following MeSH terms and keywords were used: heat wave, heat wave, morbidity, hospital admission, hospitalization, emergency call, emergency medical services, and outpatient visit. Thirty-three studies were included in the final analysis. Most studies found a short-term negative health impact of heat waves on morbidity. The elderly, children, and males were more vulnerable during heat waves, and the medical care demand increased for those with existing chronic diseases. Some social factors, such as lower socioeconomic status, can contribute to heat-susceptibility. In terms of study methods and heat wave definitions, there remain inconsistencies and uncertainties. Relevant policies and guidelines need to be developed to protect vulnerable populations. Morbidity indicators should be adopted in heat wave early warning systems in order to guide the effective implementation of public health actions. Full article
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Open AccessArticle
Estimating Risks of Heat Strain by Age and Sex: A Population-Level Simulation Model
Int. J. Environ. Res. Public Health 2015, 12(5), 5241-5255; https://doi.org/10.3390/ijerph120505241 - 18 May 2015
Cited by 7 | Viewed by 2354
Abstract
Individuals living in hot climates face health risks from hyperthermia due to excessive heat. Heat strain is influenced by weather exposure and by individual characteristics such as age, sex, body size, and occupation. To explore the population-level drivers of heat strain, we developed [...] Read more.
Individuals living in hot climates face health risks from hyperthermia due to excessive heat. Heat strain is influenced by weather exposure and by individual characteristics such as age, sex, body size, and occupation. To explore the population-level drivers of heat strain, we developed a simulation model that scales up individual risks of heat storage (estimated using Myrup and Morgan’s man model “MANMO”) to a large population. Using Australian weather data, we identify high-risk weather conditions together with individual characteristics that increase the risk of heat stress under these conditions. The model identifies elevated risks in children and the elderly, with females aged 75 and older those most likely to experience heat strain. Risk of heat strain in males does not increase as rapidly with age, but is greatest on hot days with high solar radiation. Although cloudy days are less dangerous for the wider population, older women still have an elevated risk of heat strain on hot cloudy days or when indoors during high temperatures. Simulation models provide a valuable method for exploring population level risks of heat strain, and a tool for evaluating public health and other government policy interventions. Full article
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Open AccessArticle
Prevalence of Marijuana Use among University Students in Bolivia, Colombia, Ecuador, and Peru
Int. J. Environ. Res. Public Health 2015, 12(5), 5233-5240; https://doi.org/10.3390/ijerph120505233 - 15 May 2015
Cited by 7 | Viewed by 2701
Abstract
Young adults 18 to 25 years old show the highest prevalence of marijuana use in Latin America. This study analyzes the changes in prevalence of marijuana use among university students in the Andean Community (Bolivia, Colombia, Ecuador, and Peru) from two studies carried [...] Read more.
Young adults 18 to 25 years old show the highest prevalence of marijuana use in Latin America. This study analyzes the changes in prevalence of marijuana use among university students in the Andean Community (Bolivia, Colombia, Ecuador, and Peru) from two studies carried out in 2009 and in 2012. Data were collected through representative two-stage samples of universities and students in the Andean Community. An online survey was administered using a standardized questionnaire. Prevalence was calculated for lifetime, past year, and past month. Marijuana was the most widely used illicit substance consumed among university students, in 2009 and in 2012. Past month prevalence among university students in 2009 in Colombia was 5.27%, in Peru 1.00%, in Ecuador 1.68%, and in Bolivia 0.76%. Past month prevalence in 2012 in Colombia was 7.14%, in Ecuador 3.67%, in Peru 1.62%, and in Bolivia 1.45% in 2012. Among university students in the Andean Community, past month prevalence increased among both males and females between 2009 and 2012 in most countries. Marijuana continues to be the most commonly used illicit drug in Latin American countries. Increases in prevalence among young adults could have important implications for national drug policy. Full article
(This article belongs to the Special Issue Substance and Drug Abuse Prevention)
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Open AccessArticle
Are Metals Emitted from Electronic Cigarettes a Reason for Health Concern? A Risk-Assessment Analysis of Currently Available Literature
Int. J. Environ. Res. Public Health 2015, 12(5), 5215-5232; https://doi.org/10.3390/ijerph120505215 - 15 May 2015
Cited by 32 | Viewed by 13604
Abstract
Background: Studies have found that metals are emitted to the electronic cigarette (EC) aerosol. However, the potential health impact of exposure to such metals has not been adequately defined. The purpose of this study was to perform a risk assessment analysis, evaluating the [...] Read more.
Background: Studies have found that metals are emitted to the electronic cigarette (EC) aerosol. However, the potential health impact of exposure to such metals has not been adequately defined. The purpose of this study was to perform a risk assessment analysis, evaluating the exposure of electronic cigarette (EC) users to metal emissions based on findings from the published literature. Methods: Two studies were found in the literature, measuring metals emitted to the aerosol from 13 EC products. We estimated that users take on average 600 EC puffs per day, but we evaluated the daily exposure from 1200 puffs. Estimates of exposure were compared with the chronic Permissible Daily Exposure (PDE) from inhalational medications defined by the U.S. Pharmacopeia (cadmium, chromium, copper, lead and nickel), the Minimal Risk Level (MRL) defined by the Agency for Toxic Substances and Disease Registry (manganese) and the Recommended Exposure Limit (REL) defined by the National Institute of Occupational Safety and Health (aluminum, barium, iron, tin, titanium, zinc and zirconium). Results: The average daily exposure from 13 EC products was 2.6 to 387 times lower than the safety cut-off point of PDEs, 325 times lower than the safety limit of MRL and 665 to 77,514 times lower than the safety cut-off point of RELs. Only one of the 13 products was found to result in exposure 10% higher than PDE for one metal (cadmium) at the extreme daily use of 1200 puffs. Significant differences in emissions between products were observed. Conclusions: Based on currently available data, overall exposure to metals from EC use is not expected to be of significant health concern for smokers switching to EC use, but is an unnecessary source of exposure for never-smokers. Metal analysis should be expanded to more products and exposure can be further reduced through improvements in product quality and appropriate choice of materials. Full article
Open AccessArticle
Impulsivity and Reasons for Living Among African American Youth: A Risk-Protection Framework of Suicidal Ideation
Int. J. Environ. Res. Public Health 2015, 12(5), 5196-5214; https://doi.org/10.3390/ijerph120505196 - 15 May 2015
Cited by 6 | Viewed by 2418
Abstract
This study aims to explore the impact of specific facets of impulsivity as measured by the UPPS Impulsive Behavior Scale (UPPS), as well as reasons for living in predicting suicidal ideation among African American college-aged students. The incremental validity of each facet of [...] Read more.
This study aims to explore the impact of specific facets of impulsivity as measured by the UPPS Impulsive Behavior Scale (UPPS), as well as reasons for living in predicting suicidal ideation among African American college-aged students. The incremental validity of each facet of the UPPS interacting with reasons for living, a construct meant to buffer against risk for suicide, was explored in a sample of African American students (N = 130; ages 18–24). Results revealed significant interactions between reasons for living and two factors of impulsivity, (lack of) premeditation and sensation seeking. Higher levels of sensation seeking and lack of premeditation in conjunction with lower reasons for living was associated with increased suicidal ideation. Neither urgency nor (lack of) perseverance significantly interacted with reasons for living in association with suicidal ideation. These results suggest including elements of impulsivity, specifically sensation seeking and (lack of) premeditation, when screening for suicidal ideation among African American youth. Future investigations should continue to integrate factors of both risk and protection when determining risk for suicide. Full article
(This article belongs to the Special Issue Suicide Prevention among Youth)
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Open AccessArticle
Resistance of Stenotrophomonas maltophilia to Fluoroquinolones: Prevalence in a University Hospital and Possible Mechanisms
Int. J. Environ. Res. Public Health 2015, 12(5), 5177-5195; https://doi.org/10.3390/ijerph120505177 - 13 May 2015
Cited by 11 | Viewed by 2651
Abstract
Objective: The purpose of this study was to investigate the clinical distribution and genotyping of Stenotrophomonas maltophilia, its resistance to antimicrobial agents, and the possible mechanisms of this drug resistance. Methods: S. maltophilia isolates were collected from clinical specimens in [...] Read more.
Objective: The purpose of this study was to investigate the clinical distribution and genotyping of Stenotrophomonas maltophilia, its resistance to antimicrobial agents, and the possible mechanisms of this drug resistance. Methods: S. maltophilia isolates were collected from clinical specimens in a university hospital in Northwestern China during the period between 2010 and 2012, and were identified to the species level with a fully automated microbiological system. Antimicrobial susceptibility testing was performed for S. maltophilia with the Kirby-Bauer disc diffusion method. The minimal inhibitory concentrations (MICs) of norfloxacin, ofloxacin, chloramphenicol, minocycline, ceftazidime, levofloxacin and ciprofloxacin against S. maltophilia were assessed using the agar dilution method, and changes in the MIC of norfloxacin, ciprofloxacin and ofloxacin were observed after the addition of reserpine, an efflux pump inhibitor. Fluoroquinolone resistance genes were detected in S. maltophilia using a polymerase chain reaction (PCR) assay, and the expression of efflux pump smeD and smeF genes was determined using a quantitative fluorescent (QF)-PCR assay. Pulsed-field gel electrophoresis (PFGE) was employed to genotype identified S. maltophilia isolates. Results: A total of 426 S. maltophilia strains were isolated from the university hospital from 2010 to 2012, consisting of 10.1% of total non-fermentative bacteria. The prevalence of norfloxacin, ciprofloxacin and ofloxacin resistance was 32.4%, 21.9% and 13.2% in the 114 S. maltophilia isolates collected from 2012, respectively. Following reserpine treatment, 19 S. maltophilia isolates positive for efflux pump were identified, and high expression of smeD and smeF genes was detected in two resistant isolates. gyrA, parC, smeD, smeE and smeF genes were detected in all 114 S. maltophilia isolates, while smqnr gene was found in 25.4% of total isolates. Glu-Lys mutation (GAA-AAA) was detected at the 151th amino acid of the gyrA gene, while Gly-Arg mutation (GGC-CGC) was found at the 37th amino acid of the parC gene. However, no significant difference was observed in the prevalence of gyrA or parC mutation between fluoroquinolone-resistant and -susceptible isolates (p> 0.05). The smqnr gene showed 92% to 99% heterogenicity among the 14 S. maltophilia clinical isolates. PFGE of 29 smqnr gene-positive S. maltophilia clinical isolates revealed 25 PFGE genotypes and 28 subgenotypes. Conclusions: Monitoring the clinical distribution and antimicrobial resistance of S. maltophilia is of great significance for the clinical therapy of bacterial infections. Reserpine is effective to inhibit the active efflux of norfloxacin, ciprofloxacin and ofloxacin on S. maltophilia and reduce MIC of fluoroquinolones against the bacteria. The expression of efflux pump smeD and smeF genes correlates with the resistance of S. maltophilia to fluoroquinolones. Full article
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