International Journal of Environmental Research and Public Health

7196 KiB

Open AccessCommentary

The Potential Role of Neglected and Underutilised Crop Species as Future Crops under Water Scarce Conditions in Sub-Saharan Africa

by Pauline Chivenge^1,2,*,†, Tafadzwanashe Mabhaudhi^2,†

, Albert T. Modi²

and Paramu Mafongoya²

^† These authors contributed equally to this work.

¹ International Crops Research Institute for the Semi-Arid Tropics, P.O. Box 776, Bulawayo, Zimbabwe

² School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, P. Bag X01, Scottsville 3209, Pietermaritzburg, South Africa

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 5685-5711; https://doi.org/10.3390/ijerph120605685 - 26 May 2015

Cited by 317 | Viewed by 21716

Abstract

Modern agricultural systems that promote cultivation of a very limited number of crop species have relegated indigenous crops to the status of neglected and underutilised crop species (NUCS). The complex interactions of water scarcity associated with climate change and variability in sub-Saharan Africa [...] Read more.

Modern agricultural systems that promote cultivation of a very limited number of crop species have relegated indigenous crops to the status of neglected and underutilised crop species (NUCS). The complex interactions of water scarcity associated with climate change and variability in sub-Saharan Africa (SSA), and population pressure require innovative strategies to address food insecurity and undernourishment. Current research efforts have identified NUCS as having potential to reduce food and nutrition insecurity, particularly for resource poor households in SSA. This is because of their adaptability to low input agricultural systems and nutritional composition. However, what is required to promote NUCS is scientific research including agronomy, breeding, post-harvest handling and value addition, and linking farmers to markets. Among the essential knowledge base is reliable information about water utilisation by NUCS with potential for commercialisation. This commentary identifies and characterises NUCS with agronomic potential in SSA, especially in the semi-arid areas taking into consideration inter alia: (i) what can grow under water-scarce conditions, (ii) water requirements, and (iii) water productivity. Several representative leafy vegetables, tuber crops, cereal crops and grain legumes were identified as fitting the NUCS category. Agro-biodiversity remains essential for sustainable agriculture. Full article

(This article belongs to the Special Issue Proceeding of 'Ecosystems and Human Well-Being in the Transition towards Green Economy')

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677 KiB

Open AccessArticle

Road-Traffic Noise: Annoyance, Risk Perception, and Noise Sensitivity in the Finnish Adult Population

by Enembe Oku Okokon^*, Anu W. Turunen, Sari Ung-Lanki, Anna-Kaisa Vartiainen, Pekka Tiittanen and Timo Lanki

Department of Health Protection, National Institute for Health and Welfare, Neulaniementie 4, P.O. Box 95, FI-70701 Kuopio, Finland

Int. J. Environ. Res. Public Health 2015, 12(6), 5712-5734; https://doi.org/10.3390/ijerph120605712 - 26 May 2015

Cited by 86 | Viewed by 8504

Abstract

Exposure to road-traffic noise commonly engenders annoyance, the extent of which is determined by factors not fully understood. Our aim was to estimate the prevalence and determinants of road-traffic noise annoyance and noise sensitivity in the Finnish adult population, while comparing the perceptions [...] Read more.

Exposure to road-traffic noise commonly engenders annoyance, the extent of which is determined by factors not fully understood. Our aim was to estimate the prevalence and determinants of road-traffic noise annoyance and noise sensitivity in the Finnish adult population, while comparing the perceptions of road-traffic noise to exhausts as environmental health problems. Using a questionnaire that yielded responses from 1112 randomly selected adult Finnish respondents, we estimated road-traffic noise- and exhausts-related perceived exposures, health-risk perceptions, and self-reported annoyance on five-point scales, while noise sensitivity estimates were based on four questions. Determinants of noise annoyance and sensitivity were investigated using multivariate binary logistic regression and linear regression models, respectively. High or extreme noise annoyance was reported by 17% of respondents. Noise sensitivity scores approximated a Gaussian distribution. Road-traffic noise and exhausts were, respectively, considered high or extreme population-health risks by 22% and 27% of respondents. Knowledge of health risks from traffic noise, OR: 2.04 (1.09–3.82) and noise sensitivity, OR: 1.07 (1.00–1.14) were positively associated with annoyance. Knowledge of health risks (p < 0.045) and positive environmental attitudes (p < 000) were associated with higher noise sensitivity. Age and sex were associated with annoyance and sensitivity only in bivariate models. A considerable proportion of Finnish adults are highly annoyed by road-traffic noise, and perceive it to be a significant health risk, almost comparable to traffic exhausts. There is no distinct noise-sensitive population subgroup. Knowledge of health risks of road-traffic noise, and attitudinal variables are associated with noise annoyance and sensitivity. Full article

(This article belongs to the Special Issue The Combined Health Effects of Environmental Exposures)

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661 KiB

Open AccessArticle

Development of Primer Sets for Loop-Mediated Isothermal Amplification that Enables Rapid and Specific Detection of Streptococcus dysgalactiae, Streptococcus uberis and Streptococcus agalactiae

by Deguo Wang^1,† and Yanhong Liu^2,*,†

¹ Henan Postdoctoral Research Base, Food and Bioengineering College, Xuchang University, Xuchang 461000, China

² Molecular Characterization of Foodborne Pathogens Research Unit, Eastern Regional Research Center, Agricultural Research Service, U.S. Department of Agriculture, 600 East Mermaid Lane, Wyndmoor, PA 19038, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 5735-5742; https://doi.org/10.3390/ijerph120605735 - 26 May 2015

Cited by 10 | Viewed by 5115

Abstract

Streptococcus dysgalactiae, Streptococcus uberis and Streptococcus agalactiae are the three main pathogens causing bovine mastitis, with great losses to the dairy industry. Rapid and specific loop-mediated isothermal amplification methods (LAMP) for identification and differentiation of these three pathogens are not available. With [...] Read more.

Streptococcus dysgalactiae, Streptococcus uberis and Streptococcus agalactiae are the three main pathogens causing bovine mastitis, with great losses to the dairy industry. Rapid and specific loop-mediated isothermal amplification methods (LAMP) for identification and differentiation of these three pathogens are not available. With the 16S rRNA gene and 16S-23S rRNA intergenic spacers as targets, four sets of LAMP primers were designed for identification and differentiation of S. dysgalactiae, S. uberis and S. agalactiae. The detection limit of all four LAMP primer sets were 0.1 pg DNA template per reaction, the LAMP method with 16S rRNA gene and 16S-23S rRNA intergenic spacers as the targets can differentiate the three pathogens, which is potentially useful in epidemiological studies. Full article

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Open AccessArticle

Effects of Simulated Heat Waves with Strong Sudden Cooling Weather on ApoE Knockout Mice

by Shuyu Zhang¹, Zhengzhong Kuang² and Xiakun Zhang^3,*

¹ Hebei Provincial Meteorological Bureau, 178 Tiyu South Street, Shijiazhuang 050021, China

² School of Applied Meteorology, Nanjing University of Information Sciences and Technology, 219 Ningliu Road, Nanjing 210044, China

³ National Meteorological Centre, 46 Zhongguancun South Street, Beijing 100081, China

Int. J. Environ. Res. Public Health 2015, 12(6), 5743-5757; https://doi.org/10.3390/ijerph120605743 - 26 May 2015

Cited by 7 | Viewed by 4762

Abstract

This study analyzes the mechanism of influence of heat waves with strong sudden cooling on cardiovascular diseases (CVD) in ApoE−/− mice. The process of heat waves with strong sudden cooling was simulated with a TEM1880 meteorological-environment simulation chamber according to the data obtained [...] Read more.

This study analyzes the mechanism of influence of heat waves with strong sudden cooling on cardiovascular diseases (CVD) in ApoE−/− mice. The process of heat waves with strong sudden cooling was simulated with a TEM1880 meteorological-environment simulation chamber according to the data obtained at 5 a.m. of 19 June 2006 to 11 p.m. of 22 June 2006. Forty-eight ApoE−/− mice were divided into six blocks based on their weight. Two mice from each block were randomly assigned to control, heat wave, temperature drop, and rewarming temperature groups. The experimental groups were transferred into the climate simulator chamber for exposure to the simulated heat wave process with strong sudden temperature drop. After 55, 59, and 75 h of exposure, the experimental groups were successively removed from the chamber to monitor physiological indicators. Blood samples were collected by decollation, and the hearts were harvested in all groups. The levels of heat stress factors (HSP60, SOD, TNF, sICAM-1, HIF-1α), cold stress factors (NE, EPI), vasoconstrictor factors (ANGII, ET-1, NO), and four items of blood lipid (TC, TG, HDL-C, and LDL-C) were measured in each ApoE−/− mouse. Results showed that the heat waves increased the levels of heat stress factors except SOD decreased, and decreased the levels of vasoconstrictor factors and blood lipid factors except TC increased. The strong sudden temperature drop in the heat wave process increased the levels of cold stress factors, vasoconstrictor factors and four blood lipid items (except the level of HDL-C which decreased) and decreased the levels of heat stress factors (except the level of SOD which increased). The analysis showed that heat waves could enhance atherosclerosis of ApoE−/− mice. The strong sudden temperature drop during the heat wave process increased the plasma concentrations of NE and ANGII, which indicates SNS activation, and resulted in increased blood pressure. NE and ANGII are vasoconstrictors involved in systemic vasoconstriction especially in the superficial areas of the body and conducive to increased blood pressure. The increase in the blood lipid levels of TG, LDL-C, TC, and LDL-C/HDL-C further aggravated CVD. This paper explored the influence mechanism of the heat waves with sudden cooling on CVD in ApoE−/− mice. Full article

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Open AccessArticle

Are Women in Turkey Both Risks and Resources in Disaster Management?

by Özden Işık^1,2, Naşide Özer^3,*, Nurdan Sayın⁴, Afet Mishal⁵, Oğuz Gündoğdu⁴ and Ferhat Özçep⁴

¹ Istanbul Neighborhood Disaster Volunteers (MAG), Istanbul 34524, Turkey

² AFAD (Emergency and Disaster Management Department), Istanbul Governorship, Istanbul 34410, Turkey

³ Division of Seismology, Department of Geophysics, Istanbul University, Istanbul 34320, Turkey

⁴ Division of Earth Physics, Department of Geophysics, Istanbul University, Istanbul 34320, Turkey

⁵ Department of Health, Istanbul University, Istanbul 34740, Turkey

Int. J. Environ. Res. Public Health 2015, 12(6), 5758-5774; https://doi.org/10.3390/ijerph120605758 - 26 May 2015

Cited by 23 | Viewed by 15244

Abstract

From a global perspective, the universality of gender-related societal issues is particularly significant. Although gender inequality is considered a sociological problem, the large number of female victims in disasters warrants an assessment of disaster management sciences. In this article, related concepts are discussed [...] Read more.

From a global perspective, the universality of gender-related societal issues is particularly significant. Although gender inequality is considered a sociological problem, the large number of female victims in disasters warrants an assessment of disaster management sciences. In this article, related concepts are discussed based on their relevance sociologically and in disaster management to develop a common terminology and examine this complex topic, which is rooted in different social profiles and anthropological heterogeneity throughout the world. A brief history is discussed, and significant examples are provided from different disasters in Turkey to illustrate why a woman-oriented approach should be adopted when evaluating concepts of gender inequality. Observations of disasters have shown that it is important to apply international standards (humanitarian charter and minimum disaster response standards), especially during periods of response and rehabilitation. Relevant factors related to gender should be included in these standards, such as women’s health and hygiene, which will be discussed in more detail. A woman-based approach is designed in relation to two aspects: risks and resources. Thus, gender-sensitive methods of mitigating and preventing disasters are provided. The main purpose of the article is to contribute to the development of a universal culture that prioritizes gender in disaster management. Full article

(This article belongs to the Special Issue Gender and Geoethics in the Geosciences)

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Open AccessArticle

Polycyclic Aromatic Hydrocarbons in the Dagang Oilfield (China): Distribution, Sources, and Risk Assessment

by Haihua Jiao^1,2,†, Xiaoping Rui^2,3,†, Shanghua Wu^2,†, Zhihui Bai^2,*

, Xuliang Zhuang² and Zhanbin Huang⁴

^† These authors contributed equally to this work.

¹ Department of Biological Sciences and Technology, Changzhi University, Changzhi 046011, China

² Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China

³ College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China

⁴ School of Chemical and Environmental Engineering, China University of Mining and Technology-Beijing, Beijing 100083, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 5775-5791; https://doi.org/10.3390/ijerph120605775 - 26 May 2015

Cited by 25 | Viewed by 5699

Abstract

The levels of 16 polycyclic aromatic hydrocarbons (PAHs) were investigated in 27 upper layer (0–25 cm) soil samples collected from the Dagang Oilfield (China) in April 2013 to estimate their distribution, possible sources, and potential risks posed. The total concentrations of PAHs (∑PAHs) [...] Read more.

The levels of 16 polycyclic aromatic hydrocarbons (PAHs) were investigated in 27 upper layer (0–25 cm) soil samples collected from the Dagang Oilfield (China) in April 2013 to estimate their distribution, possible sources, and potential risks posed. The total concentrations of PAHs (∑PAHs) varied between 103.6 µg·kg⁻¹ and 5872 µg·kg⁻¹, with a mean concentration of 919.8 µg·kg⁻¹; increased concentrations were noted along a gradient from arable desert soil (mean 343.5 µg·kg⁻¹), to oil well areas (mean of 627.3 µg·kg⁻¹), to urban and residential zones (mean of 1856 µg·kg⁻¹). Diagnostic ratios showed diverse source of PAHs, including petroleum, liquid fossil fuels, and biomass combustion sources. Combustion sources were most significant for PAHs in arable desert soils and residential zones, while petroleum sources were a significant source of PAHs in oilfield areas. Based ontheir carcinogenity, PAHs were classified as carcinogenic (B) or not classified/non-carcinogenic (NB). The total concentrations of carcinogenic PAHs (∑BPAHs) varied from 13.3 µg·kg⁻¹ to 4397 µg·kg⁻¹ across all samples, with a mean concentration of 594.4 µg·kg⁻¹. The results suggest that oilfield soil is subject to a certain level of ecological environment risk. Full article

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Open AccessArticle

Development of a Quantitative Methodology to Assess the Impacts of Urban Transport Interventions and Related Noise on Well-Being

by Matthias Braubach^1,*, Myriam Tobollik², Pierpaolo Mudu¹, Rosemary Hiscock³

, Dimitris Chapizanis⁴, Denis A. Sarigiannis⁴, Menno Keuken⁵, Laura Perez^6,7 and Marco Martuzzi¹

¹ European Centre for Environment and Health, World Health Organization (WHO) Regional Office for Europe, Platz der Vereinten Nationen 1, 53113 Bonn, Germany

² Federal Environment Agency, Section II 1.6 Exposure Assessment and Environmental Health Indicators, 14195 Berlin, Germany

³ School of Geographical Sciences, University of Bristol, University Road, Bristol BS8 1SS, UK

⁴ Department of Chemical Engineering, Aristotle University of Thessaloniki, Environmental Engineering Laboratory, 54124 Thessaloniki, Greece

⁵ Netherlands Organisation for Applied Scientific Research (TNO), 3508 TA Utrecht, The Netherlands

⁶ Swiss Tropical and Public Health Institute, Socinstr. 57, 4002 Basel, Switzerland

⁷ University of Basel, Peterspl. 1, 4003 Basel, Switzerland

Int. J. Environ. Res. Public Health 2015, 12(6), 5792-5814; https://doi.org/10.3390/ijerph120605792 - 26 May 2015

Cited by 21 | Viewed by 7202

Abstract

Well-being impact assessments of urban interventions are a difficult challenge, as there is no agreed methodology and scarce evidence on the relationship between environmental conditions and well-being. The European Union (EU) project “Urban Reduction of Greenhouse Gas Emissions in China and Europe” (URGENCHE) [...] Read more.

Well-being impact assessments of urban interventions are a difficult challenge, as there is no agreed methodology and scarce evidence on the relationship between environmental conditions and well-being. The European Union (EU) project “Urban Reduction of Greenhouse Gas Emissions in China and Europe” (URGENCHE) explored a methodological approach to assess traffic noise-related well-being impacts of transport interventions in three European cities (Basel, Rotterdam and Thessaloniki) linking modeled traffic noise reduction effects with survey data indicating noise-well-being associations. Local noise models showed a reduction of high traffic noise levels in all cities as a result of different urban interventions. Survey data indicated that perception of high noise levels was associated with lower probability of well-being. Connecting the local noise exposure profiles with the noise-well-being associations suggests that the urban transport interventions may have a marginal but positive effect on population well-being. This paper also provides insight into the methodological challenges of well-being assessments and highlights the range of limitations arising from the current lack of reliable evidence on environmental conditions and well-being. Due to these limitations, the results should be interpreted with caution. Full article

(This article belongs to the Special Issue Sound and Health related Quality of Life)

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Open AccessArticle

In Search of an Integrative Measure of Functioning

by Rosamond H. Madden^1,*, Nick Glozier²

, Nicola Fortune^1,3

, Maree Dyson⁴, John Gilroy¹, Anita Bundy⁵, Gwynnyth Llewellyn¹, Luis Salvador-Carulla^1,2

, Sue Lukersmith¹, Elias Mpofu⁵ and Richard Madden^1,3

¹ Centre for Disability Research and Policy, University of Sydney, P.O. Box 170, NSW 1826, Australia

² Brain & Mind Research Institute, Sydney Medical School, University of Sydney, 94 Mallett St., Camperdown, NSW 2050, Australia

³ National Centre for Classification in Health, University of Sydney, P.O. Box 170, NSW 1826, Australia

⁴ Dyson Consulting Group, 450 Chapel Street, South Yarra, VIC 3141, Australia

⁵ Faculty of Health Sciences, University of Sydney, East Street, Lidcombe 2141, Australia

Int. J. Environ. Res. Public Health 2015, 12(6), 5815-5832; https://doi.org/10.3390/ijerph120605815 - 26 May 2015

Cited by 26 | Viewed by 8505

Abstract

International trends towards people-centred, integrative care and support require any measurement of functioning and disability to meet multiple aims. The information requirements of two major Australian programs for disability and rehabilitation are outlined, and the findings of two searches for suitable measures of [...] Read more.

International trends towards people-centred, integrative care and support require any measurement of functioning and disability to meet multiple aims. The information requirements of two major Australian programs for disability and rehabilitation are outlined, and the findings of two searches for suitable measures of functioning and disability are analysed. Over 30 current measures of functioning were evaluated in each search. Neither search found a generic measure of functioning suitable for these multibillion dollar programs, relevant to a wide range of people with a variety of health conditions and functioning experiences, and capable of indicating support needs, associated costs, progress and outcomes. This unsuccessful outcome has implications internationally for policy-relevant information for disability, rehabilitation and related programs. The paper outlines the features of an Integrative Measure of Functioning (IMF) based on the concepts of functioning and environmental factors in the International Classification of Functioning, Disability and Health (ICF). An IMF would be applicable across a variety of health conditions, settings and purposes, ranging from individual assessment to public health. An IMF could deliver person-centred, policy-relevant information for a range of programs, promoting harmonised language and measurement and supporting international trends in human services and public health. Full article

(This article belongs to the Special Issue Disability and Public Health)

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Open AccessArticle

by Chung-Yen Lu^1,2, Jia-Min Lin³, Ying-Yi Chen⁴ and Yi-Chun Chen^5,*

¹ School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 404, Taiwan

² Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan

³ Institute of Environmental Health, National Taiwan University, Taipei 100, Taiwan

⁴ Institute of Environmental and Occupational Health Sciences, National Yang-Ming University, Taipei 100, Taiwan

⁵ Department of Health Management, I-Shou University, Kaohsiung 824, Taiwan

Int. J. Environ. Res. Public Health 2015, 12(6), 5833-5845; https://doi.org/10.3390/ijerph120605833 - 27 May 2015

Cited by 76 | Viewed by 8895

Abstract

This study investigated whether sick building syndrome (SBS) complaints among office workers were associated with the indoor air quality. With informed consent, 417 employees in 87 office rooms of eight high-rise buildings completed a self-reported questionnaire for symptoms experienced at work during the [...] Read more.

This study investigated whether sick building syndrome (SBS) complaints among office workers were associated with the indoor air quality. With informed consent, 417 employees in 87 office rooms of eight high-rise buildings completed a self-reported questionnaire for symptoms experienced at work during the past month. Carbon dioxide (CO₂), temperature, humidity and total volatile organic compounds (TVOCs) in each office were simultaneously measured for eight office hours using portable monitors. Time-averaged workday difference between the indoor and the outdoor CO₂ concentrations (dCO₂) was calculated as a surrogate measure of ventilation efficiency for each office unit. The prevalence rates of SBS were 22.5% for eye syndrome, 15.3% for upper respiratory and 25.4% for non-specific syndromes. Tiredness (20.9%), difficulty in concentrating (14.6%), eye dryness (18.7%) were also common complaints. The generalized estimating equations multivariate logistic regression analyses showed that adjusted odds ratios (aORs) and 95% confidence interval (CI) per 100 ppm increase in dCO₂ were significantly associated with dry throat (1.10, 95% CI = (1.00–1.22)), tiredness (1.16, 95% CI = (1.04–1.29)) and dizziness (1.22, 95% CI = (1.08–1.37)). The ORs for per 100 ppb increases in TVOCs were also associated with upper respiratory symptoms (1.06, 95% CI = (1.04–1.07)), dry throat (1.06, 95% CI = (1.03–1.09)) and irritability (1.02, 95% CI = (1.01–1.04)). In conclusion, the association between some SBS symptoms and the exposure to CO₂ and total VOCs are moderate but may be independently significant. Full article

(This article belongs to the Special Issue Indoor Environmental Quality: Exposures and Occupant Health)

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Open AccessArticle

Effect of Pesticide Exposure on Immunological, Hematological and Biochemical Parameters in Thai Orchid Farmers— A Cross-Sectional Study

by Soraya Aroonvilairat¹, Wannapa Kespichayawattana¹, Thiwaree Sornprachum¹, Papada Chaisuriya¹, Taweeratana Siwadune² and Kavi Ratanabanangkoon^1,3,*

¹ Center of Excellence on Environmental Health and Toxicology (EHT), and Laboratory of Immunology, Kampangpetch 6 Road, Lak-si, Bangkok 10210, Thailand

² Department of Mathematics, Faculty of Science, Mahidol University, Rama VI Road, Ratchathewi, Bangkok 10400, Thailand

³ Chulabhorn Graduate Institute, Kampangpetch 6 Road, Lak-si, Bangkok 10210, Thailand

Int. J. Environ. Res. Public Health 2015, 12(6), 5846-5861; https://doi.org/10.3390/ijerph120605846 - 27 May 2015

Cited by 53 | Viewed by 7486

Abstract

Various studies have found that many Thai orchid farmers used excessive amounts of pesticides without proper protective gear, but no toxicological study has been made. This cross-sectional study aimed to evaluate the immunological, hematological and biochemical statuses of these farmers. Sixty four orchid [...] Read more.

Various studies have found that many Thai orchid farmers used excessive amounts of pesticides without proper protective gear, but no toxicological study has been made. This cross-sectional study aimed to evaluate the immunological, hematological and biochemical statuses of these farmers. Sixty four orchid farmers and 60 controls were studied. Plasma cholinesterase activity, the percentage and absolute number of B lymphocytes (CD19⁺) were significantly lower in the farmers group (3966.32 ± 1165.48 U/L, 11.61 ± 4.09% and 312.26 ± 164.83 cells/mm3, respectively) as compared to those of controls (5048.85 ± 1139.40 U/L, 14.32 ± 4.23%, 420.34 ± 195.18 cells/mm³, respectively). There was a statistically significant higher level of serum IgE among the orchid farmers (0.031 ± 0.011 mg/dL vs. 0.018 ± 0.007 mg/dL) but not IgG, IgA and IgM, levels. Serum lysozyme level, lymphocyte proliferative responses to mitogens, hematological parameters and kidney function test, were not significantly different between the two groups. The liver function profiles showed significantly lower levels of albumin and serum protein in the farmer group. Thus frequent pesticide exposure resulted in subtle changes of some biological parameters. These changes, though may not be clinically significant, strongly indicated that caution in handing pesticides by these farmers is warranted. Full article

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Open AccessArticle

The Expansion of the Economic Frontier and the Diffusion of Violence in the Amazon

by Patrícia Feitosa Souza^1,*, Diego Ricardo Xavier², Stephane Rican³, Vanderlei Pascoal De Matos² and Christovam Barcellos²

¹ National School of Public Health (ENSP)-Fiocruz, Street Leopoldo Bulhões, 1480—Manguinhos, Rio de Janeiro 21041-210, Brazil

² Information Laboratory Health-LIS, Laboratory GIS, Avenue Brasil, 4365 Pavilhão Hai ty Moussatché, Sala 231-Manguinhos, Rio de Janeiro 21045-900, Brazil

³ Space and Territory Health Laboratory, Department of Geography, University Paris Ouest Nanterre Defense, 200 Avenue, Republic Nanterre, Paris 92000, France

Int. J. Environ. Res. Public Health 2015, 12(6), 5862-5885; https://doi.org/10.3390/ijerph120605862 - 27 May 2015

Cited by 13 | Viewed by 6605

Abstract

Over the last few decades, the occupation of the Amazon and the expansion of large-scale economic activities have exerted a significant negative impact on the Amazonian environment and on the health of the Amazon’s inhabitants. These processes have altered the context of the [...] Read more.

Over the last few decades, the occupation of the Amazon and the expansion of large-scale economic activities have exerted a significant negative impact on the Amazonian environment and on the health of the Amazon’s inhabitants. These processes have altered the context of the manifestation of health problems in time and space and changed the characteristics of the spatial diffusion of health problems in the region. This study analyzed the relationships between the various economic processes of territorial occupation in the Amazon and the spatial diffusion of homicidal violence through the configuration of networks of production, as well as the movements of population and merchandise. Statistical data on violence, deforestation, the production of agricultural items, and socio-economic variables, georeferenced and available for the 771 municipalities of the Legal Amazon were used in this study. The results suggest that the diffusion of violence closely follows the economic expansion front, which is related to deforestation and livestock production but has little relation to grain production, demonstrating steps and typologies of recent occupation in the Amazon that promote violence. These spatial patterns reveal environmental and socio-economic macro-determinants that materialize in geographic space through the construction of highways and the formation of city networks. Full article

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Open AccessArticle

Assessment of Electromagnetic Interference with Active Cardiovascular Implantable Electronic Devices (CIEDs) Caused by the Qi A13 Design Wireless Charging Board

by Tobias Seckler^*, Kai Jagielski and Dominik Stunder

The Research Center for Bioelectromagnetic Interaction (FEMU), Institute and Out-patient Clinic of Occupational Medicine, RWTH Aachen University, Pauwelsstr 30, 52074 Aachen, Germany

Int. J. Environ. Res. Public Health 2015, 12(6), 5886-5904; https://doi.org/10.3390/ijerph120605886 - 27 May 2015

Cited by 18 | Viewed by 8612

Abstract

Electromagnetic interference is a concern for people wearing cardiovascular implantable electronic devices (CIEDs). The aim of this study was to assess the electromagnetic compatibility between CIEDs and the magnetic field of a common wireless charging technology. To do so the voltage induced in [...] Read more.

Electromagnetic interference is a concern for people wearing cardiovascular implantable electronic devices (CIEDs). The aim of this study was to assess the electromagnetic compatibility between CIEDs and the magnetic field of a common wireless charging technology. To do so the voltage induced in CIEDs by Qi A13 design magnetic fields were measured and compared with the performance limits set by ISO 14117. In order to carry this out a measuring circuit was developed which can be connected with unipolar or bipolar pacemaker leads. The measuring system was positioned at the four most common implantation sites in a torso phantom filled with physiological saline solution. The phantom was exposed by using Helmholtz coils from 5 µT to 27 µT with 111 kHz sine‑bursts or by using a Qi A13 design wireless charging board (Qi‑A13‑Board) in two operating modes “power transfer” and “pinging”. With the Helmholtz coils the lowest magnetic flux density at which the performance limit was exceeded is 11 µT. With the Qi‑A13‑Board in power transfer mode 10.8% and in pinging mode 45.7% (2.2% at 10 cm distance) of the performance limit were reached at maximum. In neither of the scrutinized cases, did the voltage induced by the Qi‑A13‑Board exceed the performance limits. Full article

(This article belongs to the Special Issue Electromagnetic Fields and Health)

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Open AccessArticle

Simultaneous Exposure to Heavy Metals among Residents in the Industrial Complex: Korean National Cohort Study

by Heejin Park¹, Kyoungho Lee²

, Chan-Seok Moon³

, Kyungsook Woo¹, Tack-Shin Kang⁴, Eun-Kyung Chung⁵ and Bu-Soon Son^1,*

¹ Department of Environmental Health Science, Soonchunhyang University, 22 Soonchunhyang-ro, Asan-si, 336-745, Korea

² Department of Occupational Epidemiology, Samsung Health Research Institute, Samsung Electronics, Suwon city 443-742, Korea

³ Department of Industrial Health, Catholic University of Pusan, 57 Oryundae-ro, Geumjeong-gu, Busan, 609-817, Korea

⁴ Department of Environmental Health, National Institute of Environment Research, 42 Hwangyeong-ro, Incheon, 404-170, Korea

⁵ School of Public Health, Seoul National University, 1 Gwanak-ro, Seoul, 151-015, Korea

Int. J. Environ. Res. Public Health 2015, 12(6), 5905-5917; https://doi.org/10.3390/ijerph120605905 - 27 May 2015

Cited by 10 | Viewed by 5032

Abstract

A survey was conducted to evaluate the multi-exposure level and correlation among toxic metal biomarkers (Cd, Pb, and Hg). A total of 592 individuals who participated in the survey were residents near an industrial complex in Gwangyang and Yeosu (exposed group) and of [...] Read more.

A survey was conducted to evaluate the multi-exposure level and correlation among toxic metal biomarkers (Cd, Pb, and Hg). A total of 592 individuals who participated in the survey were residents near an industrial complex in Gwangyang and Yeosu (exposed group) and of Hadong and Namhae (control group) in southern Korea from May 2007 to November 2010. The Gwangyang and Yeosu area exposed groups had slightly higher blood Pb (2.21 and 1.90 µg/dL), urinary Cd observed values (2.20 and 1.46 µg/L), urinary Cd with a urinary creatinine correction (1.43 and 1.25 µg/g Cr), and urinary Hg observed values (2.26 and 0.98 µg/L) in women participants than those in the Hadong and Namhae area (control group). Blood Pb (3.18 and 2.55 µg/dL), urinary Hg observed values (1.14 and 0.92 µg/L), and urinary Hg with a urinary creatinine correction (1.06 and 0.96 µg/L) for male participants were also slightly higher than those in the Hadong and Namhae area (control group). The correlation among urinary Cd, Hg and Pb concentrations in the blood was significant. We suggest that the exposed group of residents were simultaneously exposed to Pb, Cd, and Hg from contaminated ambient air originating from the iron manufacturing industrial complex. Full article

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Open AccessArticle

Cardiovascular Mortality Associated with Low and High Temperatures: Determinants of Inter-Region Vulnerability in China

by Xunfeng Yang^1,2,†, Lianfa Li^1,*,†, Jinfeng Wang^1,†, Jixia Huang^3,4 and Shijun Lu⁵

¹ State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Datun Road, Beijing 100101, China

² University of Chinese Academy of Sciences, Beijing 100049, China

³ Precision Forestry Key Laboratory of Beijing, Beijing Forestry University, Beijing 100083, China

⁴ College of Forestry, Beijing Forestry University, Beijing 100083, China

⁵ National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Xicheng District, Beijing 100050, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 5918-5933; https://doi.org/10.3390/ijerph120605918 - 27 May 2015

Cited by 22 | Viewed by 5708

Abstract

The objectives of this study were to estimate the effects of temperature on cardiovascular mortality in 26 regions in the south and west of China from 2008 to 2011, and to identify socioeconomic and demographic factors contributing to such inter-region variation in the [...] Read more.

The objectives of this study were to estimate the effects of temperature on cardiovascular mortality in 26 regions in the south and west of China from 2008 to 2011, and to identify socioeconomic and demographic factors contributing to such inter-region variation in the temperature effect. A separate Poisson generalized additive model (GAM) was fitted to estimate percent changes in cardiovascular mortality at low and high temperatures on a daily basis for each region. The model used the smooth functions to model the nonlinear effects of temperature and humidity and to control for the seasonal factor using the calendar time variable. Given variation in the magnitude of the temperature effect on cardiovascular mortality, we employed a Bayesian network (BN) to identify potential region-specific socioeconomic and demographic factors that may explain the variation. In most regions, an increasing trend in high or low temperature was associated with an increase in cardiovascular mortality, with variation in the magnitude of the temperature effects across regions. Three factors, including per capita years of education (as an indicator of economic status), percentage of the population over 65 years of age and percentage of women had direct impact on cold-related cardiovascular mortality. Number of hospital beds (as an indicator of the availability of medical resources), percentage of population engaged in industrial occupations, and percentage of women showed direct impact on heat-related cardiovascular mortality. Due to the socioeconomic and demographic inequalities between regions, the development of customized prevention and adaptation programs to address the low/high temperatures in vulnerable regions should be prioritized. Full article

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Open AccessArticle

Study of the Influence of the Orientation of a 50-Hz Magnetic Field on Fetal Exposure Using Polynomial Chaos Decomposition

by Ilaria Liorni^1,2,*, Marta Parazzini^1,†

, Serena Fiocchi^1,† and Paolo Ravazzani^1,†

¹ CNR Consiglio Nazionale delle Ricerche, Istituto di Elettronica e di Ingegneria dell'Informazione e delle Telecomunicazioni IEIIT, Piazza Leonardo da Vinci 32, Milan 20133, Italy

² Dipartimento di Elettronica, Informazione e Bioingegneria DEIB, Politecnico di Milano, Piazza Leonardo da Vinci 32, Milan 20133, Italy

Int. J. Environ. Res. Public Health 2015, 12(6), 5934-5953; https://doi.org/10.3390/ijerph120605934 - 27 May 2015

Cited by 17 | Viewed by 6301

Abstract

Human exposure modelling is a complex topic, because in a realistic exposure scenario, several parameters (e.g., the source, the orientation of incident fields, the morphology of subjects) vary and influence the dose. Deterministic dosimetry, so far used to analyze human exposure to electromagnetic [...] Read more.

Human exposure modelling is a complex topic, because in a realistic exposure scenario, several parameters (e.g., the source, the orientation of incident fields, the morphology of subjects) vary and influence the dose. Deterministic dosimetry, so far used to analyze human exposure to electromagnetic fields (EMF), is highly time consuming if the previously-mentioned variations are considered. Stochastic dosimetry is an alternative method to build analytical approximations of exposure at a lower computational cost. In this study, it was used to assess the influence of magnetic flux density (B) orientation on fetal exposure at 50 Hz by polynomial chaos (PC). A PC expansion of induced electric field (E) in each fetal tissue at different gestational ages (GA) was built as a function of B orientation. Maximum E in each fetal tissue and at each GA was estimated for different exposure configurations and compared with the limits of the International Commission of Non-Ionising Radiation Protection (ICNIRP) Guidelines 2010. PC theory resulted in an efficient tool to build accurate approximations of E in each fetal tissue. B orientation strongly influenced E, with a variability across tissues from 10% to 43% with respect to the mean value. However, varying B orientation, maximum E in each fetal tissue was below the limits of ICNIRP 2010 at all GAs. Full article

(This article belongs to the Special Issue Electromagnetic Fields and Health)

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Open AccessReview

Household Water Quantity and Health: A Systematic Review

by Rachel D. Stelmach¹ and Thomas Clasen^2,*

¹ Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA

² Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 5954-5974; https://doi.org/10.3390/ijerph120605954 - 28 May 2015

Cited by 52 | Viewed by 7392

Abstract

While the quantity of water used in the home is thought to be an important determinant of health, much of the evidence relies on using water access as a proxy for quantity. This review examines the health effects of household water quantity using [...] Read more.

While the quantity of water used in the home is thought to be an important determinant of health, much of the evidence relies on using water access as a proxy for quantity. This review examines the health effects of household water quantity using studies that directly measured water quantity. We searched MEDLINE, EMBASE, the Cochrane Library, Web of Science, and article reference lists. Eligible studies included experimental and observational studies that measured a difference in water quantity and quantified an association between water quantity and health outcomes. 21 studies, divided into six of the many possible water-quantity associated outcomes, met the eligibility criteria. Due to heterogeneity in designs, settings, methods, and outcomes, a meta-analysis was inappropriate. Overall results showed a positive association between water quantity and health outcomes, but the effect depended on how the water was used. Increased water usage for personal hygiene was generally associated with improved trachoma outcomes, while increased water consumption was generally associated with reduced gastrointestinal infection and diarrheal disease and improved growth outcomes. In high-income countries, increased water consumption was associated with higher rates of renal cell carcinoma and bladder cancer but not associated with type II diabetes, cardiac-related mortality, or all-cause mortality. Full article

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Open AccessArticle

Modelling Anopheles gambiae s.s. Population Dynamics with Temperature- and Age-Dependent Survival

by Céline Christiansen-Jucht^1,*, Kamil Erguler², Chee Yan Shek¹, María-Gloria Basáñez¹ and Paul E. Parham³

¹ Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London St Mary's Campus, Norfolk Place, London W2 1PG, UK

² Energy, Environment, and Water Research Center, The Cyprus Institute, Nicosia 2121, Cyprus

³ Department of Public Health and Policy, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 3GL, UK

Int. J. Environ. Res. Public Health 2015, 12(6), 5975-6005; https://doi.org/10.3390/ijerph120605975 - 28 May 2015

Cited by 21 | Viewed by 9081

Abstract

Climate change and global warming are emerging as important threats to human health, particularly through the potential increase in vector- and water-borne diseases. Environmental variables are known to affect substantially the population dynamics and abundance of the poikilothermic vectors of disease, but the [...] Read more.

Climate change and global warming are emerging as important threats to human health, particularly through the potential increase in vector- and water-borne diseases. Environmental variables are known to affect substantially the population dynamics and abundance of the poikilothermic vectors of disease, but the exact extent of this sensitivity is not well established. Focusing on malaria and its main vector in Africa, Anopheles gambiae sensu stricto, we present a set of novel mathematical models of climate-driven mosquito population dynamics motivated by experimental data suggesting that in An. gambiae, mortality is temperature and age dependent. We compared the performance of these models to that of a “standard” model ignoring age dependence. We used a longitudinal dataset of vector abundance over 36 months in sub-Saharan Africa for comparison between models that incorporate age dependence and one that does not, and observe that age-dependent models consistently fitted the data better than the reference model. This highlights that including age dependence in the vector component of mosquito-borne disease models may be important to predict more reliably disease transmission dynamics. Further data and studies are needed to enable improved fitting, leading to more accurate and informative model predictions for the An. gambiae malaria vector as well as for other disease vectors. Full article

(This article belongs to the Special Issue Climate Change Impacts on Vector-borne Diseases)

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Open AccessArticle

Socioeconomic Inequalities and Occupational Injury Disability in China: A Population-Based Survey

by Haochen Wang, Gong Chen, Zhenjie Wang and Xiaoying Zheng^*

Institute of Population Research, WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing 100871, China

Int. J. Environ. Res. Public Health 2015, 12(6), 6006-6015; https://doi.org/10.3390/ijerph120606006 - 28 May 2015

Cited by 8 | Viewed by 4944

Abstract

Objective: To estimate the prevalence of occupational injury disability (OID) and to examine the socioeconomic status of OID in China. Methods: The data derived from the China National Sample Survey on Disability in 2006 involving people aged 16–59 years old. Descriptive [...] Read more.

Objective: To estimate the prevalence of occupational injury disability (OID) and to examine the socioeconomic status of OID in China. Methods: The data derived from the China National Sample Survey on Disability in 2006 involving people aged 16–59 years old. Descriptive statistics are used to measure OID’s prevalence, and a binary logistic regression is used to identify the risk factors. Results: The population-weighted prevalence of OID is 1.81 (95% confidence interval (CI): 1.67–1.94). Socioeconomic risk factors include male sex, older age, living in urban areas, junior high school education, income below the poverty line, a lack of occupational injury insurance, living in the western region and working in high-risk occupations. Conclusions: OID is common among Chinese people aged 16–59 years old. Being male or older and having a lower income are risk factors for OID, similar to the results of previous research, but education is different. More training and education needs to be implemented to prevent OID. Full article

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Open AccessArticle

Review of HIV Testing Efforts in Historically Black Churches

by Latrice Crystal Pichon^1,*,†

and Terrinieka Williams Powell^2,†

¹ School of Public Health, University of Memphis, 209 Robison Hall, Memphis, TN 38152, USA

² Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, E4614 Baltimore, MD 21205, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6016-6026; https://doi.org/10.3390/ijerph120606016 - 28 May 2015

Cited by 16 | Viewed by 4967

Abstract

This paper aims to critically assess the state of HIV testing in African American churches. A comprehensive review of peer-reviewed publications on HIV testing in church-based settings was conducted by two independent coders. Twenty-six papers published between 1991 and 2015, representing 24 unique [...] Read more.

This paper aims to critically assess the state of HIV testing in African American churches. A comprehensive review of peer-reviewed publications on HIV testing in church-based settings was conducted by two independent coders. Twenty-six papers published between 1991 and 2015, representing 24 unique projects, were identified addressing at least one dimension of HIV testing. Thirteen faith-based projects have implemented HIV testing events or had clergy promote the importance of testing and knowing one’s HIV status, but empirical data and rigorous study designs were limited. Only eight papers reported onsite HIV testing in churches. Less than 5% of the studies reported the percentage of congregants who returned for their test results. Finally, no study has examined at baseline or post-intervention behavioral intentions to be screened for HIV. Future research is needed to evaluate the effectiveness of HIV testing in churches and to explore the possibilities of the role of the church and leadership structure in the promotion of HIV treatment and care. Full article

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Open AccessCommentary

Organising a Safe Space for Navigating Social-Ecological Transformations to Sustainability

by Laura Pereira^1,*, Timothy Karpouzoglou^2,†, Samir Doshi^3,† and Niki Frantzeskaki^4,†

¹ School of Environmental and Geographical Sciences, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa

² Public Administration and Policy Group, Wageningen University, Hollandseweg 1, Wageningen 6700 EW, The Netherlands

³ American Association for the Advancement of Science, 1200 New York Ave NW, Washington, DC 20005, USA

⁴ Dutch Research Institute for Transitions, Faculty of Social Sciences, Erasmus University, Rotterdam 3062 PA, The Netherlands

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6027-6044; https://doi.org/10.3390/ijerph120606027 - 28 May 2015

Cited by 76 | Viewed by 13943

Abstract

The need for developing socially just living conditions for the world’s growing population whilst keeping human societies within a ‘safe operating space’ has become a modern imperative. This requires transformative changes in the dominant social norms, behaviours, governance and management regimes that guide [...] Read more.

The need for developing socially just living conditions for the world’s growing population whilst keeping human societies within a ‘safe operating space’ has become a modern imperative. This requires transformative changes in the dominant social norms, behaviours, governance and management regimes that guide human responses in areas such as urban ecology, public health, resource security (e.g., food, water, energy access), economic development and biodiversity conservation. However, such systemic transformations necessitate experimentation in public arenas of exchange and a deepening of processes that can widen multi-stakeholder learning. We argue that there is an emergent potential in bridging the sustainability transitions and resilience approaches to create new scientific capacity that can support large-scale social-ecological transformations (SETs) to sustainability globally, not just in the West. In this article, we elucidate a set of guiding principles for the design of a ‘safe space’ to encourage stronger interactions between these research areas and others that are relevant to the challenges faced. We envisage new opportunities for transdisciplinary collaboration that will develop an adaptive and evolving community of practice. In particular, we emphasise the great opportunity for engaging with the role of emerging economies in facilitating safe space experimentation. Full article

(This article belongs to the Special Issue Proceeding of 'Ecosystems and Human Well-Being in the Transition towards Green Economy')

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Open AccessArticle

The Effect of Engagement in Everyday Occupations, Role Overload and Social Support on Health and Life Satisfaction among Mothers

by Michal Avrech Bar^1,* and Tal Jarus²

¹ Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel

² Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, T325 Koerner Pavilion, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada

Int. J. Environ. Res. Public Health 2015, 12(6), 6045-6065; https://doi.org/10.3390/ijerph120606045 - 28 May 2015

Cited by 39 | Viewed by 11642

Abstract

One of the founding assumptions underlying the health professions is the belief that there is a strong relationship between engagement in occupations, health, and wellbeing. The ability to perform everyday occupations (occupational performance) has a positive effect on health and wellbeing. However, there [...] Read more.

One of the founding assumptions underlying the health professions is the belief that there is a strong relationship between engagement in occupations, health, and wellbeing. The ability to perform everyday occupations (occupational performance) has a positive effect on health and wellbeing. However, there is also conflicting evidence indicating that participation in multiple roles or in certain occupations may lead to poorer health. Therefore, there is a need to better understand this relationship. The purpose of the present study was to examine three possible theoretical models to explain mothers’ health and life satisfaction from the perspective of their occupational performance, their role load, and their social support. 150 married mothers, ages of 25–45, who had at least one child between the ages of one to ten years, participated in the study. Data were collected by using seven self-report questionnaires. The models were analyzed using Structural Equation Modeling. The results show that social support has a direct effect on mothers’ physical health and life satisfaction and an indirect effect, mediated through the occupational performance variables, on mothers’ mental health and life satisfaction. Role overload does not affect mothers’ health and life satisfaction. These results suggest that mothers could benefit from health programs that help them manage their occupational routines. Such programs should focus on improving the mother’s occupational performance and adapting her social environment to fit her occupational needs. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

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Open AccessArticle

Evaluation of Quality of Life of Those Living near a Wind Farm

by Bożena Mroczek¹, Joanna Banaś², Małgorzata Machowska-Szewczyk² and Donata Kurpas^3,4,*

¹ Department of Humanities in Medicine, Faculty of Health Sciences, Pomeranian Medical University, 11 Chlapowskiego St., 70-204 Szczecin, Poland

² Faculty of Computer Science and Information Technology, West Pomeranian University of Technology, Szczecin Wydział Informatyki, 41 Zolnierska St., 71-210 Szczecin, Poland

³ Department of Family Medicine, Wroclaw Medical University, 1 Syrokomli St., 51-141 Wroclaw, Poland

⁴ Opole Medical School, 68 Katowicka St., 45-060 Opole, Poland

Int. J. Environ. Res. Public Health 2015, 12(6), 6066-6083; https://doi.org/10.3390/ijerph120606066 - 29 May 2015

Cited by 22 | Viewed by 5951

Abstract

Objectives: Health-related quality of life (HRQoL) can serve as a multidimensional means of evaluating the relationship between the presence of wind turbines in residential areas and their consequence for health. The purpose of this study was to determine whether a relationship exists [...] Read more.

Objectives: Health-related quality of life (HRQoL) can serve as a multidimensional means of evaluating the relationship between the presence of wind turbines in residential areas and their consequence for health. The purpose of this study was to determine whether a relationship exists between the presence of wind farms at different stages of development and the HRQoL of people living in their vicinity in Poland. Method: The instruments employed in this study were the SF-36v2, a questionnaire measuring self-reported health problems, and a sociodemographic questionnaire. The study involved 1277 people who lived within 2 km from a wind turbine. Results: The highest overall QoL scores were obtained by respondents living the closest to wind turbines. The mental health, role emotional, and social functioning scores were significantly higher among respondents living near wind farms and wind-farm construction sites than among those living close to locations where wind farms were planned but where construction had not yet begun. Positive correlations were found between physical and mental component scores and reactions to the news of plans to construct a wind farm. Significant differences in physical and mental component scores were observed between residents who reacted calmly and those who responded with apprehension. Residents who expected the improvement of their financial standing as a result of the wind farm assessed their general health higher than those who did not expect to receive any economic benefits. The lowest QoL scores corresponded to frequent headaches, stomach aches, and back pain over the previous three months, as well as recurrent problems with falling asleep, anxiety, and a lack of acceptance of the project. Conclusion: The lowest overall QoL and general health scores were noted among residents of places where wind-farm developments were either at the stage of planning or under construction. In order to find ways of reducing environmental stress and its adverse effects on health, it is necessary to conduct research on residents of places where a wind farm is either planned or under construction, or has just been completed. Full article

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Open AccessArticle

An ICF-Based Model for Implementing and Standardizing Multidisciplinary Obesity Rehabilitation Programs within the Healthcare System

by Amelia Brunani^1,*, Alberto Raggi², Anna Sirtori¹, Maria Elisa Berselli¹, Valentina Villa³, Francesca Ceriani³, Stefania Corti³, Matilde Leonardi², Paolo Capodaglio¹

and ICF-OBESITY Group^1,†

¹ Department of Rehabilitation Medicine, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Piancavallo, 28921 Verbania, Italy

² Neurology, Public Health and Disability Unit—Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy

³ Psychology Research Laboratory, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28921 Verbania, Italy

^† Group: Alice Zanini, Calogero Vinci, Elena Tacchini, Valentina Vicari, Erica Cantelli.

Int. J. Environ. Res. Public Health 2015, 12(6), 6084-6091; https://doi.org/10.3390/ijerph120606084 - 29 May 2015

Cited by 9 | Viewed by 7383

Abstract

Introduction/Objective: In this study, we aimed to design an ICF-based individual rehabilitation project for obese patients with comorbidities (IRPOb) integrated into the Rehab-CYCLE to standardize rehabilitative programs. This might facilitate the different health professionals involved in the continuum of care of obese [...] Read more.

Introduction/Objective: In this study, we aimed to design an ICF-based individual rehabilitation project for obese patients with comorbidities (IRPOb) integrated into the Rehab-CYCLE to standardize rehabilitative programs. This might facilitate the different health professionals involved in the continuum of care of obese patients to standardize rehabilitation interventions. Methods: After training on the ICF and based on the relevant studies, ICF categories were identified in a formal consensus process by our multidisciplinary team. Thereafter, we defined an individual rehabilitation project based on a structured multi-disciplinary approach to obesity. Results: the proposed IRPOb model identified the specific intervention areas (nutritional, physiotherapy, psychology, nursing), the short-term goals, the intervention modalities, the professionals involved and the assessment of the outcomes. Information was shared with the patient who signed informed consent. Conclusions: The model proposed provides the following advantages: (1) standardizes rehabilitative procedures; (2) facilitates the flow of congruent and updated information from the hospital to outpatient facilities, relatives, and care givers; (3) addresses organizational issues; (4) might serve as a benchmark for professionals who have limited specific expertise in rehabilitation of comorbid obese patients. Full article

(This article belongs to the Special Issue Disability and Public Health)

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Open AccessCommentary

Favourable Changes of the Risk-Benefit Ratio in Alpine Skiing

by Martin Burtscher^* and Gerhard Ruedl

Department of Sport Science, Medical Section, University of Innsbruck, Fürstenweg 185, A-6020 Innsbruck, Austria

Int. J. Environ. Res. Public Health 2015, 12(6), 6092-6097; https://doi.org/10.3390/ijerph120606092 - 29 May 2015

Cited by 8 | Viewed by 4957

Abstract

During the past five decades recreational alpine skiing has become increasingly safer. The numerous annual media reports on ski injuries have to be interpreted on the basis of the tremendous numbers of skiers. These favourable changes seem primarily be due to the introduction [...] Read more.

During the past five decades recreational alpine skiing has become increasingly safer. The numerous annual media reports on ski injuries have to be interpreted on the basis of the tremendous numbers of skiers. These favourable changes seem primarily be due to the introduction of short carving skis, more rigid and comfortable ski boots, the use of protective gear like helmets, and the optimized preparation of ski slopes. The associated health benefits from skiing, especially arising from its association with a healthier life style, and possibly also from effects related to hypoxia preconditioning and increasing subjective vitality by natural elements clearly outweigh the health hazards. Technical improvements will likely help further reducing the injury risk. At least hypothetically, each individual skier could help to prevent injuries by the development of an appropriate physical fitness and responsible behaviour on ski slopes thereby optimizing the risk-benefit ratio of alpine skiing. Full article

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Open AccessArticle

Serum Biomarkers of Exposure to Perfluoroalkyl Substances in Relation to Serum Testosterone and Measures of Thyroid Function among Adults and Adolescents from NHANES 2011–2012

by Ryan C. Lewis, Lauren E. Johns and John D. Meeker^*

Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6098-6114; https://doi.org/10.3390/ijerph120606098 - 29 May 2015

Cited by 153 | Viewed by 12722

Abstract

Perfluoroalkyl substances (PFASs) are a group of environmentally-persistent chemicals that have been widely used in many industrial applications. There is human and animal evidence that PFASs may alter levels of reproductive and thyroid-related hormones. However, human studies on the potential age-related effects of [...] Read more.

Perfluoroalkyl substances (PFASs) are a group of environmentally-persistent chemicals that have been widely used in many industrial applications. There is human and animal evidence that PFASs may alter levels of reproductive and thyroid-related hormones. However, human studies on the potential age-related effects of PFASs on these outcomes among males and females are limited. We explored the relationship between serum PFASs and serum total testosterone (T), thyroid stimulating hormone (TSH), and free and total triiodothyronine (FT3, TT3) and thyroxine (FT4, TT4) among males and females 12 to 80 years of age from the 2011–2012 cycle of the National Health and Nutrition Examination Survey. Associations were assessed using multiple linear regression models that were stratified on sex and age categories. Effect estimates from the majority of the adjusted models were not statistically significant. However, exposure to PFASs may be associated with increases in FT3, TT3, and FT4 among adult females, but during adolescence, PFASs may be related to increases in TSH among males and decreases in TSH among females. No significant relationships were observed between PFASs and T in any of the models. These findings suggest that exposure to PFASs may disrupt thyroid hormone homeostasis. Full article

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Open AccessReview

Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature

by Linda Haddad^1,*, Omar El-Shahawy², Roula Ghadban³, Tracey E. Barnett⁴ and Emily Johnson⁵

¹ College of Nursing, University of Florida, Gainesville, FL 32610, USA

² Social and Behavioral Health Department, Virginia Commonwealth University, 830 East Main Street, Richmond, VA 23298, USA

³ School of Nursing, Virginia Commonwealth University, 821 West Franklin Street, Richmond, VA 23284, USA

⁴ College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA

⁵ College of Health and Human Performance, University of Florida, Gainesville, FL 32610, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6115-6135; https://doi.org/10.3390/ijerph120606115 - 29 May 2015

Cited by 33 | Viewed by 8256

Abstract

Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the [...] Read more.

Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Methods: Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. Results: To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Conclusion: Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States. Full article

(This article belongs to the Special Issue Tobacco Control 2015)

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Open AccessArticle

Does Treatment Impact Health Outcomes for Patients After Acute Coronary Syndrome?

by Jelena Umbrasienė^1,*, Giedrius Vanagas¹ and Jon Venclovienė²

¹ Department of Preventive Medicine, Lithuanian University of Health Sciences, 57-302 Šiaurės ave, Kaunas LT-49264, Lithuania

² Institute of Cardiology, Lithuanian University of Health Sciences, 17 Sukilėlių ave, Kaunas LT-50009, Lithuania

Int. J. Environ. Res. Public Health 2015, 12(6), 6136-6147; https://doi.org/10.3390/ijerph120606136 - 29 May 2015

Cited by 3 | Viewed by 4289

Abstract

Background: Mortality rates for acute coronary syndrome (ACS) patients are still very high all over the world. Our study aimed to investigate the impact of ACS treatment on cardiovascular (CV) mortality eight years following ACS. Methods: A retrospective cohort study with [...] Read more.

Background: Mortality rates for acute coronary syndrome (ACS) patients are still very high all over the world. Our study aimed to investigate the impact of ACS treatment on cardiovascular (CV) mortality eight years following ACS. Methods: A retrospective cohort study with a total of 613 patients was used. The data was collected from databases and medical records. An evidence-based treatment (EBT) algorithm was used based on the ESC guidelines. Logistic regression analysis and standardized odds ratios with 95% confidence interval (CI) were used for the risk assessment, with a p level < 0.05 considered as significant. Results: The median follow-up time in this study was 7.6 years. During follow-up 48.9% of the patients (n = 300) died from CV and 207 (69%) for a relevant reason. For monotherapy ACE inhibitors and β-blockers, and for fixed dose combined drugs ACE inhibitors and diuretics, were most frequently used. EBT was provided to 37.8% of patients. The EBT use (HR 0.541, CI 0.394–0.742, p < 0.001) during follow-up period was important for reducing CV mortality in ACS patients. Conclusions: The combined use of EBT significantly improved outcomes. The recurrent myocardial infarction and percutaneous coronary intervention patients were more frequent in EBT and it was beneficial for reducing CV mortality. Full article

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Open AccessArticle

Isolation, Virulence, and Antimicrobial Resistance of Methicillin-Resistant Staphylococcus aureus (MRSA) and Methicillin Sensitive Staphylococcus aureus (MSSA) Strains from Oklahoma Retail Poultry Meats

by Lubna S. Abdalrahman, Adriana Stanley, Harrington Wells and Mohamed K. Fakhr^*

Department of Biological Science, The University of Tulsa, Tulsa, OK 74104, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6148-6161; https://doi.org/10.3390/ijerph120606148 - 29 May 2015

Cited by 74 | Viewed by 9071

Abstract

Staphylococcus aureus is one the top five pathogens causing domestically acquired foodborne illness in the U.S. Only a few studies are available related to the prevalence of S. aureus and MRSA in the U.S. retail poultry industry. The objectives of this study were [...] Read more.

Staphylococcus aureus is one the top five pathogens causing domestically acquired foodborne illness in the U.S. Only a few studies are available related to the prevalence of S. aureus and MRSA in the U.S. retail poultry industry. The objectives of this study were to determine the prevalence of S. aureus (MSSA and MRSA) in retail chicken and turkey meats sold in Tulsa, Oklahoma and to characterize the recovered strains for their antimicrobial resistance and possession of toxin genes. A total of 167 (114 chicken and 53 turkey) retail poultry samples were used in this study. The chicken samples included 61 organic samples while the rest of the poultry samples were conventional. The overall prevalence of S. aureus was 57/106 (53.8%) in the conventional poultry samples and 25/61 (41%) in the organic ones. Prevalence in the turkey samples (64.2%) was higher than in the chicken ones (42.1%). Prevalence of S. aureus did not vary much between conventional (43.4%) and organic chicken samples (41%). Two chicken samples 2/114 (1.8%) were positive for MRSA. PFGE identified the two MRSA isolates as belonging to PFGE type USA300 (from conventional chicken) and USA 500 (from organic chicken) which are community acquired CA-MRSA suggesting a human based source of contamination. MLST and spa typing also supported this conclusion. A total of 168 Staphylococcus aureus isolates (101 chicken isolates and 67 turkey isolates) were screened for their antimicrobial susceptibility against 16 antimicrobials and their possession of 18 different toxin genes. Multidrug resistance was higher in the turkey isolates compared to the chicken ones and the percentage of resistance to most of the antimicrobials tested was also higher among the turkey isolates. The hemolysin hla and hld genes, enterotoxins seg and sei, and leucocidins lukE-lukD were more prevalent in the chicken isolates. The PVL gene lukS-lukF was detected only in chicken isolates including the MRSA ones. In conclusion, S. aureus is highly prevalent in poultry retail meats sold in Oklahoma with a very low presence of human-originated MRSA. Multidrug resistance is not only prevalent in the MRSA isolates, but also in many MSSA poultry strains, particularly turkey. Full article

(This article belongs to the Special Issue Antibiotic Resistant and Pathogenic Bacteria in the Food Production Environment: Epidemiological Evolution and Control)

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Open AccessArticle

Assessment of Industry-Induced Urban Human Health Risks Related to Benzo[a]pyrene based on a Multimedia Fugacity Model: Case Study of Nanjing, China

by Linyu Xu^1,*, Huimin Song^1,2, Yan Wang¹ and Hao Yin¹

¹ State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Haidian District, Beijing 100875, China

² China Environment Publishing Co. Ltd., No.16 Guangqumennei Street, Dongcheng District, Beijing 100062, China

Int. J. Environ. Res. Public Health 2015, 12(6), 6162-6178; https://doi.org/10.3390/ijerph120606162 - 29 May 2015

Cited by 5 | Viewed by 5531

Abstract

Large amounts of organic pollutants emitted from industries have accumulated and caused serious human health risks, especially in urban areas with rapid industrialization. This paper focused on the carcinogen benzo[a]pyrene (BaP) from industrial effluent and gaseous emissions, and established a multi-pathway [...] Read more.

Large amounts of organic pollutants emitted from industries have accumulated and caused serious human health risks, especially in urban areas with rapid industrialization. This paper focused on the carcinogen benzo[a]pyrene (BaP) from industrial effluent and gaseous emissions, and established a multi-pathway exposure model based on a Level IV multimedia fugacity model to analyze the human health risks in a city that has undergone rapid industrialization. In this study, GIS tools combined with land-use data was introduced to analyze smaller spatial scales so as to enhance the spatial resolution of the results. An uncertainty analysis using a Monte Carlo simulation was also conducted to illustrate the rationale of the probabilistic assessment mode rather than deterministic assessment. Finally, the results of the case study in Nanjing, China indicated the annual average human cancer risk induced by local industrial emissions during 2002–2008 (lowest at 1.99´10^–6 in 2008 and highest at 3.34´10^–6 in 2004), which was lower than the USEPA prescriptive level (1´10^–6–1´10^–4) but cannot be neglected in the long term. The study results could not only instruct the BaP health risk management but also help future health risk prediction and control. Full article

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Open AccessArticle

Body Image and Nutritional Status Are Associated with Physical Activity in Men and Women: The ELSA-Brasil Study

by Carolina G. Coelho^1,*, Luana Giatti^1,2, Maria D. C. B. Molina³, Maria A. A. Nunes⁴ and Sandhi M. Barreto¹

¹ Public Health Postgraduate Program, Research Group on Epidemiology of Chronic and Occupational Diseases (GERMINAL), Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil

² Nutrition School, Universidade Federal de Ouro Preto, Ouro Preto, 35400-000, Brazil

³ Postgraduate Program in Public Health, Universidade Federal do Espírito Santo, Vitória, 29043-900, Brazil

⁴ Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, 90035-003, Brazil

Int. J. Environ. Res. Public Health 2015, 12(6), 6179-6196; https://doi.org/10.3390/ijerph120606179 - 29 May 2015

Cited by 42 | Viewed by 6909

Abstract

The association of body image dissatisfaction and obesity with physical activity is likely to differ according to gender. To investigate this hypothesis, we conducted a cross-sectional study among the ELSA-Brasil cohort members aged 34–65 years (n = 13,286). The body image dissatisfaction was [...] Read more.

The association of body image dissatisfaction and obesity with physical activity is likely to differ according to gender. To investigate this hypothesis, we conducted a cross-sectional study among the ELSA-Brasil cohort members aged 34–65 years (n = 13,286). The body image dissatisfaction was present even among normal weight individuals of both sexes and was associated with lesser chances of practicing moderate physical activity in women and intense physical activity in men. Men and women with central obesity were less prone to practice physical activity of high or moderate intensity. Overweight and obese men were more likely to report vigorous physical activity while obese women were less likely to report this level of physical activity. Body images as well as nutritional status are related to physical activity in both sexes, but the association with physical activity differs by gender. Full article

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Water, Sanitation, and Hygiene in Schools in Low Socio-Economic Regions in Nicaragua: A Cross-Sectional Survey

by Tania Jordanova^1,*, Ryan Cronk¹

, Wanda Obando², Octavio Zeledon Medina³, Rinko Kinoshita² and Jamie Bartram^1,*

¹ Department of Environmental Sciences and Engineering, The Water Institute, University of North Carolina, Chapel Hill, NC 27599, USA

² The United Nations Children's Fund (UNICEF), Managua 10000, Nicaragua

³ Independent Consultant, Managua 10000, Nicaragua

Int. J. Environ. Res. Public Health 2015, 12(6), 6197-6217; https://doi.org/10.3390/ijerph120606197 - 29 May 2015

Cited by 41 | Viewed by 11565

Abstract

Water, sanitation, and hygiene (WaSH) in schools contributes to better health and educational outcomes among school-aged children. In 2012, UNICEF Nicaragua and partners conducted a cross-sectional survey of WaSH in 526 schools in 12 low socio-economic status municipalities in Nicaragua. The survey gathered [...] Read more.

Water, sanitation, and hygiene (WaSH) in schools contributes to better health and educational outcomes among school-aged children. In 2012, UNICEF Nicaragua and partners conducted a cross-sectional survey of WaSH in 526 schools in 12 low socio-economic status municipalities in Nicaragua. The survey gathered information on: school characteristics; teacher and community participation; water and sanitation infrastructure; and hygiene education and habits. Survey results were analyzed for associations between variables. WaSH coverage was significantly higher in urban than rural areas. Presence of drinking water infrastructure (43%) was lower than sanitation infrastructure (64%). Eighty-one percent of schools had no hand washing stations and 74% of schools lacked soap. Sanitation facilities were not in use at 28% of schools with sanitation infrastructure and 26% of schools with water infrastructure had non-functional systems. Only 8% of schools had budgets to purchase toilet-cleaning supplies and 75% obtained supplies from students’ families. This study generates transferable WaSH sector learnings and new insights from monitoring data. Results can be used by donors, service providers, and policy makers to better target resources in Nicaraguan schools. Full article

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Open AccessReview

Petroleum Coke in the Urban Environment: A Review of Potential Health Effects

by Joseph A. Caruso^1,*, Kezhong Zhang², Nicholas J. Schroeck³, Benjamin McCoy³ and Shawn P. McElmurry⁴

¹ Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48201, USA

² Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA

³ Transnational Environmental Law Clinic, Wayne State University, Detroit, MI 48201, USA

⁴ Department of Civil & Environmental Engineering, Wayne State University, Detroit, MI 48073, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6218-6231; https://doi.org/10.3390/ijerph120606218 - 29 May 2015

Cited by 47 | Viewed by 10704

Abstract

Petroleum coke, or petcoke, is a granular coal-like industrial by-product that is separated during the refinement of heavy crude oil. Recently, the processing of material from Canadian oil sands in U.S. refineries has led to the appearance of large petcoke piles adjacent to [...] Read more.

Petroleum coke, or petcoke, is a granular coal-like industrial by-product that is separated during the refinement of heavy crude oil. Recently, the processing of material from Canadian oil sands in U.S. refineries has led to the appearance of large petcoke piles adjacent to urban communities in Detroit and Chicago. The purpose of this literature review is to assess what is known about the effects of petcoke exposure on human health. Toxicological studies in animals indicate that dermal or inhalation petcoke exposure does not lead to a significant risk for cancer development or reproductive and developmental effects. However, pulmonary inflammation was observed in long-term inhalation exposure studies. Epidemiological studies in coke oven workers have shown increased risk for cancer and chronic obstructive pulmonary diseases, but these studies are confounded by multiple industrial exposures, most notably to polycyclic aromatic hydrocarbons that are generated during petcoke production. The main threat to urban populations in the vicinity of petcoke piles is most likely fugitive dust emissions in the form of fine particulate matter. More research is required to determine whether petcoke fine particulate matter causes or exacerbates disease, either alone or in conjunction with other environmental contaminants. Full article

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Disparities in Children’s Blood Lead and Mercury Levels According to Community and Individual Socioeconomic Positions

by Sinye Lim¹, Mina Ha^2,*

, Seung-Sik Hwang³, Mia Son⁴ and Ho-Jang Kwon²

¹ Department of Occupational and Environmental Medicine, Kyung Hee University Hospital, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul 130-872, Korea

² Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-Ro, Dongnam-Gu, Cheonan, Chungnam 330-714, Korea

³ Department of Social Medicine, Inha University School of Medicine, 366 Seohae-Daero, Jung-Gu, Incheon 400-712, Korea

⁴ Department of Preventive Medicine, Kangwon National University School of Medicine, 1, Gangwondaehak-Gil, Chuncheon, Gangwon 200-701, Korea

Int. J. Environ. Res. Public Health 2015, 12(6), 6232-6248; https://doi.org/10.3390/ijerph120606232 - 29 May 2015

Cited by 22 | Viewed by 5389

Abstract

We aimed to examine the associations between blood lead and mercury levels and individual and community level socioeconomic positions (SEPs) in school-aged children. A longitudinal cohort study was performed in 33 elementary schools in 10 cities in Korea. Among a total of 6094 [...] Read more.

We aimed to examine the associations between blood lead and mercury levels and individual and community level socioeconomic positions (SEPs) in school-aged children. A longitudinal cohort study was performed in 33 elementary schools in 10 cities in Korea. Among a total of 6094 children included at baseline, the final study population, 2281 children followed-up biennially, were analyzed. The geometric mean (GM) levels of blood lead were 1.73 μg/dL (range 0.02–9.26) and 1.56 μg/dL (range 0.02–6.83) for male and female children, respectively. The blood lead levels were significantly higher in males, children living in rural areas, and those with lower individual SEP. The GM levels of blood mercury were 2.07 μg/L (range 0.09–12.67) and 2.06 μg/L (range 0.03–11.74) for males and females, respectively. Increased blood mercury levels were significantly associated with urban areas, higher individual SEP, and more deprived communities. The risk of high blood lead level was significantly higher for the lower individual SEP (odds ratio (OR) 2.18, 95% confidence interval (CI) 1.36–3.50 in the lowest educational attainment of the father), with a significant dose-response relationship observed after adjusting for the community SEP. The association between high blood lead levels and lower individual SEP was much stronger in the more deprived communities (OR 2.88, 95% CI 1.27–6.53) than in the less deprived communities (OR 1.40, 95% CI 0.76–2.59), and showed a significant decreasing trend during the follow-up only in the less deprived communities. The risk of high blood mercury levels was higher in higher individual SEP (OR 0.64, 95% CI 0.40–1.03 in the lowest educational attainment of the father), with a significant dose-response relationship noted. Significant decreasing trends were observed during the follow-up both in the less and more deprived communities. From a public health point-of-view, community level intervention with different approaches for different metals is warranted to protect children from environmental exposure. Full article

(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)

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Open AccessArticle

Class 1 Integrons and the Antiseptic Resistance Gene (qacEΔ1) in Municipal and Swine Slaughterhouse Wastewater Treatment Plants and Wastewater—Associated Methicillin-Resistant Staphylococcus aureus

by Min Tao Wan^1,2 and Chin Cheng Chou^1,*

¹ School of Veterinary Medicine, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei 106, Taiwan

² Biodiversity Research Center, Academia Sinica, 128 Academia Road, Section 2, Taipei 115, Taiwan

Int. J. Environ. Res. Public Health 2015, 12(6), 6249-6260; https://doi.org/10.3390/ijerph120606249 - 2 Jun 2015

Cited by 20 | Viewed by 5780

Abstract

Class 1 integrons are mobile gene elements (MGEs) containing qacEΔ1 that are resistant to quaternary ammonium compound (QAC) disinfectants. This study compared the abundances of class 1 integrons and antiseptic resistance genes in municipal (M) and swine slaughterhouse (S) wastewater treatment plants (WWTPs) [...] Read more.

Class 1 integrons are mobile gene elements (MGEs) containing qacEΔ1 that are resistant to quaternary ammonium compound (QAC) disinfectants. This study compared the abundances of class 1 integrons and antiseptic resistance genes in municipal (M) and swine slaughterhouse (S) wastewater treatment plants (WWTPs) and investigated the presence of class 1 integrons and antiseptic resistance genes in methicillin-resistant Staphylococcus aureus (MRSA) isolated from wastewater samples. The abundances of intI1 and qacEΔ1 genes in 96 wastewater samples were quantified using real-time quantitative polymerase chain reaction (real-time qPCR), and 113 MRSA isolates recovered from the wastewater samples were detected class 1 integrons and linked antiseptic resistance genes (qacEΔ1), and minimum inhibitory concentrations (MICs) for QAC antiseptics. The intI1 and qacEΔ1 genes were detected in all the wastewater samples, and they were more abundant in S-WWTP samples than in M-WWTP samples. A higher percentage of MRSA isolates carried qacEΔ1 in MRSA from swine wastewater samples (62.8%) than in municipal MRSA (3.7%). All the MRSA isolates showed high MICs for antiseptic agents. This study provides important evidence regarding the abundances of intI1 and qacEΔ1 genes in municipal and swine slaughterhouse wastewater, and antiseptic-resistant MRSA strains were detected in swine slaughterhouse wastewater. Full article

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An iPad-Based Tool for Improving the Skills of Children with Attention Deficit Disorder

by Natalia Wrońska¹, Begonya Garcia-Zapirain^2,*

and Amaia Mendez-Zorrilla²

¹ International Faculty of Engineering, Lodz University of Technology, Żwirki 36, Łódź 90-924, Poland

² The Deustotech-LIFE (eVIDA) Research Group, Faculty of Engineering, University of Deusto, Bilbao 48007, Spain

Int. J. Environ. Res. Public Health 2015, 12(6), 6261-6280; https://doi.org/10.3390/ijerph120606261 - 2 Jun 2015

Cited by 22 | Viewed by 8824

Abstract

Attention Deficit Hyperactivity Disorder (ADHD), with a worldwide prevalence of 5.29%–7.1%, is one of the most common neurodevelopmental disorders among children and adolescents. Apart from typical symptoms like inattention, hyperactivity and impulsiveness, patients also evidence attention deficit problems with reading comprehension. This in [...] Read more.

Attention Deficit Hyperactivity Disorder (ADHD), with a worldwide prevalence of 5.29%–7.1%, is one of the most common neurodevelopmental disorders among children and adolescents. Apart from typical symptoms like inattention, hyperactivity and impulsiveness, patients also evidence attention deficit problems with reading comprehension. This in turn causes poor school performance and widens the gap with peers without ADHD. This paper presents a novel and interactive tool based on Serious Games for Health, whose aim is not only to improve comprehension, but also hold the user’s attention. This tool is geared towards assessing reading quality and is intended for iPad devices. Preliminary results obtained from the experiment performed to evaluate the game are included in this report. A group of six typically developing children from Colegio Vizcaya aged between 8 and 12 took part in the evaluation of motivation, satisfaction and usability of the same therapy in the new media. Results obtained by participants playing the game were analysed together with questionnaires concerning the usability of the system. Game evaluation resulted in relatively good statistics-average score was 3 points out of 4 and average time for completing the exercise was 59 seconds. A SUS questionnaire with an average score of 92.75 out of 100 indicates that the game presented is user-friendly and an effective tool. Moreover, based on the feedback obtained from participants, the game had been improved and additional functionality introduced. Older participants completed the first game faster than the younger ones, but age was not influential in subsequent games. Full article

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Relationship between Urinary Pesticide Residue Levels and Neurotoxic Symptoms among Women on Farms in the Western Cape, South Africa

by Portia M. Motsoeneng and Mohamed A. Dalvie^*

Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town 7935, South Africa

Int. J. Environ. Res. Public Health 2015, 12(6), 6281-6299; https://doi.org/10.3390/ijerph120606281 - 2 Jun 2015

Cited by 33 | Viewed by 5709

Abstract

Background: This cross-sectional study aimed to investigate the relationship between urinary pesticide residue levels and neurotoxic symptoms amongst women working on Western Cape farms in South Africa. Method: A total of 211 women were recruited from farms (n = 121) and [...] Read more.

Background: This cross-sectional study aimed to investigate the relationship between urinary pesticide residue levels and neurotoxic symptoms amongst women working on Western Cape farms in South Africa. Method: A total of 211 women were recruited from farms (n = 121) and neighbouring towns (n = 90). Participant assessment was via a Q16 questionnaire, reporting on pesticide exposures and measurement of urinary OP metabolite concentrations of dialkyl phosphates (DAP) and chlorpyriphos, 3,5,6-trichloropyridinol (TCPY) and of pyrethroid (PYR) metabolite concentrations (3- phenoxybenzoic acid (3PBA), 4-fluoro-3-phenoxybenzoic acid (4F3PBA), cis-2,2-dibromovinyl-2,2-dimethylcyclopropane-1-carboxylic acid (DBCA), and the cis- and trans isomers of 2,2-dichlorovinyl-2,2-dimethylcyclopropane-1-carboxylic acid. Results: Median urinary pesticide metabolites were slightly (6%–49%) elevated in the farm group compared to the town group, with 2 metabolites significantly higher and some lower in the farm group. The prevalence of all Q16 symptoms was higher amongst farm women compared to town women. Three Q16 symptoms (problems with buttoning, reading and notes) were significantly positively associated with three pyrethroid metabolites (cis- and trans-DCCA and DBCA), although associations may due to chance as multiple comparisons were made. The strongest association for a pyrethroid metabolite was between problems with buttoning and DBCA (odds ratio (OR) = 8.93, 95% confidence interval (CI):1.71–46.5. There was no association between Q16 symptoms and OP metabolites. Conclusions: Women farm residents and rural women from neighbouring towns in the Western Cape are exposed to OP and PYR pesticides. The study did not provide strong evidence that pesticides are associated with neurotoxic symptoms but associations found could be explored further. Full article

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Open AccessArticle

Toxic Releases and Risk Disparity: A Spatiotemporal Model of Industrial Ecology and Social Empowerment

by Hannah Aoyagi¹ and Oladele A. Ogunseitan^1,2,*

¹ School of Social Ecology, University of California, Irvine, CA 92697, USA

² Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, CA 92697, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6300-6318; https://doi.org/10.3390/ijerph120606300 - 2 Jun 2015

Cited by 7 | Viewed by 5487

Abstract

Information-based regulations (IBRs) are founded on the theoretical premise that public participation in accomplishing policy goals is empowered by open access to information. Since its inception in 1988, the Toxics Release Inventory (TRI) has provided the framework and regulatory impetus for the compilation [...] Read more.

Information-based regulations (IBRs) are founded on the theoretical premise that public participation in accomplishing policy goals is empowered by open access to information. Since its inception in 1988, the Toxics Release Inventory (TRI) has provided the framework and regulatory impetus for the compilation and distribution of data on toxic releases associated with industrial development, following the tenets of IBR. As TRI emissions are reputed to disproportionately affect low-income communities, we investigated how demographic characteristics are related to change in TRI emissions and toxicity risks between 1989 and 2002, and we sought to identify factors that predict these changes. We used local indicators of spatial association (LISA) maps and spatial regression techniques to study risk disparity in the Los Angeles urban area. We also surveyed 203 individuals in eight communities in the same region to measure the levels of awareness of TRI, attitudes towards air pollution, and general environmental risk. We discovered, through spatial lag models, that changes in gross and toxic emissions are related to community ethnic composition, poverty level, home ownership, and base 1989 emissions (R-square = 0.034–0.083). We generated a structural equation model to explain the determinants of social empowerment to act on the basis of environmental information. Hierarchical confirmatory factor analysis (HCFA) supports the theoretical model that individual empowerment is predicted by risk perception, worry, and awareness (Chi-square = 63.315, p = 0.022, df = 42). This study provides strong evidence that spatiotemporal changes in regional-scale environmental risks are influenced by individual-scale empowerment mediated by IBRs. Full article

(This article belongs to the Special Issue Hazardous Waste and Human Health-2015)

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Open AccessArticle

An Evaluation of Antifungal Agents for the Treatment of Fungal Contamination in Indoor Air Environments

by Senthaamarai Rogawansamy^1,†, Sharyn Gaskin^1,*,†, Michael Taylor^1,2 and Dino Pisaniello¹

¹ Occupational and Environmental Hygiene Laboratory, Discipline of Public Health, School of Population Health, University of Adelaide, South Australia 5005, Australia

² Health and Environment, School of the Environment, Flinders University, South Australia 5042, Australia

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6319-6332; https://doi.org/10.3390/ijerph120606319 - 2 Jun 2015

Cited by 47 | Viewed by 13439

Abstract

Fungal contamination in indoor environments has been associated with adverse health effects for the inhabitants. Remediation of fungal contamination requires removal of the fungi present and modifying the indoor environment to become less favourable to growth. This may include treatment of indoor environments [...] Read more.

Fungal contamination in indoor environments has been associated with adverse health effects for the inhabitants. Remediation of fungal contamination requires removal of the fungi present and modifying the indoor environment to become less favourable to growth. This may include treatment of indoor environments with an antifungal agent to prevent future growth. However there are limited published data or advice on chemical agents suitable for indoor fungal remediation. The aim of this study was to assess the relative efficacies of five commercially available cleaning agents with published or anecdotal use for indoor fungal remediation. The five agents included two common multi-purpose industrial disinfectants (Cavicide^® and Virkon^®), 70% ethanol, vinegar (4.0%-4.2% acetic acid), and a plant-derived compound (tea tree (Melaleuca alternifolia) oil) tested in both a liquid and vapour form. Tea tree oil has recently generated interest for its antimicrobial efficacy in clinical settings, but has not been widely employed for fungal remediation. Each antifungal agent was assessed for fungal growth inhibition using a disc diffusion method against a representative species from two common fungal genera, (Aspergillus fumigatus and Penicillium chrysogenum), which were isolated from air samples and are commonly found in indoor air. Tea tree oil demonstrated the greatest inhibitory effect on the growth of both fungi, applied in either a liquid or vapour form. Cavicide^® and Virkon^® demonstrated similar, although less, growth inhibition of both genera. Vinegar (4.0%–4.2% acetic acid) was found to only inhibit the growth of P. chrysogenum, while 70% ethanol was found to have no inhibitory effect on the growth of either fungi. There was a notable inhibition in sporulation, distinct from growth inhibition after exposure to tea tree oil, Virkon^®, Cavicide^® and vinegar. Results demonstrate that common cleaning and antifungal agents differ in their capacity to inhibit the growth of fungal genera found in the indoor air environment. The results indicate that tea tree oil was the most effective antifungal agent tested, and may have industrial application for the remediation of fungal contamination in residential and occupational buildings. Full article

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Open AccessReview

Prototype Early Warning Systems for Vector-Borne Diseases in Europe

by Jan C. Semenza

European Centre for Disease Prevention and Control, Tomtebodavagen 11A, SE-171 83 Stockholm, Sweden

Int. J. Environ. Res. Public Health 2015, 12(6), 6333-6351; https://doi.org/10.3390/ijerph120606333 - 2 Jun 2015

Cited by 32 | Viewed by 22581

Abstract

Globalization and environmental change, social and demographic determinants and health system capacity are significant drivers of infectious diseases which can also act as epidemic precursors. Thus, monitoring changes in these drivers can help anticipate, or even forecast, an upsurge of infectious diseases. The [...] Read more.

Globalization and environmental change, social and demographic determinants and health system capacity are significant drivers of infectious diseases which can also act as epidemic precursors. Thus, monitoring changes in these drivers can help anticipate, or even forecast, an upsurge of infectious diseases. The European Environment and Epidemiology (E3) Network has been built for this purpose and applied to three early warning case studies: (1) The environmental suitability of malaria transmission in Greece was mapped in order to target epidemiological and entomological surveillance and vector control activities. Malaria transmission in these areas was interrupted in 2013 through such integrated preparedness and response activities. (2) Since 2010, recurrent West Nile fever outbreaks have ensued in South/eastern Europe. Temperature deviations from a thirty year average proved to be associated with the 2010 outbreak. Drivers of subsequent outbreaks were computed through multivariate logistic regression models and included monthly temperature anomalies for July and a normalized water index. (3) Dengue is a tropical disease but sustained transmission has recently emerged in Madeira. Autochthonous transmission has also occurred repeatedly in France and in Croatia mainly due to travel importation. The risk of dengue importation into Europe in 2010 was computed with the volume of international travelers from dengue affected areas worldwide.These prototype early warning systems indicate that monitoring drivers of infectious diseases can help predict vector-borne disease threats. Full article

(This article belongs to the Special Issue Climate Change Impacts on Vector-borne Diseases)

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Open AccessArticle

SaDA: From Sampling to Data Analysis—An Extensible Open Source Infrastructure for Rapid, Robust and Automated Management and Analysis of Modern Ecological High-Throughput Microarray Data

by Kumar Saurabh Singh^1,*, Dominique Thual², Roberto Spurio¹ and Nicola Cannata³

¹ School of Biosciences and Veterinary Medicine, University of Camerino, Via Gentile III da Varano Camerino 62032, Italy

² Next Generation Bioinformatics s.r.l Camerino 62032, Italy

³ School of Science and Technology, University of Camerino, Via Madonna delle Carceri Camerino 62032, Italy

Int. J. Environ. Res. Public Health 2015, 12(6), 6352-6366; https://doi.org/10.3390/ijerph120606352 - 3 Jun 2015

Cited by 5 | Viewed by 6285

Abstract

One of the most crucial characteristics of day-to-day laboratory information management is the collection, storage and retrieval of information about research subjects and environmental or biomedical samples. An efficient link between sample data and experimental results is absolutely important for the successful outcome [...] Read more.

One of the most crucial characteristics of day-to-day laboratory information management is the collection, storage and retrieval of information about research subjects and environmental or biomedical samples. An efficient link between sample data and experimental results is absolutely important for the successful outcome of a collaborative project. Currently available software solutions are largely limited to large scale, expensive commercial Laboratory Information Management Systems (LIMS). Acquiring such LIMS indeed can bring laboratory information management to a higher level, but most of the times this requires a sufficient investment of money, time and technical efforts. There is a clear need for a light weighted open source system which can easily be managed on local servers and handled by individual researchers. Here we present a software named SaDA for storing, retrieving and analyzing data originated from microorganism monitoring experiments. SaDA is fully integrated in the management of environmental samples, oligonucleotide sequences, microarray data and the subsequent downstream analysis procedures. It is simple and generic software, and can be extended and customized for various environmental and biomedical studies. Full article

(This article belongs to the Special Issue Small Solutions for Big Water-Related Problems—Innovative Microarrays and Small Sensors to Cope with Water Quality and Food Security)

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Open AccessArticle

Health Status and Risk Factors among Adolescent Survivors One Month after the 2014 Ludian Earthquake

by Bihan Tang^†, Yang Ge^†, Chen Xue^†, Peng Kang, Yuan Liu, Xu Liu, Zhipeng Liu, Wenya Yu and Lulu Zhang^*

¹ Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai 200433, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6367-6377; https://doi.org/10.3390/ijerph120606367 - 4 Jun 2015

Cited by 6 | Viewed by 5516

Abstract

Background: An earthquake struck Ludian in Yunnan Province (China) on 3 August 2014, resulting in 3143 injuries, 617 deaths, and 112 missing persons. Our study aimed at estimating the health status and associated determinants among adolescent survivors after the Ludian earthquake. Methods: [...] Read more.

Background: An earthquake struck Ludian in Yunnan Province (China) on 3 August 2014, resulting in 3143 injuries, 617 deaths, and 112 missing persons. Our study aimed at estimating the health status and associated determinants among adolescent survivors after the Ludian earthquake. Methods: A cross-sectional survey of 845 was conducted at the Ludian No. 1 Middle School. Descriptive statistics, t-tests, ANOVA and stepwise linear regression analysis were used for data analysis. Results: The mean scores on the physical component summary (PCS) and mental component summary (MCS) were 46.23 (SD = 7.10) and 36.34 (SD = 7.09), respectively. Lower PCS scores in the aftermath of an earthquake were associated with being trapped or in danger, being female, being an ethnic minority, injury to self and house damage, while lower MSC scores were associated with fear during the earthquake, Han ethnicity, death in the family, not being involved in the rescue and low household income. Conclusions: In our study, significant associations between demographic, socio-economic, and trauma-related experiences variables and overall physical and mental health of adolescent survivors were presented. The results of this study help expand our knowledge of health status among adolescent survivors after the Ludian earthquake. Full article

(This article belongs to the Special Issue Health Behaviors and Public Health)

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Clear Skies and Grey Areas: Flight Attendants’ Secondhand Smoke Exposure and Attitudes toward Smoke-Free Policy 25 Years since Smoking was Banned on Airplanes

by Frances A. Stillman^1,*, Andrea Soong¹, Laura Y. Zheng² and Ana Navas-Acien²

¹ Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA

² Department of Environmental Health Sciences, Baltimore, Johns Hopkins Bloomberg School of Public Health, MD 21205, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6378-6387; https://doi.org/10.3390/ijerph120606378 - 4 Jun 2015

Cited by 4 | Viewed by 6305

Abstract

Our objective was to provide descriptive data on flight attendant secondhand smoke (SHS) exposure in the work environment, and to examine attitudes toward SHS exposure, personal health, and smoke-free policy in the workplace and public places. Flight attendants completed a web-based survey of [...] Read more.

Our objective was to provide descriptive data on flight attendant secondhand smoke (SHS) exposure in the work environment, and to examine attitudes toward SHS exposure, personal health, and smoke-free policy in the workplace and public places. Flight attendants completed a web-based survey of self-reported SHS exposure and air quality in the work environment. We assessed the frequency and duration of SHS exposure in distinct areas of the workplace, attitudes toward SHS exposure and its health effects, and attitudes toward smoke-free policy in the workplace as well as general public places. A total of 723 flight attendants participated in the survey, and 591 responded to all survey questions. The mean level of exposure per flight attendant over the past month was 249 min. The majority of participants reported being exposed to SHS always/often in outdoor areas of an airport (57.7%). Participants who worked before the in-flight smoking ban (n = 240) were more likely to support further smoking policies in airports compared to participants who were employed after the ban (n = 346) (76.7% versus 60.4%, p-value < 0.01). Flight attendants are still being exposed to SHS in the workplace, sometimes at concerning levels during the non-flight portions of their travel. Flight attendants favor smoke-free policies and want to see further restrictions in airports and public places. Full article

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Open AccessArticle

State-Issued Identification Cards Reveal Patterns in Adult Weight Status

by Daniel S. Morris^1,*, Eric C. Main², Jenine K. Harris³, Abraham Moland¹ and Curtis Cude²

¹ School of Community Health, Portland State University, Portland, OR 97201, USA

² Oregon Health Authority Public Health Division, Portland, OR 97232, USA

³ George Warren Brown School of Social Work, Washington University in St. Louis, MO 63119, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6388-6402; https://doi.org/10.3390/ijerph120606388 - 8 Jun 2015

Cited by 1 | Viewed by 5641

Abstract

Background: State-issued identification cards are a promising data source for neighborhood-level obesity estimates. Methods: We used information from three million Oregon state-issued identification cards to compute age-adjusted estimates of average adult body mass index (BMI) for each census tract in the state. We [...] Read more.

Background: State-issued identification cards are a promising data source for neighborhood-level obesity estimates. Methods: We used information from three million Oregon state-issued identification cards to compute age-adjusted estimates of average adult body mass index (BMI) for each census tract in the state. We used multivariate linear regression to identify associations between weight status and population characteristics, food access, commuting behavior, and geography. Results: Together, home values, education, race, ethnicity, car commuting, and rural-urban commuting area (RUCA) explained 86% of the variation in BMI among tracts. BMI was lower in areas with higher home values and greater educational attainment, and higher in areas with more workers commuting by car. Discussion: Our findings are consistent with other research on socioeconomic disparities in obesity. This demonstrates state-issued identification cards are a promising data source for BMI surveillance and may offer new insight into the association between weight status and economic and environmental factors. Public health agencies should explore options for developing their own obesity estimates from identification card data. Full article

(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)

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Open AccessArticle

Smoking Cessation among Low-Socioeconomic Status and Disadvantaged Population Groups: A Systematic Review of Research Output

by Ryan J. Courtney^1,*, Sundresan Naicker¹, Anthony Shakeshaft¹

, Philip Clare¹, Kristy A. Martire^1,2 and Richard P. Mattick¹

¹ National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia

² School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia

Int. J. Environ. Res. Public Health 2015, 12(6), 6403-6422; https://doi.org/10.3390/ijerph120606403 - 8 Jun 2015

Cited by 24 | Viewed by 10763

Abstract

Background: Smoking cessation research output should move beyond descriptive research of the health problem to testing interventions that can provide causal data and effective evidence-based solutions. This review examined the number and type of published smoking cessation studies conducted in low-socioeconomic status [...] Read more.

Background: Smoking cessation research output should move beyond descriptive research of the health problem to testing interventions that can provide causal data and effective evidence-based solutions. This review examined the number and type of published smoking cessation studies conducted in low-socioeconomic status (low-SES) and disadvantaged population groups. Methods: A systematic database search was conducted for two time periods: 2000–2004 (TP1) and 2008–2012 (TP2). Publications that examined smoking cessation in a low-SES or disadvantaged population were coded by: population of interest; study type (reviews, non-data based publications, data-based publications (descriptive, measurement and intervention research)); and country. Intervention studies were coded in accordance with the Cochrane Effective Practice and Organisation of Care data collection checklist and use of biochemical verification of self-reported abstinence was assessed. Results: 278 citations were included. Research output (i.e., all study types) had increased from TP1 27% to TP2 73% (χ² = 73.13, p < 0.001), however, the proportion of data-based research had not significantly increased from TP1 and TP2: descriptive (TP1 = 23% vs. TP2 = 33%) or intervention (TP1 = 77% vs. TP2 = 67%). The proportion of intervention studies adopting biochemical verification of self-reported abstinence had significantly decreased from TP1 to TP2 with an increased reliance on self-reported abstinence (TP1 = 12% vs. TP2 = 36%). Conclusions: The current research output is not ideal or optimal to decrease smoking rates. Research institutions, scholars and funding organisations should take heed to review findings when developing future research and policy. Full article

(This article belongs to the Special Issue Tobacco Control 2015)

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What is the Relationship between Risky Outdoor Play and Health in Children? A Systematic Review

by Mariana Brussoni^1,2,*, Rebecca Gibbons³, Casey Gray⁴, Takuro Ishikawa¹, Ellen Beate Hansen Sandseter⁵, Adam Bienenstock^6,†, Guylaine Chabot^7,†, Pamela Fuselli^8,†, Susan Herrington^9,†, Ian Janssen^10,11,†, William Pickett^11,†, Marlene Power^12,†, Nick Stanger^13,†, Margaret Sampson¹⁴ and Mark S. Tremblay^4,15

¹ British Columbia Injury Research & Prevention Unit, Child & Family Research Institute, University of British Columbia, British Columbia Children's Hospital, F511-4480 Oak Street, Vancouver, BC V6H 3V4, Canada

² Department of Pediatrics, School of Population & Public Health, University of British Columbia, British Columbia Children's Hospital, F511-4480 Oak Street, Vancouver, BC V6H 3V4, Canada

³ School of Population & Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6H 3V4, Canada

⁴ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada

⁵ Department of Physical Education and Health, College of Early Childhood Education, Queen Maud University, Thrond Nergaards Vei 7, NO-7044 Trondheim, Norway

⁶ Bienenstock Natural Playgrounds, 64 Hatt Street, Dundas, ON L9H 7T6, Canada

⁷ Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute, Laval University, 2725 Chemin Ste-Foy, Local Y4283, QC G1V 4G5, Canada

⁸ Parachute, 150 Eglinton Avenue East, Suite 300, Toronto, ON M4P 1E8, Canada

⁹ School of Architecture and Landscape Architecture, University of British Columbia, 379-2357 Main Mall, Vancouver, BC B6T 1Z4, Canada

¹⁰ School of Kinesiology and Health Studies, Queen's University, 99 University Avenue, Kingston, ON K7L 2P5, Canada

¹¹ Department of Public Health Sciences, Carruthers Hall, Queen's University, Kingston, ON K7L 2P5, Canada

¹² Forest School Canada, 411 Corkstown Road, Ottawa, ON K2K 2Y1, Canada

¹³ Department of Environmental Studies, Huxley College of the Environment, Western Washington University, 416 High Street, Bellingham, Washington, DC 98225, USA

¹⁴ Library Services, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada

¹⁵ Department of Pediatrics, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada

^† These authors contributed equally to this work.

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Int. J. Environ. Res. Public Health 2015, 12(6), 6423-6454; https://doi.org/10.3390/ijerph120606423 - 8 Jun 2015

Cited by 316 | Viewed by 89666

Abstract

Risky outdoor play has been associated with promoting children’s health and development, but also with injury and death. Risky outdoor play has diminished over time, concurrent with increasing concerns regarding child safety and emphasis on injury prevention. We sought to conduct a systematic [...] Read more.

Risky outdoor play has been associated with promoting children’s health and development, but also with injury and death. Risky outdoor play has diminished over time, concurrent with increasing concerns regarding child safety and emphasis on injury prevention. We sought to conduct a systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression. The review indicated the need for additional “good quality” studies; however, we note that even in the face of the generally exclusionary systematic review process, our findings support the promotion of risky outdoor play for healthy child development. These positive results with the marked reduction in risky outdoor play opportunities in recent generations indicate the need to encourage action to support children’s risky outdoor play opportunities. Policy and practice precedents and recommendations for action are discussed. Full article

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What Is the Relationship between Outdoor Time and Physical Activity, Sedentary Behaviour, and Physical Fitness in Children? A Systematic Review

by Casey Gray^1,*, Rebecca Gibbons², Richard Larouche¹, Ellen Beate Hansen Sandseter³, Adam Bienenstock^4,†, Mariana Brussoni^5,6,†, Guylaine Chabot^7,†, Susan Herrington^8,†, Ian Janssen^9,10,†, William Pickett^10,†, Marlene Power^11,†, Nick Stanger^12,†, Margaret Sampson¹³ and Mark S. Tremblay^1,14

¹ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada

² School of Population & Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6H 3V4, Canada

³ Department of Physical Education and Health, Queen Maud University College of Early Childhood Education, Thrond Nergaards Vei 7, NO-7044 Trondheim, Norway

⁴ Bienenstock Natural Playgrounds, 64 Hatt Street, Dundas, ON L9H 7T6, Canada

⁵ British Columbia Injury Research & Prevention Unit, Child & Family Research Institute, British Columbia Children's Hospital, University of British Columbia, F511-4480 Oak Street, Vancouver, BC V6H 3V4, Canada

⁶ Department of Pediatrics, School of Population & Public Health, British Columbia Children's Hospital, University of British Columbia, F511-4480 Oak Street, Vancouver, BC V6H 3V4, Canada

⁷ Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Laval University, 2725 Chemin Ste-Foy, Local Y4283, Quebec, QC G1V 4G5, Canada

⁸ School of Architecture and Landscape Architecture, University of British Columbia, 379-2357 Main Mall, Vancouver, BC B6T 1Z4, Canada

⁹ School of Kinesiology and Health Studies, Queen's University, 99 University Avenue, Kingston, ON K7L 2P5, Canada

¹⁰ Department of Public Health Sciences, Queen's University, Carruthers Hall, Kingston, ON K7L 2P5, Canada

¹¹ Forest School Canada, 411 Corkstown Road, Ottawa, ON K2K 2Y1, Canada

¹² Department of Environmental Studies, Huxley College of the Environment, Western Washington University, 416 High Street, Bellingham, WA 98225, USA

¹³ Library Services, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada

¹⁴ Department of Pediatrics, Faculty of Medicine, University of Ottawa, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada

^† These authors contributed equally to this work.

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Int. J. Environ. Res. Public Health 2015, 12(6), 6455-6474; https://doi.org/10.3390/ijerph120606455 - 8 Jun 2015

Cited by 295 | Viewed by 36595

Abstract

The objective of this systematic review was to examine the relationship between outdoor time and: (1) physical activity, (2) cardiorespiratory fitness, (3) musculoskeletal fitness, (4) sedentary behaviour; or (5) motor skill development in children aged 3–12 years. We identified 28 relevant studies that [...] Read more.

The objective of this systematic review was to examine the relationship between outdoor time and: (1) physical activity, (2) cardiorespiratory fitness, (3) musculoskeletal fitness, (4) sedentary behaviour; or (5) motor skill development in children aged 3–12 years. We identified 28 relevant studies that were assessed for quality using the GRADE framework. The systematic review revealed overall positive effects of outdoor time on physical activity, sedentary behaviour, and cardiorespiratory fitness, although causality could not be assumed due to a lack of RCTs. Motor skill development was unrelated to outdoor time; however, this relationship was only examined in a single study of preschool children. No studies were found that examined associations between outdoor time and musculoskeletal fitness. Full article

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Position Statement on Active Outdoor Play

by Mark S. Tremblay^1,2,3,*, Casey Gray¹, Shawna Babcock^4,†, Joel Barnes¹, Christa Costas Bradstreet^5,†, Dawn Carr^6,†, Guylaine Chabot⁷, Louise Choquette^8,†, David Chorney^9,†, Cam Collyer^10,†, Susan Herrington^11,†, Katherine Janson⁵, Ian Janssen^12,†, Richard Larouche¹, William Pickett^13,†, Marlene Power^14,†, Ellen Beate Hansen Sandseter^15,†, Brenda Simon^16,† and Mariana Brussoni¹⁷

¹ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada

² Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada

³ School of Human Kinetics, University of Ottawa, 125 University Private, Ottawa, Ontario, K1N 1A2, Canada

⁴ KidActive, 559A, Burtron Lane, Combermere, Ontario, K0J 1L0, Canada

⁵ ParticipACTION, 77 Bloor Street West, Toronto, Ontario, M5S 1M2, Canada

⁶ Canadian Parks Council, 455 Hunter Street West, Peterborough, Ontario, K9H 2M7, Canada

⁷ Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Laval University, 2725 Chemin Ste-Foy, Québec City, Québec, G1V 4G5, Canada

⁸ Best Start Resource Centre—Health Nexus, 180 Dundas Street West, Toronto, Ontario, M5G 1Z8, Canada

⁹ PHE Canada, 301-2197 Riverside Drive, Ottawa, Ontario, K1H 7X3, Canada

¹⁰ Evergreen, 550 Bayview Avenue, Toronto, Ontario, M4W 3X8, Canada

¹¹ School of Architecture and Landscape Architecture, University of British Columbia, 379-2357 Main Mall, Vancouver, British Columbia, B6T 1Z4, Canada

¹² Department of Public Health Sciences, School of Kinesiology and Health Studies, Queen's University, 99 University Avenue, Kingston, Ontario, K7L 2P5, Canada

¹³ Department of Public Health Sciences, Carruthers Hall, Queen's University, Kingston, Ontario, K7L 2P5, Canada

¹⁴ Forest School Canada, Child and Nature Alliance of Canada, 411 Corkstown Road, Ottawa, Ontario, K2K 2Y1, Canada

¹⁵ Department of Physical Education and Health, College of Early Childhood Education, Queen Maud University, Thrond Nergaardsvei 7, NO-7044 Trondheim, Norway

¹⁶ PLAYbynature, 226 Albany Avenue, Toronto, Ontario, M5R 3C6, Canada

¹⁷ British Columbia Injury Research & Prevention Unit, Department of Pediatrics, School of Population & Public Health, Child & Family Research Institute, British Columbia Children's Hospital, University of British Columbia, , F511-4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada

^† These authors contributed equally to this work.

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Int. J. Environ. Res. Public Health 2015, 12(6), 6475-6505; https://doi.org/10.3390/ijerph120606475 - 8 Jun 2015

Cited by 283 | Viewed by 54148

Abstract

A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3–12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement [...] Read more.

A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3–12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement on the relative benefits and harms of active (including risky) outdoor play. The Position Statement development process was informed by two systematic reviews, a critical appraisal of the current literature and existing position statements, engagement of research experts (N = 9) and cross-sectorial individuals/organizations (N = 17), and an extensive stakeholder consultation process (N = 1908). More than 95% of the stakeholders consulted strongly agreed or somewhat agreed with the Position Statement; 14/17 participating individuals/organizations endorsed it; and over 1000 additional individuals and organizations requested their name be listed as a supporter. The final Position Statement on Active Outdoor Play states: “Access to active play in nature and outdoors—with its risks— is essential for healthy child development. We recommend increasing children’s opportunities for self-directed play outdoors in all settings—at home, at school, in child care, the community and nature.” The full Position Statement provides context for the statement, evidence supporting it, and a series of recommendations to increase active outdoor play opportunities to promote healthy child development. Full article

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Environmental Asthma Reduction Potential Estimates for Selected Mitigation Actions in Finland Using a Life Table Approach

by Isabell Katharina Rumrich^* and Otto Hänninen

Department of Health Protection, National Institute for Health and Welfare (THL), Kuopio 70210 Finland

Int. J. Environ. Res. Public Health 2015, 12(6), 6506-6522; https://doi.org/10.3390/ijerph120606506 - 9 Jun 2015

Cited by 2 | Viewed by 5576

Abstract

Aims: To quantify the reduction potential of asthma in Finland achievable by adjusting exposures to selected environmental factors. Methods: A life table model for the Finnish population for 1986–2040 was developed and Years Lived with Disability caused by asthma and attributable to the [...] Read more.

Aims: To quantify the reduction potential of asthma in Finland achievable by adjusting exposures to selected environmental factors. Methods: A life table model for the Finnish population for 1986–2040 was developed and Years Lived with Disability caused by asthma and attributable to the following selected exposures were estimated: tobacco smoke (smoking and second hand tobacco smoke), ambient fine particles, indoor dampness and mould, and pets. Results: At baseline (2011) about 25% of the total asthma burden was attributable to the selected exposures. Banning tobacco was the most efficient mitigation action, leading to 6% reduction of the asthma burden. A 50% reduction in exposure to dampness and mould as well as a doubling in exposure to pets lead each to a 2% reduction. Ban of urban small scale wood combustion, chosen as a mitigation action to reduce exposure to fine particles, leads to a reduction of less than 1% of the total asthma burden. Combination of the most efficient mitigation actions reduces the total asthma burden by 10%. A more feasible combination of mitigation actions leads to 6% reduction of the asthma burden. Conclusions: The adjustment of environmental exposures can reduce the asthma burden in Finland by up to 10%. Full article

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Open AccessArticle

When Distraction Holds Relevance: A Prospective Memory Benefit for Older Adults

by Joana S. Lourenço and Elizabeth A. Maylor^*

Department of Psychology, University of Warwick, Coventry CV4 7AL, UK

Int. J. Environ. Res. Public Health 2015, 12(6), 6523-6541; https://doi.org/10.3390/ijerph120606523 - 9 Jun 2015

Cited by 7 | Viewed by 5747

Abstract

Evidence is accumulating to show that age-related increases in susceptibility to distracting information can benefit older more than young adults in several cognitive tasks. Here we focus on prospective memory (i.e., remembering to carry out future intentions) and examine the effect [...] Read more.

Evidence is accumulating to show that age-related increases in susceptibility to distracting information can benefit older more than young adults in several cognitive tasks. Here we focus on prospective memory (i.e., remembering to carry out future intentions) and examine the effect of presenting distracting information that is intention-related as a function of age. Young and older adults performed an ongoing 1-back working memory task to a rapid stream of pictures superimposed with to-be-ignored letter strings. Participants were additionally instructed to respond to target pictures (namely, animals) and, for half of the participants, some strings prior to the targets were intention-related words (i.e., animals). Results showed that presenting intention-related distracting information during the ongoing task was particularly advantageous for target detection in older compared to young adults. Moreover, a prospective memory benefit was observed even for older adults who showed no explicit memory for the target distracter words. We speculate that intention-related distracter information enhanced the accessibility of the prospective memory task and suggest that when distracting information holds relevance to intentions it can serve a compensatory role in prospective remembering in older adults. Full article

(This article belongs to the Special Issue Aging and Cognition)

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Ecosystem Functions Connecting Contributions from Ecosystem Services to Human Wellbeing in a Mangrove System in Northern Taiwan

by Hwey-Lian Hsieh¹, Hsing-Juh Lin^1,2, Shang-Shu Shih³

and Chang-Po Chen^1,*

¹ Biodiversity Research Center, Academia Sinica, Taipei 115, Taiwan

² Department of Life Sciences and Research Center for Global Change Biology, National Chung Hsing University, Taichung 402, Taiwan

³ Hydrotech Research Institute, National Taiwan University, Taipei 106, Taiwan

Int. J. Environ. Res. Public Health 2015, 12(6), 6542-6560; https://doi.org/10.3390/ijerph120606542 - 9 Jun 2015

Cited by 23 | Viewed by 7523

Abstract

The present study examined a mangrove ecosystem in northern Taiwan to determine how the various components of ecosystem function, ecosystem services and human wellbeing are connected. The overall contributions of mangrove services to specific components of human wellbeing were also assessed. A network [...] Read more.

The present study examined a mangrove ecosystem in northern Taiwan to determine how the various components of ecosystem function, ecosystem services and human wellbeing are connected. The overall contributions of mangrove services to specific components of human wellbeing were also assessed. A network was developed and evaluated by an expert panel consisting of hydrologists, ecologists, and experts in the field of culture, landscape or architecture. The results showed that supporting habitats was the most important function to human wellbeing, while water quality, habitable climate, air quality, recreational opportunities, and knowledge systems were services that were strongly linked to human welfare. Security of continuous supply of services appeared to be the key to a comfortable life. From a bottom-up and top-down perspective, knowledge systems (a service) were most supported by ecosystem functions, while the security of continuous supply of services (wellbeing) had affected the most services. In addition, the overall benefits of mangrove services to human prosperity concentrated on mental health, security of continuous supply of services, and physical health. Full article

(This article belongs to the Special Issue Proceedings from 2014 Global Land Project (GLP) Asia Conference)

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The Impact of Different Degrees of Feedback on Physical Activity Levels: A 4-Week Intervention Study

by Karen Van Hoye^*, Filip Boen^† and Johan Lefevre^†

¹ Department of Kinesiology, Physical Activity, Sports & Health Research Group, KU Leuven, Leuven 3001, Belgium

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6561-6581; https://doi.org/10.3390/ijerph120606561 - 9 Jun 2015

Cited by 21 | Viewed by 7194

Abstract

Assessing levels of physical activity (PA) and providing feedback about these levels might have an effect on participant’s PA behavior. This study discusses the effect of different levels of feedback—from minimal to use of a feedback display and coach—on PA over a 4-week [...] Read more.

Assessing levels of physical activity (PA) and providing feedback about these levels might have an effect on participant’s PA behavior. This study discusses the effect of different levels of feedback—from minimal to use of a feedback display and coach—on PA over a 4-week intervention period. PA was measured at baseline, during and immediately after the intervention. Participants (n = 227) were randomly assigned to a Minimal Intervention Group (MIG-no feedback), Pedometer Group (PG-feedback on steps taken), Display Group (DG-feedback on steps, minutes of moderate to vigorous physical activity and energy expenditure) or Coaching Group (CoachG-same as DG with need-supportive coaching). Two-way ANCOVA showed no significant Group × Time interaction effect for the different PA variables between the MIG and PG. Also no differences emerged between PG and DG. As hypothesized, CoachG had higher PA values throughout the intervention compared with DG. Self-monitoring using a pedometer resulted in more steps compared with a no-feedback condition at the start of the intervention. However, adding individualized coaching seems necessary to increase the PA level until the end of the intervention. Full article

(This article belongs to the Special Issue Health Behaviors and Public Health)

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Association of Serum Free Fatty Acids with Hypertension and Insulin Resistance among Rural Uyghur Adults in Far Western China

by Shu-Xia Guo^1,2,*,†

, Yi-Zhong Yan^1,†, La-Ti Mu¹, Qiang Niu¹, Jia He¹, Jia-Ming Liu¹, Shu-Gang Li^1,2, Jing-Yu Zhang¹, Heng Guo¹ and Dong-Sheng Rui¹

¹ Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China

² Department of Pathology, Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China

Int. J. Environ. Res. Public Health 2015, 12(6), 6582-6590; https://doi.org/10.3390/ijerph120606582 - 9 Jun 2015

Cited by 20 | Viewed by 4908

Abstract

Objective: We aimed to investigate whether free fatty acid (FFA) levels in hypertensive patients result from increased blood pressure or the accompanying condition of insulin resistance (IR). Furthermore, we aimed to study the role of IR in the onset and development of [...] Read more.

Objective: We aimed to investigate whether free fatty acid (FFA) levels in hypertensive patients result from increased blood pressure or the accompanying condition of insulin resistance (IR). Furthermore, we aimed to study the role of IR in the onset and development of hypertension and then provide a basis for the prevention and treatment of hypertension and metabolic syndrome (MS). Design and Methods: The study included 68 essential hypertensive patients without IR, 87 normotensive subjects with IR, 82 essential hypertensive patients with IR and 74 normotensive subjects without IR. Analysis of covariance was used to compare FFA concentrations among the four groups to determine the association between FFA concentrations and hypertension and IR. Results: A significant difference in FFA concentrations among the four groups was found using a one-factor analysis of variance (p < 0.001). A significant difference was also found among the adjusted means of the four groups (essential hypertensive patients with IR vs. normotensive subjects without IR: 0.703 mg/L vs. 0.516 mg/L, p < 0.001; essential hypertensive patients with IR vs. normotensive subjects with IR: 0.703 mg/L vs. 0.525 mg/L, p < 0.001; essential hypertensive patients with IR vs. essential hypertensive patients without IR: 0.703 mg/L vs. 0.579 mg/L, p = 0.002; normotensive subjects with IR vs. normotensive subjects without IR: 0.525 mg/L vs. 0.516 mg/L, p = 0.007; essential hypertensive patients without IR vs. normotensive subjects without IR: 0.579 mg/L vs. 0.516 mg/L, p < 0.001). However, no significant interaction was detected between IR and hypertension regarding the FFA concentration. Conclusions: FFA is an independent factor for IR and hypertension among Uyghur adults in a rural area of Xinjiang. Full article

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Open AccessArticle

Why Don’t Smokers Want Help to Quit? A Qualitative Study of Smokers’ Attitudes towards Assisted vs. Unassisted Quitting

by Kylie Morphett^1,2,*, Brad Partridge³, Coral Gartner^1,2

, Adrian Carter^1,4 and Wayne Hall^1,3

¹ University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Site, Herston, 4029 Queensland, Australia

² University of Queensland, School of Public Health, Corner of Wyndham Street and Herston Road, Herston, 4006 Queensland, Australia

³ University of Queensland Centre for Youth Substance Abuse, Mental Health Centre, Royal Brisbane and Women's Hospital, Herston, 4029 Queensland, Australia

⁴ School of Psychological Sciences, Monash University Clinical and Imaging Neuroscience, 770 Blackburn Road, Monash University, Clayton, 3800 Victoria, Australia

Int. J. Environ. Res. Public Health 2015, 12(6), 6591-6607; https://doi.org/10.3390/ijerph120606591 - 10 Jun 2015

Cited by 68 | Viewed by 10441

Abstract

The development of prescription medication for smoking cessation and the introduction of evidence-based guidelines for health professionals has increasingly medicalised smoking cessation. There are debates about whether medicalisation is a positive development, or whether it has devalued unassisted quitting. In this debate the [...] Read more.

The development of prescription medication for smoking cessation and the introduction of evidence-based guidelines for health professionals has increasingly medicalised smoking cessation. There are debates about whether medicalisation is a positive development, or whether it has devalued unassisted quitting. In this debate the views of smokers have been neglected. This study explored the attitudes of smokers towards a range of quitting methods, and their considerations when judging their value. We conducted semi-structured interviews with 29 smokers and analysed data using thematic analysis. The results show that the perceived nature of an individual smoker’s addiction was central to judgments about the value of pharmacological cessation aids, as was personal experience with a method, and how well it was judged to align with an individual’s situation and personality. Unassisted quitting was often described as the best method. Negative views of pharmacological cessation aids were frequently expressed, particularly concerns about side effects from prescription medications. Smokers’ views about the value of different methods were not independent: attitudes about cessation aids were shaped by positive attitudes towards unassisted quitting. Examining smokers’ attitudes towards either assisted or unassisted quitting in isolation provides incomplete information on quitting preferences. Full article

(This article belongs to the Special Issue Tobacco Control 2015)

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Open AccessArticle

Spatial and Temporal Distribution of PM_2.5 Pollution in Xi’an City, China

by Ping Huang^*, Jingyuan Zhang^†, Yuxiang Tang^† and Lu Liu^†

¹ State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, 5 South Zhongguancun Street, Haidian District, Beijing 100081, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6608-6625; https://doi.org/10.3390/ijerph120606608 - 10 Jun 2015

Cited by 48 | Viewed by 6943

Abstract

The monitoring data of the 13 stations in Xi’an city for the whole years of 2013 and 2014 was counted and analyzed. Obtaining the spatial and temporal distribution characteristics of PM_2.5 was the goal. Cluster analysis and the wavelet transform were utilized [...] Read more.

The monitoring data of the 13 stations in Xi’an city for the whole years of 2013 and 2014 was counted and analyzed. Obtaining the spatial and temporal distribution characteristics of PM_2.5 was the goal. Cluster analysis and the wavelet transform were utilized to discuss the regional distribution characteristics of PM_2.5 concentration (ρ(PM_2.5)) and the main features of its yearly changes and sudden changes. Additionally, some relevant factors were taken into account to interpret the changes. The results show that ρ(PM_2.5) in Xi’an during 2013 was generally higher than in 2014, it is high in winter and low in summer, and the high PM_2.5 concentration centers are around the People’s Stadium and Caotan monitoring sites; For the regional PM_2.5 distribution, the 13 sites can be divided into three categories, in which Textile city is Cluster 1, and High-tech Western is Cluster 2, and Cluster 3 includes the remaining 11 monitoring sites; the coefficient of goodness of the cluster analysis is 0.6761, which indicates that the result is acceptable. As for the yearly change, apart from June and July, the average ρ(PM_2.5) concentration has been above the normal concentration criteria of Chinese National Standard (50 g/m³); cloudy weather and low winds are the major meteorological factors leading to the sudden changes of ρ(PM_2.5). Full article

(This article belongs to the Special Issue Technology, Data, and the Assessment of Atmospheric Exposure on Finer Scales)

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Open AccessArticle

Gender-Specific Analyses of the Prevalence and Factors Associated with Substance Use and Misuse among Bosniak Adolescents

by Natasa Zenic^1,†, Admir Terzic^2,3,†, Jelena Rodek¹, Miodrag Spasic¹ and Damir Sekulic^1,4,*,†

¹ Faculty of Kinesiology, University of Split, Teslina 6, Split-21000, Croatia

² High School "Hasan Kikic", Sarajevks 1, Gradacac-76250, Bosnia and Herzegovina

³ Faculty of Physical Education and Sport, University of Tuzla, 2nd October 1, Tuzla-75000, Tuzla, Bosnia and Herzegovina

⁴ Department of Health Care Studies, University of Split, R. Boskovica 31, Split-21000, Croatia

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6626-6640; https://doi.org/10.3390/ijerph120606626 - 10 Jun 2015

Cited by 22 | Viewed by 5168

Abstract

Ethnicity and religion are known to be important factors associated with substance use and misuse (SUM). Ethnic Bosniaks, Muslims by religion, are the third largest ethnic group in the territory of the former Yugoslavia, but no study has examined SUM patterns among them. [...] Read more.

Ethnicity and religion are known to be important factors associated with substance use and misuse (SUM). Ethnic Bosniaks, Muslims by religion, are the third largest ethnic group in the territory of the former Yugoslavia, but no study has examined SUM patterns among them. The aim of this study was to explore the prevalence of SUM and to examine scholastic-, familial- and sport-factors associated with SUM in adolescent Bosniaks from Bosnia-and-Herzegovina. The sample comprised 970 17-to-18-year-old adolescents (48% boys). Testing was performed using an previously validated questionnaire investigating socio-demographic-factors, scholastic-variables, and sport-factors, cigarette smoking, alcohol drinking, simultaneous smoking and drinking (multiple SUM), and the consumption of other drugs. The 30% of boys and 32% of girls smoke (OR = 1.13; 95% CI = 0.86–1.49), 41% of boys and 27% of girls are defined as harmful alcohol drinkers (OR = 1.94; 95% CI = 1.48–2.54), multiple SUM is prevalent in 17% of boys and 15% of girls (OR = 1.11; 95% CI = 0.79–1.56), while the consumption of other drugs, including sedatives, is higher in girls (6% and 15% for boys and girls, respectively; OR = 2.98; 95% CI = 1.89–4.70). Scholastic achievement is negatively associated with SUM. SUM is more prevalent in those girls who report higher income, and boys who report a worse familial financial situation. The study revealed more negative than positive associations between sport participation and SUM, especially among girls. Results can help public health authorities to develop more effective prevention campaign against SUM in adolescence. Full article

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Open AccessArticle

Predicting the Probability of Failure of Cementitious Sewer Pipes Using Stochastic Finite Element Method

by Amir M. Alani¹ and Asaad Faramarzi^2,*

¹ School of Computing and Technology, University of West London, 8th Floor, Villiers House, Ealing Broadway, London W5 2PA, UK

² School of Civil Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK

Int. J. Environ. Res. Public Health 2015, 12(6), 6641-6656; https://doi.org/10.3390/ijerph120606641 - 10 Jun 2015

Cited by 17 | Viewed by 6317

Abstract

In this paper, a stochastic finite element method (SFEM) is employed to investigate the probability of failure of cementitious buried sewer pipes subjected to combined effect of corrosion and stresses. A non-linear time-dependant model is used to determine the extent of concrete corrosion. [...] Read more.

In this paper, a stochastic finite element method (SFEM) is employed to investigate the probability of failure of cementitious buried sewer pipes subjected to combined effect of corrosion and stresses. A non-linear time-dependant model is used to determine the extent of concrete corrosion. Using the SFEM, the effects of different random variables, including loads, pipe material, and corrosion on the remaining safe life of the cementitious sewer pipes are explored. A numerical example is presented to demonstrate the merit of the proposed SFEM in evaluating the effects of the contributing parameters upon the probability of failure of cementitious sewer pipes. The developed SFEM offers many advantages over traditional probabilistic techniques since it does not use any empirical equations in order to determine failure of pipes. The results of the SFEM can help the concerning industry (e.g., water companies) to better plan their resources by providing accurate prediction for the remaining safe life of cementitious sewer pipes. Full article

(This article belongs to the Special Issue Environmental Systems Engineering)

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Physiological and Psychological Effects of Viewing a Kiwifruit (Actinidia deliciosa ‘Hayward’) Orchard Landscape in Summer in Japan

by Miho Igarashi¹, Masayuki Miwa¹, Harumi Ikei², Chorong Song¹, Michiko Takagaki¹ and Yoshifumi Miyazaki^1,*

¹ Center for Environment, Health and Field Sciences, Chiba University, 6-2-1 Kashiwa-no-ha, Kashiwa, Chiba 277-0882, Japan

² Forestry and Forest Products Research Institute, 1 Matsunosato, Tsukuba, Ibaraki 305-8687, Japan

Int. J. Environ. Res. Public Health 2015, 12(6), 6657-6668; https://doi.org/10.3390/ijerph120606657 - 11 Jun 2015

Cited by 23 | Viewed by 6797

Abstract

The physiological and psychological relaxation effects of viewing a kiwifruit (Actinidia deliciosa ‘Hayward’) orchard landscape were investigated. Seventeen Japanese adult females (46.1 ± 8.2 years) viewed a kiwifruit orchard landscape or a building site (control) for 10 min. The heart rate variability [...] Read more.

The physiological and psychological relaxation effects of viewing a kiwifruit (Actinidia deliciosa ‘Hayward’) orchard landscape were investigated. Seventeen Japanese adult females (46.1 ± 8.2 years) viewed a kiwifruit orchard landscape or a building site (control) for 10 min. The heart rate variability and heart rate were determined. The modified semantic differential method and the short-form Profile of Mood States were used to assess the psychological effects. Compared with viewing the building site, viewing the kiwifruit orchard landscape resulted in a significant increase in the parasympathetic activity, a marginally significant decrease in the heart rate, a significant increase in “comfortable”, “relaxed” and “natural” feelings and a significant improvement in mood states. Full article

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Open AccessArticle

by Evelina Pappa^1,*, Simela Chatzikonstantinidou¹, George Chalkiopoulos¹, Angelos Papadopoulos^1,2 and Dimitris Niakas¹

¹ Faculty of Social Sciences, Hellenic Open University, Riga Fereou 169 & Tsamadou, Patras 26222, Greece

² Department of Internal Medicine, "Attikon" University Hospital, 1 Rimini Street, Athens 12462, Greece

Int. J. Environ. Res. Public Health 2015, 12(6), 6669-6681; https://doi.org/10.3390/ijerph120606669 - 12 Jun 2015

Cited by 32 | Viewed by 6840

Abstract

The aim was to assess the health-related quality of life (HRQL) of the Roma and further to detect the significant determinants that are associated with their HRQL. The cross-sectional study involved 1068 Roma adults living in settlements (mean age 36). HRQL was measured [...] Read more.

The aim was to assess the health-related quality of life (HRQL) of the Roma and further to detect the significant determinants that are associated with their HRQL. The cross-sectional study involved 1068 Roma adults living in settlements (mean age 36). HRQL was measured by the Greek version of SF-36 Health Survey and further socio-demographic characteristics (sex, age, marital status, education, permanent occupation etc.) and housing conditions (stable housing, access to basic amenities such as drinkable water, drainage, electricity which compose material deprivation) were involved. Non parametric tests and multiple linear regression models were applied to identify the factors that have significant association with HRQL. After controlling for socio-demographic characteristics, health status and housing conditions, sex, age, education, chronic diseases, stable housing and material deprivation were found to be significant determinants of the Roma’s HRQL. Men reported significantly better health than women as well as those who attended school compared to the illiterate. Chronic diseases were remarkably associated with poor HRQL from 10 units in MH (Mental Health) to 34 units in RP (Role Physical). Material deprivation was related to lower GH (General Health), and VT (Vitality) scores and higher RP (Role Physical) and RE (Role Emotional) scores. Chronic conditions and illiteracy are two key areas that contribute significantly to worse HRQL. Policies should be part of a comprehensive and holistic strategy for the Roma through intervention to education, housing and public health. Full article

(This article belongs to the Special Issue Health Behaviors and Public Health)

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Association between Work-Family Conflict and Depressive Symptoms among Chinese Female Nurses: The Mediating and Moderating Role of Psychological Capital

by Junhui Hao¹, Di Wu², Li Liu¹, Xirui Li² and Hui Wu^1,*

¹ Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang 110013, China

² Department of English, School of Basic Medicine, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang 110013, China

Int. J. Environ. Res. Public Health 2015, 12(6), 6682-6699; https://doi.org/10.3390/ijerph120606682 - 12 Jun 2015

Cited by 75 | Viewed by 8988

Abstract

Depressive symptoms have been in the limelight for many kinds of people, but few studies have explored positive resources for combating depressive symptoms among Chinese nurses. The purpose of this study is to explore the association between work-family conflict (WFC) and depressive symptoms [...] Read more.

Depressive symptoms have been in the limelight for many kinds of people, but few studies have explored positive resources for combating depressive symptoms among Chinese nurses. The purpose of this study is to explore the association between work-family conflict (WFC) and depressive symptoms among Chinese female nurses, along with the mediating and moderating role of psychological capital (PsyCap) in this relationship. This cross-sectional study was completed during the period of September and October 2013. A questionnaire that consisted of the Center for Epidemiologic Studies Depression Scale, the Work-Family Conflict scale and the Psychological Capital Questionnair scale was distributed to nurses in Shenyang, China. A total of 824 individuals (effective response rate: 74.9%) participated. Asymptotic and resampling strategies explored the mediating role of PsyCap in the relationship between WFC and depressive symptoms. Hierarchical linear regression analyses were performed to explore the moderating role of PsyCap. Both WFC and family-work conflict (FWC) were positively related with depressive symptoms. PsyCap positively moderated the relationship of WFC with depressive symptoms. Self-efficacy and hope positively moderated the relationship of WFC with depressive symptoms. PsyCap partially mediated the relationship of FWC with depressive symptoms. Hope and optimism partially mediated the relationship of FWC with depressive symptoms. Work-family conflict, as the risk factor of depressive symptoms, can increase nurses’ depressive symptoms, and PsyCap is a positive resource to combat nurses’ depressive symptoms. PsyCap can aggravate the effects of WFC on depressive symptoms and FWC can impact PsyCap to increase nurses’ depressive symptoms. Full article

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Open AccessArticle

Comparative Evaluation of Aluminum Sulfate and Ferric Sulfate-Induced Coagulations as Pretreatment of Microfiltration for Treatment of Surface Water

by Yali Song¹, Bingzhi Dong^2,*, Naiyun Gao² and Yang Deng³

¹ School of Civil Engineering and Architecture, Zhejiang University of Science and Technology, Hangzhou 310023, China

² College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China

³ Department of Earth and Environmental Studies, Montclair State University, Montclair, NJ 07043, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6700-6709; https://doi.org/10.3390/ijerph120606700 - 12 Jun 2015

Cited by 20 | Viewed by 7176

Abstract

Two coagulants, aluminum sulfate and ferric chloride, were tested to reduce natural organic matter (NOM) as a pretreatment prior to polyvinylidene fluoride (PVDF) microfiltration (MF) membranes for potable water treatment. The results showed that the two coagulants exhibited different treatment performance in NOM [...] Read more.

Two coagulants, aluminum sulfate and ferric chloride, were tested to reduce natural organic matter (NOM) as a pretreatment prior to polyvinylidene fluoride (PVDF) microfiltration (MF) membranes for potable water treatment. The results showed that the two coagulants exhibited different treatment performance in NOM removal. Molecular weight (MW) distributions of NOM in the tested surface raw water were concentrated at 3–5 kDa and approximately 0.2 kDa. Regardless of the coagulant species and dosages, the removal of 0.2 kDa NOM molecules was limited. In contrast, NOM at 3–5 kDa were readily removed with increasing coagulant dosages. In particular, aluminum sulfate favorably removed NOM near 5 kDa, whereas ferric chloride tended to reduce 3 kDa organic substances. Although aluminum sulfate and ferric chloride could improve the flux of the ensuing MF treatment, the optimal coagulant dosages to achieve effective pretreatment were different: 2–30 mg/L for aluminum sulfate and >15 mg/L for ferric chloride. The scanning electron microscope (SEM) image of the membrane-filtered coagulated raw water showed that coagulation efficiency dramatically affected membrane flux and that good coagulation properties can reduce membrane fouling. Full article

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An Evaluation of the British Columbia Asthma Monitoring System (BCAMS) and PM_2.5 Exposure Metrics during the 2014 Forest Fire Season

by Kathleen E. McLean¹, Jiayun Yao^1,2 and Sarah B. Henderson^1,2,*

¹ Environmental Health Services, British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC V5Z 4R4, Canada

² School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada

Int. J. Environ. Res. Public Health 2015, 12(6), 6710-6724; https://doi.org/10.3390/ijerph120606710 - 12 Jun 2015

Cited by 15 | Viewed by 6720

Abstract

The British Columbia Asthma Monitoring System (BCAMS) tracks forest fire smoke exposure and asthma-related health outcomes, identifying excursions beyond expected daily counts. Weekly reports during the wildfire season support public health and emergency management decision-making. We evaluated BCAMS by identifying excursions for asthma-related [...] Read more.

The British Columbia Asthma Monitoring System (BCAMS) tracks forest fire smoke exposure and asthma-related health outcomes, identifying excursions beyond expected daily counts. Weekly reports during the wildfire season support public health and emergency management decision-making. We evaluated BCAMS by identifying excursions for asthma-related physician visits and dispensations of the reliever medication salbutamol sulfate and examining their corresponding smoke exposures. A disease outbreak detection algorithm identified excursions from 1 July to 31 August 2014. Measured, modeled, and forecasted concentrations of fine particulate matter (PM_2.5) were used to assess exposure. We assigned PM_2.5 levels to excursions by choosing the highest value within a seven day window centred on the excursion day. Smoky days were defined as those with PM_2.5 levels ≥ 25 µg/m³. Most excursions (57%–71%) were assigned measured or modeled PM_2.5 concentrations of 10 µg/m³ or higher. Of the smoky days, 55.8% and 69.8% were associated with at least one excursion for physician visits and salbutamol dispensations, respectively. BCAMS alerted most often when measures of smoke exposure were relatively high. Better performance might be realized by combining asthma-related outcome metrics in a bivariate model. Full article

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Characterization of the Particle Size Fraction associated with Heavy Metals in Suspended Sediments of the Yellow River

by Qingzhen Yao, Xiaojing Wang, Huimin Jian, Hongtao Chen and Zhigang Yu^*

Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education, Ocean University of China, Qingdao 266100, China

Int. J. Environ. Res. Public Health 2015, 12(6), 6725-6744; https://doi.org/10.3390/ijerph120606725 - 15 Jun 2015

Cited by 108 | Viewed by 7368

Abstract

Variations in the concentrations of particulate heavy metals and fluxes into the sea in the Yellow River were examined based on observational and measured data from January 2009 to December 2010. A custom-built water elutriation apparatus was used to separate suspended sediments into [...] Read more.

Variations in the concentrations of particulate heavy metals and fluxes into the sea in the Yellow River were examined based on observational and measured data from January 2009 to December 2010. A custom-built water elutriation apparatus was used to separate suspended sediments into five size fractions. Clay and very fine silt is the dominant fraction in most of the suspended sediments, accounting for >40% of the samples. Cu, Pb, Zn, Cr, Fe and Mn are slightly affected by anthropogenic activities, while Cd is moderate affected. The concentrations of heavy metals increased with decrease in particle size. For suspended sediments in the Yellow River, on average 78%–82% of the total heavy metal loading accumulated in the <16 μm fraction. About 43% and 53% of heavy metal in 2009 and 2010 respectively, were readily transported to the Bohai Sea with “truly suspended” particles, which have potentially harmful effects on marine organisms. Full article

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Impacts of Climate Change on Vector Borne Diseases in the Mediterranean Basin — Implications for Preparedness and Adaptation Policy

by Maya Negev^1,†

, Shlomit Paz^2,*,†, Alexandra Clermont³, Noemie Groag Pri-Or¹, Uri Shalom⁴, Tamar Yeger⁴ and Manfred S. Green¹

¹ School of Public Health, University of Haifa, Haifa 3498838, Israel

² Department of Geography and Environmental Studies, University of Haifa, Haifa 3498838, Israel

³ The Arava Institute for Environmental Studies, Kibbutz Ketura 8884000, Israel

⁴ Division of Pest Surveillance & Control, Israel Ministry of Environmental Protection, P.O. Box 34033, Jerusalem 95464, Israel

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6745-6770; https://doi.org/10.3390/ijerph120606745 - 15 Jun 2015

Cited by 61 | Viewed by 18692

Abstract

The Mediterranean region is vulnerable to climatic changes. A warming trend exists in the basin with changes in rainfall patterns. It is expected that vector-borne diseases (VBD) in the region will be influenced by climate change since weather conditions influence their emergence. For [...] Read more.

The Mediterranean region is vulnerable to climatic changes. A warming trend exists in the basin with changes in rainfall patterns. It is expected that vector-borne diseases (VBD) in the region will be influenced by climate change since weather conditions influence their emergence. For some diseases (i.e., West Nile virus) the linkage between emergence andclimate change was recently proved; for others (such as dengue) the risk for local transmission is real. Consequently, adaptation and preparation for changing patterns of VBD distribution is crucial in the Mediterranean basin. We analyzed six representative Mediterranean countries and found that they have started to prepare for this threat, but the preparation levels among them differ, and policy mechanisms are limited and basic. Furthermore, cross-border cooperation is not stable and depends on international frameworks. The Mediterranean countries should improve their adaptation plans, and develop more cross-sectoral, multidisciplinary and participatory approaches. In addition, based on experience from existing local networks in advancing national legislation and trans-border cooperation, we outline recommendations for a regional cooperation framework. We suggest that a stable and neutral framework is required, and that it should address the characteristics and needs of African, Asian and European countries around the Mediterranean in order to ensure participation. Such a regional framework is essential to reduce the risk of VBD transmission, since the vectors of infectious diseases know no political borders. Full article

(This article belongs to the Special Issue Climate Change Impacts on Vector-borne Diseases)

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Metallic Burden of Deciduous Teeth and Childhood Behavioral Deficits

by Tony J.H. Chan¹, Carolina Gutierrez² and Oladele A. Ogunseitan^1,3,*

¹ School of Social Ecology, University of California, Irvine, CA 92697, USA

² School of Social Sciences, University of California, Irvine, CA 92697, USA

³ Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, CA 92697, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6771-6787; https://doi.org/10.3390/ijerph120606771 - 15 Jun 2015

Cited by 13 | Viewed by 6401

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) affects 5%–8% of children in the U.S. (10% of males and 4% of females). The contributions of multiple metal exposures to the childhood behavioral deficits are unclear, although particular metals have been implicated through their neurotoxicity. The objective of [...] Read more.

Attention Deficit/Hyperactivity Disorder (ADHD) affects 5%–8% of children in the U.S. (10% of males and 4% of females). The contributions of multiple metal exposures to the childhood behavioral deficits are unclear, although particular metals have been implicated through their neurotoxicity. The objective of this study was to test the hypothesis that the body burden of Mn is positively correlated with ADHD symptoms. We also investigated the putative roles of Ca, Fe, Pb, and Hg. We collected shed molars from 266 children (138 boys and 128 girls) who lost a tooth between 11 and 13 years of age. The molars were analyzed for metals using ICP-OES. The third grade teacher of each child completed the Teacher’s Disruptive Behavior Disorders Rating Scale (DBD) to produce a score for “Total Disruptive Behavior” and subscale scores for “Attention Deficit Hyperactivity Disorder”, Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant. The mean Mn, Fe, Pb and Ca concentrations found in teeth was 6.1 ± 5.7 µg/g, 22.7 ± 24.1 µg/g, 0.9 ± 1.4 µg/g, and 6.0 × 10⁵ ± 1.6 × 10⁵ µg/g, respectively. Hg was not detected. No significant association was found between Mn and behavioral deficits. Ca was significantly negatively associated, and Pb showed a significant positive association with Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant Disorders. These findings call into question the putative independent association of manganese exposure and behavioral deficits in children, when the balance of other metallic burden, particularly Ca and Pb burdens play significant roles. Full article

(This article belongs to the Special Issue Hazardous Waste and Human Health-2015)

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Effects of Varying Particle Sizes and Different Types of LDH-Modified Anthracite in Simulated Test Columns for Phosphorous Removal

by Xiangling Zhang^*, Qiaozhen Chen, Lu Guo, Hualing Huang and Chongying Ruan

School of Civil Engineering and Architecture, Wuhan University of Technology, Wuhan 430070, China

Int. J. Environ. Res. Public Health 2015, 12(6), 6788-6800; https://doi.org/10.3390/ijerph120606788 - 16 Jun 2015

Cited by 14 | Viewed by 5983

Abstract

A comparative study was carried out for the removal of phosphorus in simulated unplanted vertical-flow constructed wetlands with different layered double hydroxide (LDHs) coated anthracite substrates. Three particle sizes of anthracites were selected and modified separately with nine kinds of LDH coating. The [...] Read more.

A comparative study was carried out for the removal of phosphorus in simulated unplanted vertical-flow constructed wetlands with different layered double hydroxide (LDHs) coated anthracite substrates. Three particle sizes of anthracites were selected and modified separately with nine kinds of LDH coating. The simulated substrates test columns loaded with the original and modified anthracites were constructed to treat the contaminated water. For the medium and large particle size modified anthracite substrates, the purification effects of total phosphorus, total dissolved phosphorus and phosphate were improved by various degrees, and the purification effect of the medium particle size anthracite is better than that of the large size one. The medium size anthracite modified by ZnCo-LDHs had optimal performance with average removal efficiencies of total phosphorus, total dissolved phosphorus and phosphate reaching 95%, 95% and 98%, respectively. The maximum adsorption capacity on ZnCo-LDHs and ZnAl-LDHs modified medium sizes anthracites were 65.79 (mg/kg) and 48.78 (mg/kg), respectively. In comparison, the small size anthracite is not suitable for LDHs modification. Full article

(This article belongs to the Special Issue Environmental Systems Engineering)

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Extent, Nature, and Risk Factors of Workplace Violence in Public Tertiary Hospitals in China: A Cross-Sectional Survey

by He Liu^1,†, Siqi Zhao^1,†, Mingli Jiao^1,2,*,†, Jingtao Wang³, David H. Peters⁴, Hong Qiao^5,*, Yuchong Zhao⁶, Ye Li¹, Lei Song⁷, Kai Xing¹, Yan Lu⁸ and Qunhong Wu^7,*

¹ Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China

² Institute of Quantitative &Technical Economics, Chinese Academy of Social Science, 5 Jian Guo Men Nei Road, Dongcheng District, Beijing 100000, China

³ Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China

⁴ Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USA

⁵ Endocrine and Metabolic Diseases, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin 150081, China

⁶ Heilongjiang Nursing College, 209 Xuefu Road, Nangang District, Harbin 150081, China

⁷ Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China

⁸ School of Public Health, Jiamusi University, Jiamusi 154007, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6801-6817; https://doi.org/10.3390/ijerph120606801 - 16 Jun 2015

Cited by 38 | Viewed by 6788

Abstract

Using a cross-sectional survey design from 11 public tertiary hospitals (a specialist hospital, four Chinese medicine hospitals, and six general hospitals) in the urban areas of Heilongjiang, we determined the nature of workplace violence that medical staff have encountered in Chinese hospitals and [...] Read more.

Using a cross-sectional survey design from 11 public tertiary hospitals (a specialist hospital, four Chinese medicine hospitals, and six general hospitals) in the urban areas of Heilongjiang, we determined the nature of workplace violence that medical staff have encountered in Chinese hospitals and identified factors associated with those experiences of violence. A total of 1129 health workers participated. The specialist hospital had the highest prevalence of physical violence (35.4%), while the general hospitals had the highest prevalence of non-physical violence (76%). Inexperienced medical staff (p < 0.001) were more likely to suffer non-physical violence than physical violence in Chinese medicine hospitals compared to experienced staff. Medical units (p = 0.001) had a high risk of non-physical violence, while surgical units (p = 0.005) had a high risk of physical violence. In general hospitals, staff with higher levels of anxiety about workplace violence were more vulnerable to both physical violence (1.67, 95% CI 1.36–2.10) and non-physical violence (1.309, 95% CI 1.136–1.508) compared to those with lower levels of anxiety, while rotating shift workers had a higher odds of physical violence (2.2, 95% CI 1.21–4.17) and non-physical violence (1.65, 95% CI 1.13–2.41) compared to fixed day shift workers. Thus, prevention should focus not only on high-risk sections of hospitals, but also on the nature of the hospital itself. Full article

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Illegal Dumping of Toxic Waste and Its Effect on Human Health in Campania, Italy

by Alfredo Mazza^1,2,*, Prisco Piscitelli^3,4,†, Cosimo Neglia^5,†, Giulia Della Rosa^5,† and Leopoldo Iannuzzi^2,†

¹ General Hospital Sarno, Local Health Authority ASL Salerno, 84087 Sarno, Italy

² National Research Council (CNR), ISPAAM, 80100 Naples, Italy

³ Southern Italy Hospital Institute, 80100 Naples, Italy

⁴ Coleman Ltd., 80100 Naples, Italy

⁵ Euro Mediterranean Scientific Biomedical Institute, 72100 Brindisi, Italy

^† All the five authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 6818-6831; https://doi.org/10.3390/ijerph120606818 - 16 Jun 2015

Cited by 60 | Viewed by 14019

Abstract

The region of Campania (particularly Naples and Caserta) has experienced an emergency in the waste management cycle during past years. Although the most critical phase has been overcome after the construction of the incineration plant in Acerra (an old-fashioned technology built up over [...] Read more.

The region of Campania (particularly Naples and Caserta) has experienced an emergency in the waste management cycle during past years. Although the most critical phase has been overcome after the construction of the incineration plant in Acerra (an old-fashioned technology built up over a few months, whose impact on environment and health has not yet been assessed), most of the underlying problems have not been resolved. The illegal burning of wheels, plastics, textiles, and other industrial residuals, along with the detection of two thousand toxic substance dumping sites, still represents major concerns of environmental pollution and population health. This review summarizes the most relevant studies, which analyzed chemical contamination (primarily dioxins and polychlorinated biphenyls (PCBs)) of the air, soil, water, animals, and humans in Campania. In addition, we reviewed information on population health (i.e., mortality data, congenital malformations, and cancer incidence). Moving from a detailed mapping of (mostly illegal) waste dumping sites in Campania, we have focused on recent studies which have found: (a) high concentrations of dioxins (≥5.0 pg TEQ/g fat) in milk samples from sheep, cows, and river buffaloes; (b) remarkable contamination of dioxin and PCBs in human milk samples from those living in the Naples and Caserta areas (PCDDs+PCDFs and dioxin-like-PCBs (dl-PCBs) assessed at 16.6 pg TEQ/g of fat; range: 7.5–43 pg/g of fat); (c) potential age-adjusted standardized mortality rates associated with some specific cancer types; (d) a statistically significant association between exposure to illegal toxic waste dumping sites and cancer mortality, even after adjustment by socio-economic factors and other environmental indicators. Full article

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Open AccessArticle

Pattern of Ambulatory Care Visits to Obstetrician-Gynecologists in Taiwan: A Nationwide Analysis

by An-Min Lynn¹, Li-Jung Lai¹, Ming-Hwai Lin^1,2,*, Tzeng-Ji Chen^1,2

, Shinn-Jang Hwang^1,2 and Peng-Hui Wang^2,3

¹ Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan

² School of Medicine, National Yang-Ming University, No.155, Sec. 2, Linong Street, Taipei 112, Taiwan

³ Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan

Int. J. Environ. Res. Public Health 2015, 12(6), 6832-6841; https://doi.org/10.3390/ijerph120606832 - 16 Jun 2015

Cited by 7 | Viewed by 5098

Abstract

Although obstetrician-gynecologists (OB-GYNs) are the main actors in the provision of health care to women, their practice patterns have rarely been analyzed. The current study investigated the nationwide ambulatory visits to OB-GYNs in Taiwan using the National Health Insurance Research Database. From the [...] Read more.

Although obstetrician-gynecologists (OB-GYNs) are the main actors in the provision of health care to women, their practice patterns have rarely been analyzed. The current study investigated the nationwide ambulatory visits to OB-GYNs in Taiwan using the National Health Insurance Research Database. From the 1/500 sampling datasets indicating 619,760 ambulatory visits in 2012, it was found that 5.8% (n = 35,697) of the visits were made to OB-GYNs. Two-fifths of the services provided were performed by male OB-GYNs aged 50–59 years. Women of childbearing age accounted for more than half of the visits to OB-GYNs (57.2%), and elderly patients above 60 years accounted for only 7.7%. The most frequent diagnoses were menstrual disorders and other forms of abnormal bleeding from the female genital tract (13.1%). Anti-infective agents were prescribed in 15.1% of the visits to OB-GYNs. The study revealed the proportion of aging practicing OB-GYNs, and our detailed results could contribute to evidence-based discussions on health policymaking. Full article

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Open AccessArticle

Evaluating the Effects of Temperature on Mortality in Manila City (Philippines) from 2006–2010 Using a Distributed Lag Nonlinear Model

by Xerxes T. Seposo^1,*

, Tran Ngoc Dang^1,2 and Yasushi Honda³

¹ Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba City, Ibaraki Prefecture 305-8577, Japan

² Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City 70000, Vietnam

³ Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba City, Ibaraki Prefecture 305-8577, Japan

Int. J. Environ. Res. Public Health 2015, 12(6), 6842-6857; https://doi.org/10.3390/ijerph120606842 - 16 Jun 2015

Cited by 32 | Viewed by 8753

Abstract

The effect of temperature on the risk of mortality has been described in numerous studies of category-specific (e.g., cause-, sex-, age-, and season-specific) mortality in temperate and subtropical countries, with consistent findings of U-, V-, and J-shaped exposure-response functions. In this study, we [...] Read more.

The effect of temperature on the risk of mortality has been described in numerous studies of category-specific (e.g., cause-, sex-, age-, and season-specific) mortality in temperate and subtropical countries, with consistent findings of U-, V-, and J-shaped exposure-response functions. In this study, we analyzed the relationship between temperature and mortality in Manila City (Philippines), during 2006–2010 to identify the potential susceptible populations. We collected daily all-cause and cause-specific death counts from the Philippine Statistics Authority-National Statistics Office and the meteorological variables were collected from the Philippine Atmospheric Geophysical and Astronomical Services Administration. Temperature-mortality relationships were modeled using Poisson regression combined with distributed lag nonlinear models, and were used to perform cause-, sex-, age-, and season-specific analyses. The minimum mortality temperature was 30 °C, and increased risks of mortality were observed per 1 °C increase among elderly persons (RR: 1.53, 95% CI: 1.31–1.80), women (RR: 1.47, 95% CI: 1.27–1.69), and for respiratory causes of death (RR: 1.52, 95% CI: 1.23–1.88). Seasonal effect modification was found to greatly affect the risks in the lower temperature range. Thus, the temperature-mortality relationship in Manila City exhibited an increased risk of mortality among elderly persons, women, and for respiratory-causes, with inherent effect modification in the season-specific analysis. The findings of this study may facilitate the development of public health policies to reduce the effects of air temperature on mortality, especially for these high-risk groups. Full article

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Open AccessArticle

Cellular Energy Allocation to Assess the Impact of Nanomaterials on Soil Invertebrates (Enchytraeids): The Effect of Cu and Ag

by Susana I. L. Gomes^1,*, Janeck J. Scott-Fordsmand² and Mónica J. B. Amorim¹

¹ Department of Biology & CESAM, University of Aveiro, Aveiro 3810-193, Portugal

² Department of Bioscience, Aarhus University, Vejlsovej 25, PO BOX 314, Silkeborg DK-8600, Denmark

Int. J. Environ. Res. Public Health 2015, 12(6), 6858-6878; https://doi.org/10.3390/ijerph120606858 - 16 Jun 2015

Cited by 48 | Viewed by 7686

Abstract

The effects of several copper (Cu) and silver (Ag) nanomaterials were assessed using the cellular energy allocation (CEA), a methodology used to evaluate the energetic status and which relates with organisms’ overall condition and response to toxic stress. Enchytraeus crypticus (Oligochatea), was exposed [...] Read more.

The effects of several copper (Cu) and silver (Ag) nanomaterials were assessed using the cellular energy allocation (CEA), a methodology used to evaluate the energetic status and which relates with organisms’ overall condition and response to toxic stress. Enchytraeus crypticus (Oligochatea), was exposed to the reproduction effect concentrations EC₂₀/₅₀of several Cu and Ag materials (CuNO₃, Cu-Field, Cu-Nwires and Cu-NPs; AgNO₃, Ag NM300K, Ag-NPs Non-coated and Ag-NPs PVP-coated) for 7 days (0-3-7d). The parameters measured were the total energy reserves available (protein, carbohydrate and lipid budgets) and the energy consumption (Ec) integrated to obtain the CEA. Results showed that these parameters allowed a clear discrimination between Cu and Ag, but less clearly within each of the various materials. For Cu there was an increase in Ec and protein budget, while for Ag a decrease was observed. The results corroborate known mechanisms, e.g., with Cu causing an increase in metabolic rate whereas Ag induces mitochondrial damage. The various Cu forms seem to activate different mechanisms with size and shape (e.g., Cu-NPs versus Cu-Nwires), causing clearly different effects. For Ag, results are in line with a slower oxidation rate of Ag-NMs in comparison with Ag-salt and hence delayed effects. Full article

(This article belongs to the Special Issue Environmental Fate and Effect of Nanoparticles and Nanomaterials)

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Open AccessArticle

Comparison of Land, Water, and Energy Requirements of Lettuce Grown Using Hydroponic vs. Conventional Agricultural Methods

by Guilherme Lages Barbosa¹, Francisca Daiane Almeida Gadelha¹, Natalya Kublik¹

, Alan Proctor¹, Lucas Reichelm¹, Emily Weissinger¹, Gregory M. Wohlleb¹ and Rolf U. Halden^1,2,*

¹ School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ 85287-5904, USA

² Center for Environmental Security, The Biodesign Institute, Global Security Initiative, Arizona State University, 781 E. Terrace Mall, Tempe, AZ 85287-5904, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6879-6891; https://doi.org/10.3390/ijerph120606879 - 16 Jun 2015

Cited by 387 | Viewed by 60804

Abstract

The land, water, and energy requirements of hydroponics were compared to those of conventional agriculture by example of lettuce production in Yuma, Arizona, USA. Data were obtained from crop budgets and governmental agricultural statistics, and contrasted with theoretical data for hydroponic lettuce production [...] Read more.

The land, water, and energy requirements of hydroponics were compared to those of conventional agriculture by example of lettuce production in Yuma, Arizona, USA. Data were obtained from crop budgets and governmental agricultural statistics, and contrasted with theoretical data for hydroponic lettuce production derived by using engineering equations populated with literature values. Yields of lettuce per greenhouse unit (815 m²) of 41 ± 6.1 kg/m²/y had water and energy demands of 20 ± 3.8 L/kg/y and 90,000 ± 11,000 kJ/kg/y (±standard deviation), respectively. In comparison, conventional production yielded 3.9 ± 0.21 kg/m²/y of produce, with water and energy demands of 250 ± 25 L/kg/y and 1100 ± 75 kJ/kg/y, respectively. Hydroponics offered 11 ± 1.7 times higher yields but required 82 ± 11 times more energy compared to conventionally produced lettuce. To the authors’ knowledge, this is the first quantitative comparison of conventional and hydroponic produce production by example of lettuce grown in the southwestern United States. It identified energy availability as a major factor in assessing the sustainability of hydroponics, and it points to water-scarce settings offering an abundance of renewable energy (e.g., from solar, geothermal, or wind power) as particularly attractive regions for hydroponic agriculture. Full article

(This article belongs to the Special Issue Environmental Systems Engineering)

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Open AccessCorrection

Correction: Samochowiec, A., et al. Monoamine Oxidase A Promoter Variable Number of Tandem Repeats (MAOA-uVNTR) in Alcoholics According to Lesch Typology. Int. J. Environ. Res. Public Health 2015, 12, 3317–3326

by Agnieszka Samochowiec¹, Magdalena Chęć¹, Edyta Kopaczewska², Jerzy Samochowiec³, Otto Lesch⁴, Elżbieta Grochans⁵

, Andrzej Jasiewicz³, Przemyslaw Bienkowski⁶, Łukasz Kołodziej⁷ and Anna Grzywacz^3,*

¹ Institute of Psychology, Department of Clinical Psychology, University of Szczecin, Krakowska 69, 71-017 Szczecin, Poland

² University Center for Education, University of Szczecin, Szwoleżerów 18a, 71-062 Szczecin, Poland

³ Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26, 71-460 Szczecin, Poland

⁴ Department of Psychiatry, Vienna University, Waehringer Guertel 18–20, A-1090 Vienna, Austria

⁵ Department of Nursing, Pomeranian Medical University, Żołnierska 48, 71-210 Szczecin, Poland

⁶ Institute of Psychiatry and Neurology, Department of Pharmacology, Sobieskiego 9, 02-957 Warszawa, Poland

⁷ Department of Orthopedics, Pomeranian Medical University, Unii Lubelskiej 1, 71-460 Szczecin, Poland

Int. J. Environ. Res. Public Health 2015, 12(6), 6892-6893; https://doi.org/10.3390/ijerph120606892 - 16 Jun 2015

Viewed by 4285

Abstract

The authors wish to make the following corrections to this paper [1]: [...] Full article

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Open AccessArticle

Mineralization and Detoxification of the Carcinogenic Azo Dye Congo Red and Real Textile Effluent by a Polyurethane Foam Immobilized Microbial Consortium in an Upflow Column Bioreactor

by Harshad Lade¹

, Sanjay Govindwar^2,* and Diby Paul^1,*

¹ Department of Environmental Engineering, Konkuk University, Seoul 143-701, Korea

² Department of Biochemistry, Shivaji University, Kolhapur 416004, India

Int. J. Environ. Res. Public Health 2015, 12(6), 6894-6918; https://doi.org/10.3390/ijerph120606894 - 16 Jun 2015

Cited by 119 | Viewed by 11534

Abstract

A microbial consortium that is able to grow in wheat bran (WB) medium and decolorize the carcinogenic azo dye Congo red (CR) was developed. The microbial consortium was immobilized on polyurethane foam (PUF). Batch studies with the PUF-immobilized microbial consortium showed complete removal [...] Read more.

A microbial consortium that is able to grow in wheat bran (WB) medium and decolorize the carcinogenic azo dye Congo red (CR) was developed. The microbial consortium was immobilized on polyurethane foam (PUF). Batch studies with the PUF-immobilized microbial consortium showed complete removal of CR dye (100 mg·L⁻¹) within 12 h at pH 7.5 and temperature 30 ± 0.2 °C under microaerophilic conditions. Additionally, 92% American Dye Manufactureing Institute (ADMI) removal for real textile effluent (RTE, 50%) was also observed within 20 h under the same conditions. An upflow column reactor containing PUF-immobilized microbial consortium achieved 99% CR dye (100 mg·L⁻¹) and 92% ADMI removal of RTE (50%) at 35 and 20 mL·h^−l flow rates, respectively. Consequent reduction in TOC (83 and 79%), COD (85 and 83%) and BOD (79 and 78%) of CR dye and RTE were also observed, which suggested mineralization. The decolorization process was traced to be enzymatic as treated samples showed significant induction of oxidoreductive enzymes. The proposed biodegradation pathway of the dye revealed the formation of lower molecular weight compounds. Toxicity studies with a plant bioassay and acute tests indicated that the PUF-immobilized microbial consortium favors detoxification of the dye and textile effluents. Full article

(This article belongs to the Special Issue Environmental Systems Engineering)

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Open AccessArticle

Occurrence of Escherichia coli, Campylobcter, Salmonella and Shiga-Toxin Producing E. coli in Norwegian Primary Strawberry Production

by Gro S. Johannessen^1,*, Karl F. Eckner², Nina Heiberg³, Marte Monshaugen⁴, Mumtaz Begum¹, Marianne Økland¹ and Helga R. Høgåsen¹

¹ Norwegian Veterinary Institute, P.O. Box 750 Sentrum, Oslo N-0106, Norway

² Vann-og Avløpsetaten, P.O. Box 4704 Sofienberg, 0506 Oslo, Norway

³ Gartnerhallen SA, P.O. Box 111 Alnabru, Oslo N-0614, Norway

⁴ School of Veterinary Science, Norwegian University of Life Sciences, P.O. Box 8146 Dep., Oslo N-0033, Norway

Int. J. Environ. Res. Public Health 2015, 12(6), 6919-6932; https://doi.org/10.3390/ijerph120606919 - 17 Jun 2015

Cited by 12 | Viewed by 6254

Abstract

The aim of this study was to investigate the bacteriological quality of strawberries at harvest and to study risk factors such as irrigation water, soil and picker’s hand cleanliness. Four farms were visited during the harvest season in 2012. Samples of strawberries, irrigation [...] Read more.

The aim of this study was to investigate the bacteriological quality of strawberries at harvest and to study risk factors such as irrigation water, soil and picker’s hand cleanliness. Four farms were visited during the harvest season in 2012. Samples of strawberries, irrigation water, soil and hand swabs were collected and analyzed for E. coli, Campylobacter, Salmonella and STEC Although fecal indicators and pathogens were found in environmental samples, only one of 80 samples of strawberries was positive for E. coli (1.0 log₁₀ cfu/g) and pathogens were not detected in any of the strawberry samples. The water samples from all irrigation sources were contaminated with E. coli in numbers ranging from 0 to 3.3 log₁₀ cfu/g. Campylobacter (8/16 samples) and Salmonella (1/16 samples) were isolated from samples with high numbers of E. coli. The water samples collected from a lake had lower numbers of E. coli than the samples from rivers and a stream. The present study indicated continuous background contamination in the primary production environment. Although the background contamination was not reflected on the strawberries tested here, the results must be interpreted with caution due to the limited number of samples. Full article

(This article belongs to the Special Issue Food Safety)

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Vertical Distribution of Bacterial Community Diversity and Water Quality during the Reservoir Thermal Stratification

by Hai-Han Zhang^*, Sheng-Nan Chen, Ting-Lin Huang, Wei-Xing Ma, Jin-Lan Xu and Xin Sun

School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, No.13, YanTa Road, Xi'an 710055, China

Int. J. Environ. Res. Public Health 2015, 12(6), 6933-6945; https://doi.org/10.3390/ijerph120606933 - 17 Jun 2015

Cited by 33 | Viewed by 7754

Abstract

Reservoir thermal stratification drives the water temperature and dissolved oxygen gradient, however, the characteristic of vertical water microbial community during thermal stratification is so far poorly understood. In this work, water bacterial community diversity was determined using the Illumina Miseq sequencing technique. The [...] Read more.

Reservoir thermal stratification drives the water temperature and dissolved oxygen gradient, however, the characteristic of vertical water microbial community during thermal stratification is so far poorly understood. In this work, water bacterial community diversity was determined using the Illumina Miseq sequencing technique. The results showed that epilimnion, metalimnion and hypolimnion were formed steadily in the JINPEN drinking water reservoir. Water temperature decreased steadily from the surface (23.11 °C) to the bottom (9.17 °C). Total nitrogen ranged from 1.07 to 2.06 mg/L and nitrate nitrogen ranged from 0.8 to 1.84 mg/L. The dissolved oxygen concentration decreased sharply below 50 m, and reached zero at 65 m. The Miseq sequencing revealed a total of 4127 operational taxonomic units (OTUs) with 97% similarity, which were affiliated with 15 phyla including Acidobacteria, Actinobacteria, Armatimonadetes, Bacteroidetes, Caldiserica, Chlamydiae, Chlorobi, Chloroflexi, Cyanobacteria, Firmicutes, Gemmatimonadetes, Nitrospirae, Planctomycetes, Proteobacteria, and Verrucomicrobia. The highest Shannon diversity was 4.41 in 45 m, and the highest Chao 1 diversity was 506 in 5 m. Rhodobacter dominated in 55 m (23.24%) and 65 m (12.58%). Prosthecobacter dominated from 0.5 to 50 m. The heat map profile and redundancy analysis (RDA) indicated significant difference in vertical water bacterial community composition in the reservoir. Meanwhile, water quality properties including dissolved oxygen, conductivity, nitrate nitrogen and total nitrogen have a dramatic influence on vertical distribution of bacterial communities. Full article

(This article belongs to the Special Issue Water Microbial Pollution and Disinfection)

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Open AccessCorrection

Correction: Sahlin, E., et al. Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness. Int. J. Environ. Res. Public Health 2015, 12, 1928–1951

by Eva Sahlin^1,*, Gunnar Ahlborg, Jr.², Artur Tenenbaum³ and Patrik Grahn¹

¹ Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, P.O. Box 88, Alnarp S-230 53, Sweden

² Institute of Stress Medicine, Sweden and Sahlgrenska Academy, University of Gothenburg, Region Västra Götaland, Carl Skottbergs Gata 22B, Göteborg SE-413 19, Sweden

³ Arbetslivet, Region Västra Götaland, Skaraborgs Sjukhus Skövde, Skövde SE- 541 85, Sweden

Int. J. Environ. Res. Public Health 2015, 12(6), 6946-6947; https://doi.org/10.3390/ijerph120606946 - 17 Jun 2015

Cited by 3 | Viewed by 4477

Abstract

The authors wish to make the following corrections to their paper published in the International Journal of Environmental Research and Public Health [1]: [...] Full article

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Open AccessArticle

Flooding and Clostridium difficile Infection: A Case-Crossover Analysis

by Cynthia J. Lin^1,2, Timothy J. Wade^3,* and Elizabeth D. Hilborn³

¹ University of North Carolina, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC 27599, USA

² Oak Ridge Institute for Science and Education (ORISE) Research Participation Program at the U.S. Environmental Protection Agency, Chapel Hill, NC 27599, USA

³ USA Environmental Protection Agency (EPA), Office of Research and Development, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, Research Triangle Park, NC 27709, USA

Int. J. Environ. Res. Public Health 2015, 12(6), 6948-6964; https://doi.org/10.3390/ijerph120606948 - 17 Jun 2015

Cited by 19 | Viewed by 6760

Abstract

Clostridium difficile is a bacterium that can spread by water. It often causes acute gastrointestinal illness in older adults who are hospitalized and/or receiving antibiotics; however, community-associated infections affecting otherwise healthy individuals have become more commonly reported. A case-crossover study was used to [...] Read more.

Clostridium difficile is a bacterium that can spread by water. It often causes acute gastrointestinal illness in older adults who are hospitalized and/or receiving antibiotics; however, community-associated infections affecting otherwise healthy individuals have become more commonly reported. A case-crossover study was used to assess emergency room (ER) and outpatient visits for C. difficile infection following flood events in Massachusetts from 2003 through 2007. Exposure status was based on whether or not a flood occurred prior to the case/control date during the following risk periods: 0–6 days, 7–13 days, 14–20 days, and 21–27 days. Fixed-effects logistic regression was used to estimate the risk of diagnosis with C. difficile infection following a flood. There were 129 flood events and 1575 diagnoses of C. difficile infection. Among working age adults (19–64 years), ER and outpatient visits for C. difficile infection were elevated during the 7–13 days following a flood (Odds Ratio, OR = 1.69; 95% Confidence Interval, CI: 0.84, 3.37). This association was more substantial among males (OR = 3.21; 95% CI: 1.01–10.19). Associations during other risk periods were not observed (p < 0.05). Although we were unable to differentiate community-associated versus nosocomial infections, a potential increase in C. difficile infections should be considered as more flooding is projected due to climate change. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

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Open AccessCommunication

Comparison of Six Chromogenic Agar Media for the Isolation of a Broad Variety of Non-O157 Shigatoxin-Producing Escherichia coli (STEC) Serogroups

by Bavo Verhaegen^1,2, Koen De Reu^1,*, Marc Heyndrickx^1,3 and Lieven De Zutter²

¹ Institute for Agricultural and Fisheries Research (ILVO), Technology and Food Science Unit, Brusselsesteenweg 370, 9090 Melle, Belgium

² Faculty of Veterinary Medicine, Department of Veterinary Public Health and Food Safety, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium

³ Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium

Int. J. Environ. Res. Public Health 2015, 12(6), 6965-6978; https://doi.org/10.3390/ijerph120606965 - 17 Jun 2015

Cited by 39 | Viewed by 14066

Abstract

The isolation of non-O157 STEC from food samples has proved to be challenging. The selection of a suitable selective isolation agar remains problematic. The purpose of this study was to qualitatively and quantitatively evaluate six chromogenic agar media for the isolation of STEC: [...] Read more.

The isolation of non-O157 STEC from food samples has proved to be challenging. The selection of a suitable selective isolation agar remains problematic. The purpose of this study was to qualitatively and quantitatively evaluate six chromogenic agar media for the isolation of STEC: Tryptone Bile X-glucuronide agar (TBX), Rainbow^® Agar O157 (RB), Rapid E. coli O157:H7 (RE), Modified MacConkey Agar (mMac), CHROMagar^TM STEC (Chr ST) and chromID^TM EHEC (Chr ID). During this study, 45 E. coli strains were used, including 39 STEC strains belonging to 16 different O serogroups and 6 non-STEC E. coli. All E. coli strains were able to grow on TBX and RB, whereas one STEC strain was unable to grow on Chr ID and a number of other STEC strains did not grow on mMac, CHROMagar STEC and Rapid E. coli O157:H7. However, only the latter three agars were selective enough to completely inhibit the growth of the non-STEC E. coli. Our conclusion was that paired use of a more selective agar such as CHROMagar STEC together with a less selective agar like TBX or Chr ID might be the best solution for isolating non-O157 STEC from food. Full article

(This article belongs to the Special Issue Food Safety)

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Open AccessArticle

Diverse Land Use and the Impact on (Irrigation) Water Quality and Need for Measures — A Case Study of a Norwegian River

by Gro S. Johannessen^1,*, Aina C. Wennberg², Ingrid Nesheim² and Ingun Tryland²

¹ Norwegian Veterinary Institute, P.O. Box 750 Sentrum, NO-0106 Oslo, Norway

² Norwegian Institute for Water Research, Gaustadalléen 21, NO-0349 Oslo, Norway

Int. J. Environ. Res. Public Health 2015, 12(6), 6979-7001; https://doi.org/10.3390/ijerph120606979 - 17 Jun 2015

Cited by 11 | Viewed by 6252

Abstract

Surface water is used for irrigation of food plants all over the World. Such water can be of variable hygienic quality, and can be contaminated from many different sources. The association of contaminated irrigation water with contamination of fresh produce is well established, [...] Read more.

Surface water is used for irrigation of food plants all over the World. Such water can be of variable hygienic quality, and can be contaminated from many different sources. The association of contaminated irrigation water with contamination of fresh produce is well established, and many outbreaks of foodborne disease associated with fresh produce consumption have been reported. The objective of the present study was to summarize the data on fecal indicators and selected bacterial pathogens to assess the level of fecal contamination of a Norwegian river used for irrigation in an area which has a high production level of various types of food commodities. Sources for fecal pollution of the river were identified. Measures implemented to reduce discharges from the wastewater sector and agriculture, and potential measures identified for future implementation are presented and discussed in relation to potential benefits and costs. It is important that the users of the water, independent of intended use, are aware of the hygienic quality and the potential interventions that may be applied. Our results suggest that contamination of surface water is a complex web of many factors and that several measures and interventions on different levels are needed to achieve a sound river and safe irrigation. Full article

(This article belongs to the Special Issue Food Safety)

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Open AccessArticle

Public Knowledge, Beliefs and Behavior on Antibiotic Use and Self-Medication in Lithuania

by Eglė Pavydė^1,*, Vincentas Veikutis^2,†, Asta Mačiulienė^3,†, Vytautas Mačiulis^3,†, Kęstutis Petrikonis^4,† and Edgaras Stankevičius¹

¹ Institute of Physiology and Pharmacology, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 9, Kaunas 44307, Lithuania

² Institute of Microbiology and Virology, Lithuanian University of Health Sciences, Kaunas 49264, Lithuania

³ Department of Anesthesiology, Lithuanian University of Health Sciences, Kaunas 50161, Lithuania

⁴ Department of Neurology, Lithuanian University of Health Sciences, Kaunas 50161, Lithuania

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2015, 12(6), 7002-7016; https://doi.org/10.3390/ijerph120607002 - 17 Jun 2015

Cited by 92 | Viewed by 11550

Abstract

Irrational antibiotic use has led society to antibiotic resistance—a serious health problem worldwide. This study aimed to assess public knowledge, beliefs, and behavior concerning antibiotic use and self-medication in Lithuania. The cross-sectional survey method was processed using a validated questionnaire in different regions [...] Read more.

Irrational antibiotic use has led society to antibiotic resistance—a serious health problem worldwide. This study aimed to assess public knowledge, beliefs, and behavior concerning antibiotic use and self-medication in Lithuania. The cross-sectional survey method was processed using a validated questionnaire in different regions of Lithuania. In total, 1005 adults completed the questionnaire and were included in the study. More than half of the respondents (61.1%) had poor knowledge of antibiotics. Almost half of the respondents incorrectly identified antibiotics as being effective either against viral (26.0%) or mixed (bacterial and viral) infections (21.7%). The respondents with lower educational qualifications (OR = 2.515; 95% CI 1.464–4.319; p = 0.001) and those from rural areas (OR = 1.765; 95% CI 1.041–2.991; p = 0.035) were significantly less knowledgeable of antibiotics. There was no significant difference between genders, different age groups, or different parenthood status. The determined level of self–medication with antibiotics was 31.0%. The men (OR = 1.650; 95% CI 1.120–2.430; p = 0.011), the respondents from rural areas (OR = 2.002; 95% CI 1.343–2.985; p = 0.001), and those without children (OR = 2.428; 95% CI 1.477–3.991; p < 0.001) were more likely to use antibiotics in self-medication. Lithuanian residents’ knowledge of antibiotics is insufficient. More information about antibiotic use should be provided by physicians and pharmacists. Self-medication with antibiotics is a serious problem in Lithuania and requires considerable attention. Full article

(This article belongs to the Special Issue Health Behaviors and Public Health)

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Open AccessArticle

Lifestyle Behaviours Add to the Armoury of Treatment Options for Panic Disorder: An Evidence-Based Reasoning

by Rod Lambert

School of Health Sciences and Health Economics Consulting, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK

Int. J. Environ. Res. Public Health 2015, 12(6), 7017-7043; https://doi.org/10.3390/ijerph120607017 - 18 Jun 2015

Cited by 1 | Viewed by 6182

Abstract

This article presents an evidence-based reasoning, focusing on evidence of an Occupational Therapy input to lifestyle behaviour influences on panic disorder that also provides potentially broader application across other mental health problems (MHP). The article begins from the premise that we are all [...] Read more.

This article presents an evidence-based reasoning, focusing on evidence of an Occupational Therapy input to lifestyle behaviour influences on panic disorder that also provides potentially broader application across other mental health problems (MHP). The article begins from the premise that we are all different. It then follows through a sequence of questions, examining incrementally how MHPs are experienced and classified. It analyses the impact of individual sensitivity at different levels of analysis, from genetic and epigenetic individuality, through neurotransmitter and body system sensitivity. Examples are given demonstrating the evidence base behind the logical sequence of investigation. The paper considers the evidence of how everyday routine lifestyle behaviour impacts on occupational function at all levels, and how these behaviours link to individual sensitivity to influence the level of exposure required to elicit symptomatic responses. Occupational Therapists can help patients by adequately assessing individual sensitivity, and through promoting understanding and a sense of control over their own symptoms. It concludes that present clinical guidelines should be expanded to incorporate knowledge of individual sensitivities to environmental exposures and lifestyle behaviours at an early stage. Full article

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Open AccessArticle

Annoyance Caused by Noise and Air Pollution during Pregnancy: Associated Factors and Correlation with Outdoor NO₂ and Benzene Estimations

by Ana Fernández-Somoano^1,2,*, Sabrina Llop^1,3, Inmaculada Aguilera^4,5, Ibon Tamayo-Uria^1,6, María Dolores Martínez^6,7, Maria Foraster^4,5,8,9, Ferran Ballester^1,3

and Adonina Tardón^1,2

¹ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid 28029, Spain

² Department of Preventive Medicine and Public Health, University of Oviedo, Asturias 33006, Spain

³ Unit of Epidemiology and Environmental Health, FISABIO—Universitat Jaume I—Universitat de València Joint Research, Valencia 46020, Spain

⁴ Swiss Tropical and Public Health Institute, Basel 4002, Switzerland

⁵ University of Basel, Basel 4003, Switzerland

⁶ Health Research Institute, Biodonostia, San Sebastián 20014, Spain

⁷ Department of Environment and Regional Planning, Basque Government, San Sebastian 20004, Spain

⁸ Centre for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain

⁹ Hospital del Mar—Research Institute (IMIM), Barcelona 08003, Spain

Int. J. Environ. Res. Public Health 2015, 12(6), 7044-7058; https://doi.org/10.3390/ijerph120607044 - 18 Jun 2015

Cited by 12 | Viewed by 6210

Abstract

This study aimed to describe the degree of annoyance among pregnant women in a Spanish cohort and to examine associations with proximity to traffic, NO₂ and benzene exposure. We included 2457 participants from the Spanish Childhood and Environment study. Individual exposures to [...] Read more.

This study aimed to describe the degree of annoyance among pregnant women in a Spanish cohort and to examine associations with proximity to traffic, NO₂ and benzene exposure. We included 2457 participants from the Spanish Childhood and Environment study. Individual exposures to outdoor NO₂ and benzene were estimated, temporally adjusted for pregnancy. Interviews about sociodemographic variables, noise and air pollution were carried out. Levels of annoyance were assessed using a scale from 0 (none) to 10 (strong and unbearable); a level of 8 to 10 was considered high. The reported prevalence of high annoyance levels from air pollution was 11.2% and 15.0% from noise; the two variables were moderately correlated (0.606). Significant correlations between NO₂ and annoyance from air pollution (0.154) and that from noise (0.181) were observed. Annoyance owing to noise and air pollution had a low prevalence in our Spanish population compared with other European populations. Both factors were associated with proximity to traffic. In multivariate models, annoyance from air pollution was related to NO₂, building age, and country of birth; annoyance from noise was only related to the first two. The health burden of these exposures can be increased by stress caused by the perception of pollution sources. Full article

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Open AccessReview

Therapeutic Community Treatment of an Inmate Population with Substance Use Disorders: Post-Release Trends in Re-Arrest, Re-Incarceration, and Drug Misuse Relapse

by Alexandra Galassi¹, Elias Mpofu^1,2,* and James Athanasou¹

¹ Centre for Disability Research and Policy, University of Sydney, P.O. Box 170, NSW 1826, Australia

² Discipline, Rehabilitation Counselling, University of Sydney, Lidcombe, NSW 2141, Australia

Int. J. Environ. Res. Public Health 2015, 12(6), 7059-7072; https://doi.org/10.3390/ijerph120607059 - 19 Jun 2015

Cited by 31 | Viewed by 12015

Abstract

This systematic literature review maps the evidence for the effectiveness of the therapeutic community interventions (TCI) in reducing re-arrest, re-incarceration or drug misuse following release from prison, including the extent to which these effects are retained over time. The databases searched for the [...] Read more.

This systematic literature review maps the evidence for the effectiveness of the therapeutic community interventions (TCI) in reducing re-arrest, re-incarceration or drug misuse following release from prison, including the extent to which these effects are retained over time. The databases searched for the review included PsychINFO, Medline and Scopus and reference lists from relevant articles published between 2007 and 2014. Only quantitative studies that examined the effectiveness of TCI for a prisoner population with drug dependence at the time of initial incarceration were considered. Fourteen studies were identified for inclusion in the review. Three-quarters of the studies reported TCI were effective in reducing rates of re-incarceration. About 70% of studies that examined follow-up rates of drug misuse relapse found TCI effective in reducing rates of drug misuse amongst participants. TCI participation reduced re-arrests events in 55% of the studies. Results suggest TCI effective in the short-term rather than longer term for reducing rates of re-incarceration among participants, and to a slightly lesser extent, drug misuse relapse. Full article

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Open AccessArticle

Social Support, Stigma and Disclosure: Examining the Relationship with HIV Medication Adherence among Ryan White Program Clients in the Mid-South USA

by Latrice C. Pichon^1,*

, Kristen R. Rossi², Siri A. Ogg¹, Lisa J. Krull¹ and Dorcas Young Griffin³

¹ School of Public Health, University of Memphis, Robison Hall, Memphis, TN 38152, USA

² Shelby County Health Department Epidemiology Section, 814 Jefferson Ave., Memphis, TN 38105, USA

³ Shelby County Government, 160 N. Main St., Suite 250, Memphis, TN 38103 USA

Int. J. Environ. Res. Public Health 2015, 12(6), 7073-7084; https://doi.org/10.3390/ijerph120607073 - 19 Jun 2015

Cited by 26 | Viewed by 5937

Abstract

Social support from friends and family is positively related to better health outcomes among adults living with HIV. An extension of these networks such as religious communities may be an untapped source of social support for promoting HIV medical adherence. This paper explores [...] Read more.

Social support from friends and family is positively related to better health outcomes among adults living with HIV. An extension of these networks such as religious communities may be an untapped source of social support for promoting HIV medical adherence. This paper explores the association of HIV medication adherence to satisfaction with support from family, friends and church members, as well as HIV-related stigma, and HIV disclosure. In partnership with the Shelby County Health Department, the Memphis Ryan White Part A Program, and the University of Memphis School of Public Health, a total of 286 interviewer-administered surveys were conducted with Ryan White clients. Seventy-six percent (n = 216) of participants reported being prescribed antiretroviral medication (ARVs). Nearly all participants (n = 202, 94%) prescribed ARVs reported disclosing their HIV status to someone. Almost 20% (n = 40) of those prescribed ARVs reported not being satisfied with support received from his/her church. Interestingly, participants reported rarely experiencing stigma as a result of their HIV status. The extent to which satisfaction with support from personal networks and institutional settings like the church affect medication adherence is yet to be understood. The complexity of HIV disclosure and HIV stigma in relation to these supports warrants further investigation to understand how best to improve HIV health outcomes. Full article

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Int. J. Environ. Res. Public Health, Volume 12, Issue 6 (June 2015) – 85 articles , Pages 5685-7099