Improving Knowledge about Children’s Environmental Health in Northwest China
Abstract
:1. Introduction
2. Methods
2.1. Interviews with Regional Officials, Researchers and Non-Governmental Officials
Beliefs and Attitudes |
1. What do you know/believe about impacts of air pollution on health? |
2. What do you know/believe about impacts of air pollution on health in children? |
3. What is the role of research (environmental and public health research) in informing policy to protect children? |
4. Who are the key decision makers in protecting children from air pollution? |
Current Activities |
5. What research is being done to protect children from air pollution? |
6. What policies exist to protect children from air pollution? |
7. What are health care providers doing to protect children from air pollution? |
Barriers and Solutions |
8. What barriers are there to protecting children from air pollution? |
9. What are the gaps in policies to protect children from air pollution? |
10. Who are the key strategic players in protecting children from air pollution? |
11. What are potential recommendations to protect children from air pollution? |
2.2. Pre- and Post-Conference Evaluation of Attitudes, Beliefs and Behaviors
2.3. Human Subjects
3. Results and Discussion
3.1. Results
3.1.1. Interviews with Regional Officials, Researchers and Non-Governmental Officials
Characteristic | N (%) |
---|---|
Province | – |
Gansu | 24 (33%) |
Shanxi | 13 (18%) |
Ningxia | 14 (19%) |
Qinghai | 10 (14%) |
Xinjiang | 11 (15%) |
Agency/Organization | – |
Environmental Protection Bureau | 18 (25%) |
Health Department | 31 (43%) |
Medical Service | 21 (29%) |
Nongovernmental Organization | 2 (3%) |
Rank | – |
Commissioner of Provincial Department of Health or Bureau of Environmental Protection | 25 (35%) |
Deputy/Mid-Level with Oversight of Provincial Department of Health or Bureau of Environmental Protection | 12 (17%) |
Staff of Provincial Department of Health or Bureau of Environmental Protection | 21 (29%) |
Director/President of Hospital | 14 (19%) |
Medical Service Provider at Hospital | 5 (7%) |
3.1.2. Pre- and Post-Conference Evaluation of Attitudes, Beliefs and Behaviors
Characteristic | N (%) |
---|---|
Age, mean ± SD | 38.6 ± 9.8 |
Sex | |
Male | 9 (21.4) |
Female | 33 (78.6) |
Practice type | |
Primary health care | 9 (21.4) |
Specialty health care | 16 (42.8) |
Public health/other government official | 17 (45.2) |
Province | |
Gansu | 12 (28.6) |
Xinjiang | 7 (16.7) |
Shaanxi | 8 (19.0) |
Qinghai | 10 (23.8) |
Ningxia | 5 (11.9) |
Belief Statements (n = 47) | Mean ± SD |
The role of environmental health impacts on children is of little importance (1) → of great importance (5) | 4.52 ± 0.74 |
Scientific evidence for the impact of the environment of children is not sufficient (1) → sufficient (5) | 3.10 ± 1.08 |
The magnitude of children’s environmental related-illnesses is decreasing (1) → increasing (5) | 4.54 ± 0.77 |
The control child health providers have over environmental health hazards is minimal (1) → maximal (5) | 2.81 ± 1.21 |
The control government has over environmental health hazards is minimal (1) → maximal (5) | 4.17 ± 1.19 |
The control industry has over environmental health hazards is minimal (1) → maximal (5) | 4.13 ± 1.10 |
Assessing environmental exposures through history-taking in pediatric practice is of little importance (1) → of great importance (5) | 4.21 ± 0.86 |
Conducting an environmental health history on all my patients (1) takes up too much time → does not take up too much time (5) | 1.89 ± 0.83 |
Self-Efficacy Statements (n = 47) | Mean ± SD |
How would you rate your knowledge regarding: | – |
Lead exposure | 2.56 ±1.03 |
Pesticide exposure | 2.73 ± 1.14 |
Air pollution exposure | 2.19 ± 0.89 |
Mercury exposure | 2.54 ± 0.95 |
Mold exposure | 2.81 ± 1.12 |
PCB exposure | 2.35 ± 0.84 |
Question | N (%) |
---|---|
Who are the key decision makers in protecting children from air pollution? | – |
Health care providers | 8 (17%) |
Provincial environmental officials | 22 (46%) |
Provincial health officials | 13 (27%) |
Local health officials | 7 (15%) |
Local environmental officials | 11 (23%) |
National health officials | 21 (44%) |
National environmental officials | 30 (63%) |
Industry | 15 (31%) |
Researchers | 7 (15%) |
What policies exist to protect children from air pollution? | – |
Provincial environmental regulations | 8 (17%) |
Provincial health regulations | 4 (8%) |
Local health regulations | 2 (4%) |
Local environmental regulations | 5 (10%) |
National health regulations | 14 (29%) |
National environmental regulations | 18 (38%) |
What are health care providers doing to protect children from air pollution? | – |
Provide educational materials | 16 (33%) |
Assess environmental exposures | 15 (31%) |
Communicate prevention measures to families | 22 (46%) |
Treat patients with conditions of environmental origin | 19 (40%) |
What barriers are there to protecting children from air pollution? | – |
Industry profits | 33 (69%) |
Lack of governmental regulation | 39 (81%) |
Focus of government on economic growth | 28 (58%) |
Lack of medical knowledge | 18 (38%) |
Lack of research | 19 (40%) |
Lack of public awareness | 33 (69%) |
What are the gaps in policies to protect children from air pollution? | – |
Lack of policies | 25 (52%) |
Weak enforcement | 32 (67%) |
Lack of research | 20 (42%) |
Policies do not address children | 26 (54%) |
Who are the key strategic players in protecting children from air pollution? | – |
Industry | 14 (29%) |
Provincial environmental agency | 31 (65%) |
Provincial health agency | 23 (48%) |
Local health agency | 10 (21%) |
Local environmental agency | 14 (29%) |
National health agency | 24 (50%) |
National environmental agency | 28 (58%) |
Medical provider | 7 (15%) |
Researchers | 7 (15%) |
3.2. Discussion
4. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Guimaraes, J.; Ikingura, J.; Akagi, H. Methyl mercury production and distribution in river water-sediment systems investigated through radiochemical techniques. Water Air Soil Pollut. 2000, 124, 113–124. [Google Scholar] [CrossRef]
- Feng, X.; Li, P.; Qiu, G.; Wang, S.; Li, G.; Shang, L.; Meng, B.; Jiang, H.; Bai, W.; Li, Z.; et al. Human exposure to methylmercury through rice intake in mercury mining areas, Guizhou Province, China. Environ. Sci. Technol. 2007, 42, 326–332. [Google Scholar] [CrossRef]
- Zhang, H.; Feng, X.; Larssen, T.; Qiu, G.; Vogt, R.D. In inland China, rice, rather than fish, is the major pathway for methylmercury exposure. Environ. Health Perspect. 2010, 118, 1183–1188. [Google Scholar] [CrossRef] [PubMed]
- Zhang, S.-M.; Dai, Y.-H.; Xie, X.-H.; Fan, Z.-Y.; Tan, Z.-W.; Zhang, Y.-F. Surveillance of childhood blood lead levels in 14 cities of China in 2004–2006. Biomed. Environ. Sci. 2009, 22, 288–296. [Google Scholar] [CrossRef]
- He, K.; Wang, S.; Zhang, J. Blood lead levels of children and its trend in China. Sci. Total Environ. 2009, 407, 3986–3993. [Google Scholar] [CrossRef] [PubMed]
- Huo, X.; Peng, L.; Xu, X.; Zheng, L.; Qiu, B.; Qi, Z.; Zhang, B.; Han, D.; Piao, Z. Elevated blood lead levels of children in Guiyu, an electronic waste recycling town in China. Environ. Health Perspect. 2007, 115, 1113–1117. [Google Scholar] [CrossRef] [PubMed]
- LaFraniere, S. Lead Poisoning in China: The Hidden Scourge. N.Y. Times. 2011. Available online: http://www.nytimes.com/2011/06/15/world/asia/15lead.html?_r=0 (accessed on 18 November 2015).
- Goodman, D.S. The Campaign to “Open up the West”: National, Provincial-Level and Local Perspectives; Cambridge University Press: Cambridge, UK, 2004; pp. 8–9. [Google Scholar]
- Wormuth, M.; Scheringer, M.; Vollenweider, M.; Hungerbühler, K. What are the sources of exposure to eight frequently used phthalic acid esters in Europeans? Risk Anal. 2006, 26, 803–824. [Google Scholar] [CrossRef] [PubMed]
- Sarigiannis, D.A.; Karakitsios, S.; Zikopoulos, D.; Nikolaki, S.; Kermenidou, M. Lung cancer risk from PAHs emitted from biomass combustion. Environ. Res. 2015, 137, 147–156. [Google Scholar] [CrossRef] [PubMed]
- Edginton, A.N.; Ritter, L. Predicting plasma concentrations of bisphenol A in children younger than 2 years of age after typical feeding schedules, using a physiologically based toxicokinetic model. Environ. Health Perspect. 2009, 117, 645–652. [Google Scholar] [CrossRef] [PubMed]
- Trasande, L.; Niu, J.; Li, J.; Liu, X.; Zhang, B.; Li, Z.; Ding, G.; Sun, Y.; Chen, M.; Hu, X.; et al. The environment and children’s health care in Northwest China. BMC Pediatr. 2014, 14. [Google Scholar] [CrossRef] [PubMed]
- Cifuentes, E.; Trasande, L.; Ramirez, M.; Landrigan, P. A qualitative analysis of environmental policy and children’s health in Mexico. Environ. Health 2010, 9. [Google Scholar] [CrossRef] [PubMed]
- Sofaer, S. Qualitative methods: What are they and why use them? Health Serv. Res. 1999, 34, 1101–1118. [Google Scholar] [PubMed]
- Crabtree, B.F. A Template Approach to Text Analysis: Developing and Using Codebooks; Crabtree, B.F., Miller, W.L., Eds.; Sage Publications: Newbury Park, CA, USA, 1992; pp. 93–109. [Google Scholar]
- Leininger, M. Ethnography and Ethnonursing: Models and Modes of Qualitative Data Analysis. Available online: http://scholar.glgoo.org/scholar?q=Ethnography+and+ethnonursing%3A+Models+and+modes+of+qualitative+data+analysis+&btnG=&hl=zh-CN&as_sdt=0%2C5 (accessed on 12 October 2015).
- World Health Organization. Children’s Environmental Health Survey on Child Environmental Health Awareness of Health Care Professionals. Available online: http://www.who.int/ceh/capacity/training_modules/en/ (accessed on 18 November 2015).
- National Institutes of Environmental Health Sciences. Partnerships for Environmental Public Health Evaluation Metrics Manual. Available online: http://www.niehs.nih.gov/research/supported/dert/programs/peph/metrics/ (accessed on 18 November 2015).
- Benner, P. Quality of life: A phenomenological perspective on explanation, prediction, and understanding in nursing science. Adv. Nurs. Sci. 1985, 8, 1–14. [Google Scholar] [CrossRef]
- Constas, M.A. Qualitative analysis as a public event: The documentation of category development procedures. Am. Educ. Res. J. 1992, 29, 253–266. [Google Scholar] [CrossRef]
- Fereday, J.; Muir-Cochrane, E. Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. Int. J. Qual. Methods 2006, 5, 1–11. [Google Scholar]
- Bloomberg Business. World’s 10 Biggest Refined-Nickel Producers in 2011. Available online: http://www.Bloomberg.Com/news/articles/2012-03-02/world-s-10-biggest-refined-nickel-producers-in-2011-table- (accessed on 26 August 2015).
- The China Perspective. Qinghai Province. Available online: http://www.Thechinaperspective.Com/topics/province/qinghai-province/ (accessed on 26 August 2015).
- Wehby, G.L. Living on higher ground reduces child neurodevelopment—Evidence from South America. J. Pediatr. 2013, 162, e601–e611. [Google Scholar] [CrossRef] [PubMed]
- Kan, H.; Chen, B.; Hong, C. Health impact of outdoor air pollution in China: Current knowledge and future research needs. Environ. Health Perspect. 2009, 117. [Google Scholar] [CrossRef] [PubMed]
- Attina, T.M.; Trasande, L. Economic costs of childhood lead exposure in low- and middle-income countries. Environ. Health Perspect. 2013, 121, 1097–1102. [Google Scholar] [CrossRef] [PubMed]
- Rogers, B.; McCurdy, L.E.; Slavin, K.; Grubb, K.; Roberts, J.R. Children’s environmental health faculty champions initiative: A successful model for integrating environmental health into pediatric health care. Environ. Health Perspect. 2009, 117, 850–855. [Google Scholar] [CrossRef] [PubMed]
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Share and Cite
Niu, J.; Qu, Q.; Li, J.; Liu, X.; Zhang, B.; Li, Z.; Ding, G.; Sun, Y.; Shi, Y.; Wan, Y.; et al. Improving Knowledge about Children’s Environmental Health in Northwest China. Int. J. Environ. Res. Public Health 2016, 13, 80. https://doi.org/10.3390/ijerph13010080
Niu J, Qu Q, Li J, Liu X, Zhang B, Li Z, Ding G, Sun Y, Shi Y, Wan Y, et al. Improving Knowledge about Children’s Environmental Health in Northwest China. International Journal of Environmental Research and Public Health. 2016; 13(1):80. https://doi.org/10.3390/ijerph13010080
Chicago/Turabian StyleNiu, Jingping, Qingshan Qu, Juansheng Li, Xingrong Liu, Benzhong Zhang, Zhilan Li, Guowu Ding, Yingbiao Sun, Yanrong Shi, Yaxiong Wan, and et al. 2016. "Improving Knowledge about Children’s Environmental Health in Northwest China" International Journal of Environmental Research and Public Health 13, no. 1: 80. https://doi.org/10.3390/ijerph13010080