International Journal of Environmental Research and Public Health

Editorial

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2 pages, 222 KiB

Open AccessEditorial

Landscapes and Human Health

by William C. Sullivan and Chun-Yen Chang

Int. J. Environ. Res. Public Health 2017, 14(10), 1212; https://doi.org/10.3390/ijerph14101212 - 11 Oct 2017

Cited by 11 | Viewed by 4943

Abstract

As urbanization increases around the world and fewer and fewer people have easy access to completely natural places, there is a growing need to understand how the landscapes we design and inhabit impact our health and wellbeing.[...] Full article

(This article belongs to the Special Issue Landscapes and Human Health)

Research

Jump to: Editorial, Review, Other

17 pages, 3408 KiB

Open AccessArticle

Using Upper Extremity Skin Temperatures to Assess Thermal Comfort in Office Buildings in Changsha, China

by Zhibin Wu, Nianping Li, Haijiao Cui, Jinqing Peng, Haowen Chen and Penglong Liu

Int. J. Environ. Res. Public Health 2017, 14(10), 1092; https://doi.org/10.3390/ijerph14101092 - 21 Sep 2017

Cited by 26 | Viewed by 5528

Abstract

Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments’ conclusions may not represent a realistic thermal environment [...] Read more.

Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments’ conclusions may not represent a realistic thermal environment due to the highly controlled thermal environment and few occupants. This paper focuses on determining the relationships between upper extremity skin temperatures (i.e., finger, wrist, hand and forearm) and the indoor thermal comfort. Also, the applicability of predicting thermal comfort by using upper extremity skin temperatures was explored. Field studies were performed in office buildings equipped with split air-conditioning (SAC) located in the hot summer and cold winter (HSCW) climate zone of China during the summer of 2016. Psychological responses of occupants were recorded and physical and physiological factors were measured simultaneously. Standard effective temperature (SET*) was used to incorporate the effect of humidity and air velocity on thermal comfort. The results indicate that upper extremity skin temperatures are good indicators for predicting thermal sensation, and could be used to assess the thermal comfort in terms of physiological mechanism. In addition, the neutral temperature was 24.7 °C and the upper limit for 80% acceptability was 28.2 °C in SET*. Full article

(This article belongs to the Special Issue Indoor Environmental Quality)

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12 pages, 796 KiB

Open AccessArticle

The Role of Body Adiposity Index in Determining Body Fat Percentage in Colombian Adults with Overweight or Obesity

by Robinson Ramírez-Vélez, Jorge Enrique Correa-Bautista, Katherine González-Ruíz, Alejandra Tordecilla-Sanders, Antonio García-Hermoso, Jacqueline Schmidt-RioValle and Emilio González-Jiménez

Int. J. Environ. Res. Public Health 2017, 14(10), 1093; https://doi.org/10.3390/ijerph14101093 - 21 Sep 2017

Cited by 13 | Viewed by 4411

Abstract

The aim of this study is to investigate the accuracy of body adiposity index (BAI) as a convenient tool for assessing body fat percentage (BF%) in a sample of adults with overweight/obesity using bioelectrical impedance analysis (BIA). The study population was composed of [...] Read more.

The aim of this study is to investigate the accuracy of body adiposity index (BAI) as a convenient tool for assessing body fat percentage (BF%) in a sample of adults with overweight/obesity using bioelectrical impedance analysis (BIA). The study population was composed of 96 volunteers (60% female, mean age 40.6 ± 7.5 years old). Anthropometric characteristics (body mass index, height, waist-to-height ratio, hip and waist circumference), socioeconomic status, and diet were assessed, and BF% was measured by BIA-BF% and by BAI-BF%. Pearson’s correlation coefficient was used to evaluate the correlation between BAI-BF% and BF% assessed by BIA-BF%, while controlling for potential confounders. The concordance between the BF% measured by both methods was obtained with a paired sample t-test, Lin’s concordance correlation coefficient, and Bland-Altman plot analysis. Overall, the correlation between BF% obtained by BIA-BF% and estimated by BAI-BF% was r = 0.885, p < 0.001, after adjusting for potential confounders (age, socioeconomic status, and diet). Lin’s concordance correlation coefficient was moderate in both sexes. In the men, the paired t-test showed a significant mean difference in BF% between the methods (−5.6 (95%CI −6.4 to −4.8); p < 0.001). In the women, these differences were (−3.6 (95%CI −4.7 to −2.5); p < 0.001). Overall, the bias of the BAI-BF% was −4.8 ± 3.2 BF%; p < 0.001), indicating that the BAI-BF% method significantly underestimated the BF% in comparison with the reference method. In adults with overweight/obesity, the BAI presents low agreement with BF% measured by BIA-BF%; therefore, we conclude that BIA-BF% is not accurate in either sex when body fat percentage levels are low or high. Further studies are necessary to confirm our findings in different ethnic groups. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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12 pages, 282 KiB

Open AccessArticle

Involuntary Smoking in Adolescents, Their Awareness of Its Harmfulness, and Attitudes towards Smoking in the Presence of Non-Smokers

by Dorota Kaleta, Kinga Polanska, Piotr Wojtysiak and Franciszek Szatko

Int. J. Environ. Res. Public Health 2017, 14(10), 1095; https://doi.org/10.3390/ijerph14101095 - 21 Sep 2017

Cited by 10 | Viewed by 4887

Abstract

The aim of the study was to examine involuntary smoking among young people, their awareness of its harmfulness and the factors associated with attitudes towards smoking in the presence of non-smokers. A cross-sectional study was conducted among 3552 students from a socially disadvantaged [...] Read more.

The aim of the study was to examine involuntary smoking among young people, their awareness of its harmfulness and the factors associated with attitudes towards smoking in the presence of non-smokers. A cross-sectional study was conducted among 3552 students from a socially disadvantaged rural area in central Poland. Almost 40% of the participants were exposed to involuntary smoking at home and 60% outside of home on a daily or almost daily basis. More than 80% of the students felt that smoking should be banned around children at home, 59% thought it should be banned in vehicles, and 41% in the presence of non-smokers. The majority of the students were aware of the health consequences of active smoking, and 69% understood the threats of passive smoking. Females, never-smokers and current non-smokers, as well as those without smoking parents were more likely to claim that smoking should be banned at home and in vehicles (p < 0.05). Those aware of the fact that smoking was harmful to health, who discussed those issues with their parents and teachers, and who saw school tobacco control policies, were more likely to maintain that passive smoking should be banned (p < 0.05). The study results highlight the need for programs and policies to eliminate involuntary smoking among young people. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

16 pages, 329 KiB

Open AccessArticle

Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan)

by Ruby Yu, Wan-Chi Wu, Jason Leung, Susan C. Hu and Jean Woo

Int. J. Environ. Res. Public Health 2017, 14(10), 1096; https://doi.org/10.3390/ijerph14101096 - 21 Sep 2017

Cited by 31 | Viewed by 6277

Abstract

This study aimed to compare the prevalence of frailty across three Chinese populations: Hong Kong, Taiwan-urban and Taiwan-rural. Contributing factors to disparities in frailty were also examined. Data were derived from the Osteoporotic Fractures in Men (MrOs) and Women (MsOs) (Hong Kong) Study [...] Read more.

This study aimed to compare the prevalence of frailty across three Chinese populations: Hong Kong, Taiwan-urban and Taiwan-rural. Contributing factors to disparities in frailty were also examined. Data were derived from the Osteoporotic Fractures in Men (MrOs) and Women (MsOs) (Hong Kong) Study (n = 4000) and the Taiwan Longitudinal Study on Aging (n = 2392). Frailty was defined as an index calculated from 30 multiple deficits. The ratio of the frailty index to life expectancy at birth (FI/LE) was used as an indicator of compression of morbidity. Frailty was more prevalent in Taiwan-urban (33.1%) and Taiwan-rural (38.1%) compared to Hong Kong (16.6%, p < 0.05) and was higher in women (22.6–49.7%) than in men (10.5–27.5%, p < 0.05). The ratios of FI/LE were higher in Taiwan-urban and Taiwan-rural (both 0.27) compared to Hong Kong (0.20, p < 0.05). Multivariate analyses revealed that older age, being a woman and low levels of physical activity were common risk factors for frailty across the three populations. Alcohol use was inversely associated with frailty in both Hong Kong and Taiwan-urban populations, but not in Taiwan-rural. Living alone was associated with frailty in Hong Kong men, but not in Hong Kong women or Taiwanese people. For all study populations, older age and being a woman constituted the highest attributable factor. This comparison provides useful data to inform government policies. Full article

(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)

14 pages, 703 KiB

Open AccessArticle

Attitudes, Beliefs and Predictors of Male Circumcision Promotion among Medical University Students in a Traditionally Non-Circumcising Region

by Maria Ganczak, Marcin Korzeń and Maciej Olszewski

Int. J. Environ. Res. Public Health 2017, 14(10), 1097; https://doi.org/10.3390/ijerph14101097 - 21 Sep 2017

Cited by 6 | Viewed by 6289

Abstract

Objective: To evaluate the beliefs of medical university students regarding male circumcision (MC), as well as attitudes and the predictors of its promotion in the case of adults at risk of HIV. Methods: A cross-sectional survey was conducted between 2013–2016 at the [...] Read more.

Objective: To evaluate the beliefs of medical university students regarding male circumcision (MC), as well as attitudes and the predictors of its promotion in the case of adults at risk of HIV. Methods: A cross-sectional survey was conducted between 2013–2016 at the Medical University in Szczecin, Poland, among final year Polish/foreign students from Northern Europe, using a standardized questionnaire. Results: There were 539 participants, median age 25 years, 40.8% males, and 66.8% were Polish nationals. The MC rate was 16.7%. Regarding HIV/AIDS knowledge, 66.6% of the students scored more than 75%; and, 34.2% knew that MC reduces the risk of HIV infection. One in eleven respondents (9.1%) believed that circumcised men felt more intense sexual pleasure. More than half of the respondents (54.8%) declared that they would recommend MC to adult patients at risk for HIV. The belief that circumcised men felt more intense sexual pleasure, and knowledge on MC regarding HIV risk reduction was associated with greater odds of recommending adult MC (OR = 3.35 and OR = 2.13, respectively). Conclusions: Poor knowledge of its benefits and a low willingness to promote the procedure—strongly dependent on personal beliefs—suggest that medical students may need additional training to help them to discuss MC more openly with adult men at risk for HIV infection. Knowledge may be an effective tool when making decisions regarding MC promotion. Full article

(This article belongs to the Section Global Health)

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15 pages, 927 KiB

Open AccessFeature PaperArticle

Neighborhood Context, Homeownership and Home Value: An Ecological Analysis of Implications for Health

by Roshanak Mehdipanah, Amy J. Schulz, Barbara A. Israel, Graciela Mentz, Alexa Eisenberg, Carmen Stokes and Zachary Rowe

Int. J. Environ. Res. Public Health 2017, 14(10), 1098; https://doi.org/10.3390/ijerph14101098 - 22 Sep 2017

Cited by 20 | Viewed by 6459

Abstract

While homeownership has been linked to positive health outcomes there is limited evidence regarding the conditions under which it may be health protective. We present a conceptual model linking homeownership to health, highlighting key potential pathways. Using the Detroit Metropolitan Area as a [...] Read more.

While homeownership has been linked to positive health outcomes there is limited evidence regarding the conditions under which it may be health protective. We present a conceptual model linking homeownership to health, highlighting key potential pathways. Using the Detroit Metropolitan Area as a case study, and data from the American Community Survey (2009–2013; 5-years estimates) and Michigan Department of Community Health, we tested the following questions: (1) Is neighborhood percentage non-Hispanic Black (NHB) associated with homeownership? (2) Is neighborhood percentage NHB associated with health? (3) Is the association between percentage NHB and health mediated by homeownership? (4) Does neighborhood housing value modify associations between percentage NHB and health, or between homeownership and health? Percentage NHB was associated with homeownership and health outcomes; Associations between percentage NHB and mortality, but not disability, were partially mediated by neighborhood homeownership. Neighborhood housing value modified associations between neighborhood homeownership and both disability and mortality, but not between percentage NHB and health outcomes. Findings are consistent with the thesis that health-promoting effects of homeownership may be contingent upon house values. These results add to a limited body of evidence suggesting that variations in homeownership may contribute to persistent racial and socioeconomic health inequities. Full article

(This article belongs to the Special Issue Housing and Health)

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10 pages, 290 KiB

Open AccessArticle

Comparison of Patterns of Use of Unrecorded and Recorded Spirits: Survey of Adult Drinkers in Rural Central China

by Shiqing Wei, Ping Yin, Ian M. Newman, Ling Qian, Duane F. Shell and Lok-wa Yuen

Int. J. Environ. Res. Public Health 2017, 14(10), 1099; https://doi.org/10.3390/ijerph14101099 - 22 Sep 2017

Cited by 10 | Viewed by 3700

Abstract

About 70% of the beverage alcohol consumed in China annually is spirits. Recorded spirits make up most spirit consumption, but about 25% of total alcohol consumption (1.7 L pure alcohol per capita annually) is unrecorded spirits (bai jiu), either homemade or made in [...] Read more.

About 70% of the beverage alcohol consumed in China annually is spirits. Recorded spirits make up most spirit consumption, but about 25% of total alcohol consumption (1.7 L pure alcohol per capita annually) is unrecorded spirits (bai jiu), either homemade or made in unregulated distilleries. In some parts of China, the consumption of unrecorded spirits is higher than average. This paper compares the patterns of use of unrecorded distilled spirits and recorded distilled spirits among rural residents in Central China. Interviews were conducted with 3298 individuals in 21 towns/villages in 10 counties in the Hubei, Anhui, and Hebei provinces in the People’s Republic of China. Unrecorded bai jiu drinkers chose it because of its taste and its low price. It was consumed mostly by older men, mostly at home with family, more regularly and at higher alcohol by volume (ABV) compared to recorded alcohol. Recorded bai jiu drinkers were more likely to drink away from their homes, consumed more bai jiu at memorable drinking occasions, and reported feeling sick after drinking more often than unrecorded bai jiu drinkers. This comparison of patterns of use of unrecorded bai jiu and recorded bai jiu does not suggest that unrecorded bai jiu is more problematic for drinkers. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

12 pages, 924 KiB

Open AccessArticle

Characterization of Diarrheagenic Escherichia coli Isolated in Organic Waste Products (Cattle Fecal Matter, Manure and, Slurry) from Cattle’s Markets in Ouagadougou, Burkina Faso

by Evariste Bako, Assèta Kagambèga, Kuan Abdoulaye Traore, Touwendsida Serge Bagre, Hadiza Bawa Ibrahim, Soutongnooma Caroline Bouda, Isidore Juste Ouindgueta Bonkoungou, Saidou Kaboré, Cheikna Zongo, Alfred Sababenejo Traore and Nicolas Barro

Int. J. Environ. Res. Public Health 2017, 14(10), 1100; https://doi.org/10.3390/ijerph14101100 - 22 Sep 2017

Cited by 16 | Viewed by 5564

Abstract

Cattle farming can promote diarrheal disease transmission through waste, effluents or cattle fecal matter. The study aims to characterize the diarrheagenic Escherichia coli (DEC) isolated from cattle feces, manure in the composting process and slurry, collected from four cattle markets in Ouagadougou. A [...] Read more.

Cattle farming can promote diarrheal disease transmission through waste, effluents or cattle fecal matter. The study aims to characterize the diarrheagenic Escherichia coli (DEC) isolated from cattle feces, manure in the composting process and slurry, collected from four cattle markets in Ouagadougou. A total of 585 samples (340 cattle feces, 200 slurries and 45 manures in the composting process) were collected from the four cattle markets between May 2015 and May 2016. A multiplex Polymerase Chain Reaction (PCR), namely 16-plex PCR, was used to screen simultaneously the virulence genes specific for shiga toxin-producing E. coli (STEC), enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC) and enteroaggregative E. coli (EAEC). DEC was detected in 10.76% of samples. ETEC was the most prevalent (9.91%). STEC and EAEC have been observed with the same rate (0.51%). ETEC were detected in 12.64% of cattle feces, in 6.66% of manure in the composting process and in 5% of slurry. STEC were detected in 0.58% of cattle feces and in 2.22% of manure in the composting process. EAEC was detected only in 1% of slurry and in 2.22% of manure in the composting process. ETEC strains were identified based on estIa gene and/or estIb gene and/or elt gene amplification. Of the 58 ETEC, 10.34% contained astA, 17.24% contained elt, 3.44% contained estIa and 79.31% contained estIb. The two positive EAEC strains contained only the aggR gene, and the third was positive only for the pic gene. The results show that effluent from cattle markets could contribute to the spreading of DEC in the environment in Burkina Faso. Full article

(This article belongs to the Special Issue Environmental Determinants of Infectious Disease Transmission)

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10 pages, 499 KiB

Open AccessArticle

Job Satisfaction among Health-Care Staff in Township Health Centers in Rural China: Results from a Latent Class Analysis

by Haipeng Wang, Chengxiang Tang, Shichao Zhao, Qingyue Meng and Xiaoyun Liu

Int. J. Environ. Res. Public Health 2017, 14(10), 1101; https://doi.org/10.3390/ijerph14101101 - 22 Sep 2017

Cited by 23 | Viewed by 5815

Abstract

Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate [...] Read more.

Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff’s personal and professional features; Methods: We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis was performed to identify subgroups based on the items of job satisfaction; Results: Four latent classes of job satisfaction were identified: 8.9% had high job satisfaction, belonging to “satisfied class”; 38.2% had low job satisfaction, named as “unsatisfied class”; 30.5% were categorized into “unsatisfied class with the exception of interpersonal relationships”; 22.4% were identified as “pseudo-satisfied class”, only satisfied with management-oriented items. Low job satisfaction was associated with specialty, training opportunity, and income inequality. Conclusions: The minority of health-care staff belong to the “satisfied class”. Three among four subgroups are not satisfied with income, benefit, training, and career development. Targeting policy interventions should be implemented to improve the items of job satisfaction based on the patterns and health-care staff’s features. Full article

(This article belongs to the Special Issue Healthcare Quality and Patient Satisfaction)

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15 pages, 16323 KiB

Open AccessArticle

Assessing the Allocation of Special Elderly Nursing Homes in Tokyo, Japan

by Ninglong You, Zhenjiang Shen and Tatsuya Nishino

Int. J. Environ. Res. Public Health 2017, 14(10), 1102; https://doi.org/10.3390/ijerph14101102 - 22 Sep 2017

Cited by 6 | Viewed by 4920

Abstract

Social welfare and public health departments require reliable assessments to enhance the rationality of phased construction of special elderly nursing homes (SENHs). This paper aims to assess the allocation of SENHs based on a beds-needed index for SENHs (BNIS). This may help departments [...] Read more.

Social welfare and public health departments require reliable assessments to enhance the rationality of phased construction of special elderly nursing homes (SENHs). This paper aims to assess the allocation of SENHs based on a beds-needed index for SENHs (BNIS). This may help departments determine the priority for approving locations of SENHs more accurately with a limited budget. Traditional assessments in Tokyo use the sphere of welfare, ward, and sphere of daily life as spatial units for estimating beds-to-elderly population ratios. We calculate the BNIS by introducing a parameter-improved floating catchment area method (PI-FCA) at a smaller spatial unit, the Chome. In the PI-FCA, the catchment area is generated according to the standard of average population served by SENHs and capacity, the population demand is the population of the elderly requiring care levels 3–5 and is further modified by a coefficient of potential demand via building a multivariate linear model. Improved results were obtained using the PI-FCA. Finally, this study maps the distribution of the degree of BNIS, to provide a basis for the allocation assessment of SENHs. This caters to the needs of departments and is easily applicable in other public healthcare facilities. Full article

(This article belongs to the Section Health Economics)

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14 pages, 728 KiB

Open AccessArticle

Association between Long-Term Exposure to Particulate Matter Air Pollution and Mortality in a South Korean National Cohort: Comparison across Different Exposure Assessment Approaches

by Ok-Jin Kim, Sun-Young Kim and Ho Kim

Int. J. Environ. Res. Public Health 2017, 14(10), 1103; https://doi.org/10.3390/ijerph14101103 - 23 Sep 2017

Cited by 32 | Viewed by 5516

Abstract

Increasing numbers of cohort studies have reported that long-term exposure to ambient particulate matter is associated with mortality. However, there has been little evidence from Asian countries. We aimed to explore the association between long-term exposure to particulate matter with a diameter ≤10 [...] Read more.

Increasing numbers of cohort studies have reported that long-term exposure to ambient particulate matter is associated with mortality. However, there has been little evidence from Asian countries. We aimed to explore the association between long-term exposure to particulate matter with a diameter ≤10 µm (PM₁₀) and mortality in South Korea, using a nationwide population-based cohort and an improved exposure assessment (EA) incorporating time-varying concentrations and residential addresses (EA1). We also compared the association across different EA approaches. We used information from 275,337 people who underwent health screening from 2002 to 2006 and who had follow-up data for 12 years in the National Health Insurance Service-National Sample Cohort. Individual exposures were computed as 5-year averages using predicted residential district-specific annual-average PM₁₀ concentrations for 2002–2006. We estimated hazard ratios (HRs) of non-accidental and five cause-specific mortalities per 10 µg/m³ increase in PM₁₀ using the Cox proportional hazards model. Then, we compared the association of EA1 with three other approaches based on time-varying concentrations and/or addresses: predictions in each year and addresses at baseline (EA2); predictions at baseline and addresses in each year (EA3); and predictions and addresses at baseline (EA4). We found a marginal association between long-term PM₁₀ and non-accidental mortality. The HRs of five cause-specific mortalities were mostly higher than that of non-accidental mortality, but statistically insignificant. In the comparison between EA approaches, the HRs of EA1 were similar to those of EA2 but higher than EA3 and EA4. Our findings confirmed the association between long-term exposure to PM₁₀ and mortality based on a population-representative cohort in South Korea, and suggested the importance of assessing individual exposure incorporating air pollution changes over time. Full article

(This article belongs to the Section Environmental Health)

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11 pages, 522 KiB

Open AccessArticle

Dietary Inflammatory Index and Cardiometabolic Risk Parameters in Overweight and Sedentary Subjects

by Claudia Marcela Camargo-Ramos, Jorge Enrique Correa-Bautista, María Correa-Rodríguez and Robinson Ramírez-Vélez

Int. J. Environ. Res. Public Health 2017, 14(10), 1104; https://doi.org/10.3390/ijerph14101104 - 6 Oct 2017

Cited by 54 | Viewed by 6135

Abstract

Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia. [...] Read more.

Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia. A 24-h dietary record was used to calculate the DII. Body composition variables, flow-mediated dilation (FMD), pulse wave velocity (PWV), lipid profile, glucose, glycosylated hemoglobin (Hb1Ac), and blood pressure were measured and a cardiometabolic risk score (MetScore) was calculated. A lower DII score (anti-inflammatory diet) was significantly associated with higher high-density lipoprotein-cholesterol (HDL-C) and FMD, and lower Hb1Ac and MetScore (p < 0.05). A lower DII score was inversely correlated with plasma triglyceride levels (r = −0.354, p < 0.05), glucose (r = −0.422, p < 0.05), MetScore (r = −0.228, p < 0.05), and PWV (r = −0.437, p < 0.05), and positively with FMD (r = 0.261, p < 0.05). In contrast, a higher DII score (pro-inflammatory diet) showed a positive relationship with MetScore (r = 0.410, p < 0.05) and a negative relationship with FMD (r = −0.233, p < 0.05). An increased inflammatory potential of diet was inversely associated with an improved cardiometabolic profile, suggesting the importance of promoting anti-inflammatory diets as an effective strategy for preventing CVD. Full article

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

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11 pages, 308 KiB

Open AccessArticle

Environmental Tobacco Smoke Exposure at Home and High-Sensitivity C-Reactive Protein Levels in Three-to-Five-Year-Old Children

by Eunkye Kang, Soo Young Kim, Seong Sil Chang, Sinye Lim, Hwan-Cheol Kim, Chul-Gab Lee, Yu-Mi Kim, Su Young Kim, Kee-Jae Lee, Suejin Kim and Mina Ha

Int. J. Environ. Res. Public Health 2017, 14(10), 1105; https://doi.org/10.3390/ijerph14101105 - 23 Sep 2017

Cited by 7 | Viewed by 5217

Abstract

Exposure to harmful environmental factors is particularly detrimental to younger children. We investigated the relationship between environmental tobacco smoke (ETS) exposure in pre-schoolers at home and the level of high-sensitivity C-reactive protein (hs-CRP), a predictive factor for cardiovascular disease. This study was conducted [...] Read more.

Exposure to harmful environmental factors is particularly detrimental to younger children. We investigated the relationship between environmental tobacco smoke (ETS) exposure in pre-schoolers at home and the level of high-sensitivity C-reactive protein (hs-CRP), a predictive factor for cardiovascular disease. This study was conducted in 2014 and was based on the data of preschool children from the Korean Environmental Health Survey in Children and Adolescents (2012 to 2014), a nationally representative sample. Of 577 children, aged three to five years, 482 were eventually selected for the analysis after excluding those with missing variables, or whose hs-CRP level exceeded the reference value. The proportion of pre-school children exposed to ETS at home was 14.8%. The odd ratios (OR)s of hs-CRP > 1mg/L were 4.90 (95% Confidence Interval (CI) = 1.04–23.17) and 11.66 (95% CI = 1.90–71.65) in the groups exposed to ETS 3–4 times and ≥5 times daily, respectively, compared to the non-exposed group. The risk of elevated levels of hs-CRP showed an increasing trend proportionally to the increase in ETS exposure frequency (p for trend = 0.03). Anti-smoking educational programs for parents and guardians may be helpful to reduce ETS exposure at home. Full article

(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)

15 pages, 4697 KiB

Open AccessArticle

Agricultural Capacity to Increase the Production of Select Fruits and Vegetables in the US: A Geospatial Modeling Analysis

by Zach Conrad, Christian J. Peters, Kenneth Chui, Lisa Jahns and Timothy S. Griffin

Int. J. Environ. Res. Public Health 2017, 14(10), 1106; https://doi.org/10.3390/ijerph14101106 - 23 Sep 2017

Cited by 6 | Viewed by 5119

Abstract

The capacity of US agriculture to increase the output of specific foods to accommodate increased demand is not well documented. This research uses geospatial modeling to examine the capacity of the US agricultural landbase to increase the per capita availability of an example [...] Read more.

The capacity of US agriculture to increase the output of specific foods to accommodate increased demand is not well documented. This research uses geospatial modeling to examine the capacity of the US agricultural landbase to increase the per capita availability of an example set of nutrient-dense fruits and vegetables. These fruits and vegetables were selected based on nutrient content and an increasing trend of domestic production and consumption. Geographic information system models were parameterized to identify agricultural land areas meeting crop-specific growing requirements for monthly precipitation and temperature; soil depth and type; cropland availability; and proximity to existing production centers. The results of these analyses demonstrate that crop production can be expanded by nearly 144,000 ha within existing national production centers, generating an additional 0.05 cup-equivalents of fruits and vegetables per capita per day, representing a 1.7% increase above current total F&V availability. Expanding the size of national crop production centers can further increase the availability of all F&V by 2.5%–5.4%, which is still less than the recommended amount. Challenges to increasing F&V production in the US include lack of labor availability, barriers to adoption among producers, and threats to crop yields from environmental concerns. Full article

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

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11 pages, 1857 KiB

Open AccessArticle

Methylmercury Exposure Induces Sexual Dysfunction in Male and Female Drosophila Melanogaster

by Ved Chauhan, Syian Srikumar, Sarah Aamer, Mirazkar D. Pandareesh and Abha Chauhan

Int. J. Environ. Res. Public Health 2017, 14(10), 1108; https://doi.org/10.3390/ijerph14101108 - 24 Sep 2017

Cited by 14 | Viewed by 4794

Abstract

Mercury, an environmental health hazard, is a neurotoxic heavy metal. In this study, the effect of methylmercury (MeHg) exposure was analyzed on sexual behavior in Drosophila melanogaster (fruit fly), because neurons play a vital role in sexual functions. The virgin male and female [...] Read more.

Mercury, an environmental health hazard, is a neurotoxic heavy metal. In this study, the effect of methylmercury (MeHg) exposure was analyzed on sexual behavior in Drosophila melanogaster (fruit fly), because neurons play a vital role in sexual functions. The virgin male and female flies were fed a diet mixed with different concentrations of MeHg (28.25, 56.5, 113, 226, and 339 µM) for four days, and the effect of MeHg on copulation of these flies was studied. While male and female control flies (no MeHg) and flies fed with lower concentrations of MeHg (28.25, 56.5 µM) copulated in a normal manner, male and female flies exposed to higher concentrations of MeHg (113, 226, and 339 µM) did not copulate. When male flies exposed to higher concentrations of MeHg were allowed to copulate with control female flies, only male flies fed with 113 µM MeHg were able to copulate. On the other hand, when female flies exposed to higher concentrations of MeHg were allowed to copulate with control male flies, none of the flies could copulate. After introduction of male and female flies in the copulation chamber, duration of wing flapping by male flies decreased in a MeHg-concentration-dependent manner from 101 ± 24 seconds (control) to 100.7 ± 18, 96 ±12, 59 ± 44, 31 ± 15, and 3.7 ± 2.7 seconds at 28.25, 56.5, 113, 226, and 339 µM MeHg, respectively. On the other hand, grooming in male and female flies increased in a MeHg-concentration-dependent manner. These findings suggest that MeHg exposure causes sexual dysfunction in male and female Drosophila melanogaster. Further studies showed that MeHg exposure increased oxidative stress and decreased triglyceride levels in a concentration–dependent manner in both male and female flies, suggesting that MeHg-induced oxidative stress and decreased triglyceride levels may partly contribute to sexual dysfunction in fruit flies. Full article

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9 pages, 452 KiB

Open AccessArticle

Circadian Rhythm of Wrist Temperature among Shift Workers in South Korea: A Prospective Observational Study

by Tae-Won Jang, Hyunjoo Kim, Suk-Hoon Kang, Sang-Hyo Choo, In-Seok Lee and Kyung-Hwa Choi

Int. J. Environ. Res. Public Health 2017, 14(10), 1109; https://doi.org/10.3390/ijerph14101109 - 24 Sep 2017

Cited by 15 | Viewed by 4576

Abstract

Background: Human body temperature varies with circadian rhythm. To determine the effect of shift work on the circadian rhythm of the distal-skin temperature, wrist temperatures were measured. Methods: Wrist-skin temperatures were measured by an iButton^® Temperature Logger. It was measured [...] Read more.

Background: Human body temperature varies with circadian rhythm. To determine the effect of shift work on the circadian rhythm of the distal-skin temperature, wrist temperatures were measured. Methods: Wrist-skin temperatures were measured by an iButton^® Temperature Logger. It was measured every 3 min for two and eight consecutive working days in the day and shift workers, respectively. Mesor, amplitude, and acrophase were measured by Cosinor analysis. Results: The shift-worker amplitude dropped significantly as the night shift progressed (0.92 to 0.85 °C), dropped further during rest (0.69 °C), and rose during the morning-shift days (0.82 °C). Day workers still had higher amplitudes (0.93 °C) than the morning-shift workers. The acrophase was delayed during the four night-shift days, then advanced during rest days and the morning-shift days. Nevertheless, the morning-shift worker acrophase was still significantly delayed compared to the day workers (08:03 a.m. vs. 04:11 a.m.). Conclusions: The further reduction of wrist-temperature amplitude during rest after the night shift may be due to the signal circadian rhythm disruption. Reduced amplitudes have been reported to be associated with intolerance to shift work. The findings of our study may help to design the most desirable schedule for shift workers. Full article

(This article belongs to the Section Occupational Safety and Health)

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10 pages, 279 KiB

Open AccessArticle

Knowledge, Attitude and Practice of Pregnant Women towards Varicella and Their Children’s Varicella Vaccination: Evidence from Three Distrcits in Zhejiang Province, China

by Yu Hu, Yaping Chen, Ying Wang and Hui Liang

Int. J. Environ. Res. Public Health 2017, 14(10), 1110; https://doi.org/10.3390/ijerph14101110 - 24 Sep 2017

Cited by 8 | Viewed by 4518

Abstract

Background: The objectives of this study were to examine the knowledge, attitudes and practice (KAP) towards varicella and varicella vaccine (VarV) vaccination among pregnant women in three distrcits in Zhejiang Province, China. Methods: From 1 January to 31 March 2014, pregnant [...] Read more.

Background: The objectives of this study were to examine the knowledge, attitudes and practice (KAP) towards varicella and varicella vaccine (VarV) vaccination among pregnant women in three distrcits in Zhejiang Province, China. Methods: From 1 January to 31 March 2014, pregnant women with ≥12 gestational weeks were recruited and received a self-administrated questionnaire. The first dose of VarV (VarV1) vaccination status of children from present pregnancy was extracted at 24 months of age from Zhejiang provincial immunization information system (ZJIIS). Three variables was defined as the main outcomes, which included: (1) knowing about both the availability of VarV and the number of doses required; (2) positive attitude towards the utility of varicella vaccination; (3) the vaccination coverage of VarV1, which meant the proportion of children having received the VarV1. Counts and proportions were used to describe the socio-demographic characteristics of study participants, and their relationship with study outcomes were tested using chi-square tests in univariate analysis and logistic regression in multivariable analysis. Results: A total of 629 pregnant women participated in this study. The majority of the participants (68.0%) answered correctly about the transmission route of varicella. The proportion of participants who heard about varicella vaccination was 76.5% and 66.8% knew that VarV was currently available. Only 13.5% of the participants answered correctly that the complete VarV series needed two doses. Age, immigration status, education level, household income, and number of children of the pregnant women were significant predictors of the KAP regarding the VarV vaccination. Conclusions: The current survey indicated that optimal KAP levels and coverage on VarV vaccination were observed in three districts of Zhejiang Province. Health education programs on varicella and VarV vaccination directed towards both pre-natal and post-natal women are needed, which will result in a better attitude on vaccination of VarV and in a high coverage of VarV. Full article

(This article belongs to the Section Global Health)

12 pages, 2516 KiB

Open AccessArticle

Occurrence of Virulence Genes Associated with Human Pathogenic Vibrios Isolated from Two Commercial Dusky Kob (Argyrosmus japonicus) Farms and Kareiga Estuary in the Eastern Cape Province, South Africa

by Justine Fri, Roland Ndip Ndip, Henry Akum Njom and Anna Maria Clarke

Int. J. Environ. Res. Public Health 2017, 14(10), 1111; https://doi.org/10.3390/ijerph14101111 - 25 Sep 2017

Cited by 18 | Viewed by 4608

Abstract

Background: Seafood-borne Vibrio infections, often linked to contaminated seafood and water, are of increasing global public health concern. The aim of this study was to evaluate the prevalence of human pathogenic vibrios and their associated virulence genes isolated from fish and water [...] Read more.

Background: Seafood-borne Vibrio infections, often linked to contaminated seafood and water, are of increasing global public health concern. The aim of this study was to evaluate the prevalence of human pathogenic vibrios and their associated virulence genes isolated from fish and water samples from 2 commercial dusky kob farms and Kareiga estuary, South Africa. Methods: A total of 200 samples including dusky kob fish (n = 120) and seawater (n = 80) were subjected to Vibrio screening on thiosulfate-citrate-bile salts-sucrose agar (TCBS). Presumptive isolates were confirmed and delineated to V. cholerae, V. parahaemolyticus, V. vulnificus, and V. fluvialis by PCR. Various pathogenic gene markers were screened: V. parahaemolyticus (trh and tdh), V. vulnificus (vcgE and vcgC) and V. fluvialis (stn, vfh, hupO, vfpA). Restriction Fragment Length Polymorphism (RFLP) of the vvhA gene of V. vulnificus strains was performed to determine the associated biotypes. Results: Total Vibrio prevalence was 59.4% (606/1020) of which V. fluvialis was the most predominant 193 (31.85%), followed by Vibrio vulnificus 74 (12.21%) and V. parahaemolyticus 33 (5.45%). No V. cholerae strain was detected. One of the V. parahaemolyticus strains possessed the trh gene 7 (9.46%) while most (91.9%; 68/74) V. vulnificus isolates were of the E-type genotype. V. fluvialis virulence genes detected were stn (13.5%), hupO (10.4%) and vfpA (1.0%). 12.16% (9/74) of V. vulnificus strains exhibited a biotype 3 RFLP pattern. Conclusions: This is the first report of potentially pathogenic vibrios from healthy marine fish in the study area, and therefore a public health concern. Full article

(This article belongs to the Section Environmental Health)

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12 pages, 1201 KiB

Open AccessArticle

Using Structural Equation Modeling to Assess the Links between Tobacco Smoke Exposure, Volatile Organic Compounds, and Respiratory Function for Adolescents Aged 6 to 18 in the United States

by Bonnie E. Shook-Sa, Ding-Geng Chen and Haibo Zhou

Int. J. Environ. Res. Public Health 2017, 14(10), 1112; https://doi.org/10.3390/ijerph14101112 - 25 Sep 2017

Cited by 8 | Viewed by 5587

Abstract

Asthma is an inflammatory airway disease that affects 22 million Americans in the United States. Research has found associations between impaired respiratory function, including asthma and increased symptoms among asthmatics, and common indoor air pollutants, including tobacco smoke exposure and volatile organic compounds [...] Read more.

Asthma is an inflammatory airway disease that affects 22 million Americans in the United States. Research has found associations between impaired respiratory function, including asthma and increased symptoms among asthmatics, and common indoor air pollutants, including tobacco smoke exposure and volatile organic compounds (VOCs). However, findings linking VOC exposure and asthma are inconsistent and studies are of mixed quality due to design limitations, challenges measuring VOC exposure, small sample sizes, and suboptimal statistical methodologies. Because of the correlation between tobacco smoke exposure and VOCs, and associations between both tobacco smoke and VOCs with respiratory function, it is crucial that statistical methodology employed to assess links between respiratory function and individual air pollutants control for these complex relationships. This research uses Structural Equation Modeling (SEM) to assess the relationships between respiratory function, tobacco smoke exposure, and VOC exposure among a nationally-representative sample of adolescents. SEM allows for multiple outcome variables, the inclusion of both observed and latent variables, and controls the effects of confounding and correlated variables, which is critically important and is lacking in earlier studies when estimating the effects of correlated air pollutants on respiratory function. We find evidence of associations between respiratory function and some types of VOCs, even when controlling for the effects of tobacco smoke exposure and additional covariates. Furthermore, we find that poverty has an indirect effect on respiratory function through its relationships with tobacco smoke exposure and some types of VOCs. This analysis demonstrates how SEM is a robust analytic tool for assessing associations between respiratory function and multiple exposures to pollutants. Full article

(This article belongs to the Special Issue Innovations in Biostatistical Methods and Data for Public Health Research)

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22 pages, 20546 KiB

Open AccessArticle

Evaluation of Environmental Risk Due to Metro System Construction in Jinan, China

by Guo-Fu Wang, Hai-Min Lyu, Jack Shuilong Shen, Lin-Hai Lu, Gang Li and Arul Arulrajah

Int. J. Environ. Res. Public Health 2017, 14(10), 1114; https://doi.org/10.3390/ijerph14101114 - 25 Sep 2017

Cited by 18 | Viewed by 5659

Abstract

Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic [...] Read more.

Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic Hierarchy Process (AHP) and Geographic International System (GIS). Based on the characteristics of hydrogeology and engineering geology, the assessment model is established from the perspectives of surface index and underground index. The assessment results show that the high and very high risk levels of surface index exceed 98% in the north region; and high and very high risk levels of underground index exceed 56% in urban center and southern region. The assessment result also shows that about 14% of the urban area belongs to very high risk level; regions of high risk are 20% in urban area, 9% in Changqing County and 43% in Pingyin County. In the high risk region, metro lines R1 to R3, which are under construction, and metro lines L1 to L5, which are planned, have very high and high risk. Therefore, risk control measures are proposed to protect the groundwater seepage path to spring. Full article

(This article belongs to the Section Environmental Health)

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11 pages, 2205 KiB

Open AccessArticle

Usability of a Medication Event Reminder Monitor System (MERM) by Providers and Patients to Improve Adherence in the Management of Tuberculosis

by Xiaoqiu Liu, Terrence Blaschke, Bruce Thomas, Sabina De Geest, Shiwen Jiang, Yongxin Gao, Xinxu Li, Elizabeth Whalley Buono, Stacy Buchanan, Zhiying Zhang and Shitong Huan

Int. J. Environ. Res. Public Health 2017, 14(10), 1115; https://doi.org/10.3390/ijerph14101115 - 25 Sep 2017

Cited by 57 | Viewed by 11853

Abstract

Poor initiation and implementation and premature discontinuation of anti-tuberculous therapy, all forms of nonadherence, are major reasons for treatment failure, the development of drug-resistant tuberculosis, and transmission to other non-infected individuals. Directly Observed Therapy (DOT) has been the worldwide standard, but implementation of [...] Read more.

Poor initiation and implementation and premature discontinuation of anti-tuberculous therapy, all forms of nonadherence, are major reasons for treatment failure, the development of drug-resistant tuberculosis, and transmission to other non-infected individuals. Directly Observed Therapy (DOT) has been the worldwide standard, but implementation of DOT is burdensome for providers and patients, especially in resource-limited settings, where most of the burden of active TB is located. Among the alternatives to DOT is electronic monitoring (EM) of drug dosing histories. Here we report a usability study of a newly-designed, modular electronic monitor product, called the MERM (Medication Event and Reminder Monitor), that is compatible with TB medication formats and supply chains in resource-limited settings. This study, done in a rural setting in China, showed that the use of the MERM for EM of TB medications was associated with a high degree of user performance, acceptability, and satisfaction among both TB patients and medical staff. Based on these data, EM is becoming the standard of care for drug-susceptible TB patients in China and scaled implementations in several other countries with high TB burden have begun. In addition, the MERM is being used in MDR-TB patients and in clinical trials involving patients with TB/HIV and latent TB. Full article

(This article belongs to the Section Global Health)

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13 pages, 302 KiB

Open AccessArticle

School Bullying in Urban China: Prevalence and Correlation with School Climate

by Ziqiang Han, Guirong Zhang and Haibo Zhang

Int. J. Environ. Res. Public Health 2017, 14(10), 1116; https://doi.org/10.3390/ijerph14101116 - 25 Sep 2017

Cited by 119 | Viewed by 15047

Abstract

School violence and bullying in China is under investigated, though it has become a national concern recently. Using updated national representative survey data collected in 2016 from seven provinces across China, covering students from all pre-college school types (primary, middle, high and vocational [...] Read more.

School violence and bullying in China is under investigated, though it has become a national concern recently. Using updated national representative survey data collected in 2016 from seven provinces across China, covering students from all pre-college school types (primary, middle, high and vocational schools), this paper analyzes the prevalence of school bullying and the correlation with several school attributes. The incidences of reported bullying, bullying others and witnessing bullying are 26.10%, 9.03% and 28.90%, respectively. Primary school students are more likely to be involved in bullying behaviors. Students from elite schools (leading schools) are also more likely to be involved. Relation with teachers, relation with peers and perceived academic achievement are protective factors. Being a boy is the only significant predictor of school bullying among the family and demographic characteristics used. The results highlight the importance of school climate on preventing school violence and bullying, and a whole-school intervention approach is needed for future intervention. Full article

(This article belongs to the Special Issue Youth Violence as a Public Health Issue)

12 pages, 2312 KiB

Open AccessArticle

How Fencing Affects the Soil Quality and Plant Biomass in the Grassland of the Loess Plateau

by Quanchao Zeng, Yang Liu, Li Xiao and Yimei Huang

Int. J. Environ. Res. Public Health 2017, 14(10), 1117; https://doi.org/10.3390/ijerph14101117 - 25 Sep 2017

Cited by 19 | Viewed by 4897

Abstract

Overgrazing is a severe problem in several regions in Northwestern China and has caused serious land degradation. Secondary natural succession plays an important role in the accumulation of soil carbon and nitrogen contents. Estimating the effects of grazing exclusion on soil quality and [...] Read more.

Overgrazing is a severe problem in several regions in Northwestern China and has caused serious land degradation. Secondary natural succession plays an important role in the accumulation of soil carbon and nitrogen contents. Estimating the effects of grazing exclusion on soil quality and plant diversity will improve our understanding of the succession process after overgrazing and promote judicious management of degraded pastures. This experiment was designed to measure soil properties and plant diversity following an age chronosequence of grasslands (ages ranged from one year, 12 years, 20 years, and 30 years) in Northwestern China. The results showed that continuous fencing resulted in a considerable increase in plant coverage, plant biomass (above- and below-ground biomass), and plant diversity, which can directly or indirectly improve the accumulation of soil organic carbon and total nitrogen content. The plant coverage and the above- and below-ground biomass linearly increased along the succession time, whereas soil organic C and N contents showed a significant decline in the first 12 years and, subsequently, a significant increase. The increased plant biomass caused an increase in soil organic carbon and soil total nitrogen. These results suggested that soil restoration and plant cover were an incongruous process. Generally, soil restoration is a slow process and falls behind vegetation recovery after grazing exclusion. Although the accumulation of soil C and N stocks needed a long term, vegetation restoration was a considerable option for the degraded grassland due to the significant increase of plant biomass, diversity, and soil C and N stocks. Therefore, fencing with natural succession should be considered in the design of future degraded pastures. Full article

(This article belongs to the Section Environmental Science and Engineering)

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23 pages, 2232 KiB

Open AccessArticle

Health Care Payments in Vietnam: Patients’ Quagmire of Caring for Health versus Economic Destitution

by Andre Pekerti, Quan-Hoang Vuong, Tung Manh Ho and Thu-Trang Vuong

Int. J. Environ. Res. Public Health 2017, 14(10), 1118; https://doi.org/10.3390/ijerph14101118 - 25 Sep 2017

Cited by 15 | Viewed by 9597

Abstract

In the last three decades many developing and middle-income nations’ health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing [...] Read more.

In the last three decades many developing and middle-income nations’ health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing nations. This study investigates the status of Vietnam’s current health system as a result of implementing user fees policies. A recent mandate by the government to increase the universal cover to 100% attempts to tackle inadequate insurance cover, one of the four major factors contributing to the high and increasing probability of destitution for Vietnamese patients (the other three being: non-residency, long stay in hospital, and high cost of treatment). Empirical results however suggest that this may be catastrophic for low-income earners: if insurance cover reimbursement decreases below 50% of actual health expenditures, the probability of Vietnamese falling into destitution will rise further. Our findings provide policy implications and directions to improve Vietnam’s health care system, in particular by ensuring the utilization of health services and financial protection for the people. Full article

(This article belongs to the Section Health Economics)

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20 pages, 4281 KiB

Open AccessArticle

Comparison of Malaria Simulations Driven by Meteorological Observations and Reanalysis Products in Senegal

by Ibrahima Diouf, Belen Rodriguez-Fonseca, Abdoulaye Deme, Cyril Caminade, Andrew P. Morse, Moustapha Cisse, Ibrahima Sy, Ibrahima Dia, Volker Ermert, Jacques-André Ndione and Amadou Thierno Gaye

Int. J. Environ. Res. Public Health 2017, 14(10), 1119; https://doi.org/10.3390/ijerph14101119 - 25 Sep 2017

Cited by 25 | Viewed by 7943

Abstract

The analysis of the spatial and temporal variability of climate parameters is crucial to study the impact of climate-sensitive vector-borne diseases such as malaria. The use of malaria models is an alternative way of producing potential malaria historical data for Senegal due to [...] Read more.

The analysis of the spatial and temporal variability of climate parameters is crucial to study the impact of climate-sensitive vector-borne diseases such as malaria. The use of malaria models is an alternative way of producing potential malaria historical data for Senegal due to the lack of reliable observations for malaria outbreaks over a long time period. Consequently, here we use the Liverpool Malaria Model (LMM), driven by different climatic datasets, in order to study and validate simulated malaria parameters over Senegal. The findings confirm that the risk of malaria transmission is mainly linked to climate variables such as rainfall and temperature as well as specific landscape characteristics. For the whole of Senegal, a lag of two months is generally observed between the peak of rainfall in August and the maximum number of reported malaria cases in October. The malaria transmission season usually takes place from September to November, corresponding to the second peak of temperature occurring in October. Observed malaria data from the Programme National de Lutte contre le Paludisme (PNLP, National Malaria control Programme in Senegal) and outputs from the meteorological data used in this study were compared. The malaria model outputs present some consistencies with observed malaria dynamics over Senegal, and further allow the exploration of simulations performed with reanalysis data sets over a longer time period. The simulated malaria risk significantly decreased during the 1970s and 1980s over Senegal. This result is consistent with the observed decrease of malaria vectors and malaria cases reported by field entomologists and clinicians in the literature. The main differences between model outputs and observations regard amplitude, but can be related not only to reanalysis deficiencies but also to other environmental and socio-economic factors that are not included in this mechanistic malaria model framework. The present study can be considered as a validation of the reliability of reanalysis to be used as inputs for the calculation of malaria parameters in the Sahel using dynamical malaria models. Full article

(This article belongs to the Special Issue Malaria Epidemiology and Control: Current Situation and Perspectives)

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17 pages, 347 KiB

Open AccessArticle

Mercury, Fatty Acids Content and Lipid Quality Indexes in Muscles of Freshwater and Marine Fish on the Polish Market. Risk Assessment of Fish Consumption

by Joanna Łuczyńska, Beata Paszczyk, Joanna Nowosad and Marek Jan Łuczyński

Int. J. Environ. Res. Public Health 2017, 14(10), 1120; https://doi.org/10.3390/ijerph14101120 - 25 Sep 2017

Cited by 71 | Viewed by 6154

Abstract

Mercury content and fatty acids in muscles of Perca fluviatilis L. (European perch), Leuciscus idus L. (ide), Cyprinus carpio L. (European or common carp), Oncorhynchus mykiss Walb. (rainbow trout), Platichthys flesus L. (European flounder). and Clupea harengus L. (bream) from the Polish market [...] Read more.

Mercury content and fatty acids in muscles of Perca fluviatilis L. (European perch), Leuciscus idus L. (ide), Cyprinus carpio L. (European or common carp), Oncorhynchus mykiss Walb. (rainbow trout), Platichthys flesus L. (European flounder). and Clupea harengus L. (bream) from the Polish market were investigated. The total mercury was processed with AAS. The fatty acids were analyzed by gas chromatography. The concentration of mercury in muscles varied from 0.006 to 0.138 mg/kg and decreased as follows: perch ≈ ide > flounder > herring ≈ bream ≈ rainbow trout > carp (p ≤ 0.05). There were only significant positive correlations between body weight and mercury content in muscle tissue of carp (r = 0.878), flounder (r = 0.925) and herring (r = 0.982) (p ≤ 0.05). The atherogenic index (AI), thrombogenicity index (TI) and flesh-lipid quality index (FLQ) were calculated as follows 0.33–0.70 (IA), 0.16–0.31 (IT) and 13.01–33.22 (FLQ). Hypocholesterolemic (OFA) and hypercholesterolemic fatty acids (DFA) in muscles of fish ranged from 18.26 to 23.01 and from 73.91 to 78.46, respectively. In most cases, there were not significant correlations between size (body weight and total length) and fatty acids in the muscles of the examined fish (p > 0.05). The Target Hazard Quotient (THQ) values were below 1, which shows that there is no non-carcinogenic health risk to the consumer by consuming the examined fish. Full article

(This article belongs to the Special Issue Dietary Exposures)

10 pages, 862 KiB

Open AccessArticle

Vitamin D Concentration in Maternal and Umbilical Cord Blood by Season

by Regina Wierzejska, Mirosław Jarosz, Włodzimierz Sawicki, Michał Bachanek and Magdalena Siuba-Strzelińska

Int. J. Environ. Res. Public Health 2017, 14(10), 1121; https://doi.org/10.3390/ijerph14101121 - 26 Sep 2017

Cited by 24 | Viewed by 4480

Abstract

Summer is generally considered to be the season when the body is well-supplied with vitamin D. The aim of this study was to compare maternal and umbilical cord blood concentrations of vitamin D during two extreme seasons of the year in Poland—winter and [...] Read more.

Summer is generally considered to be the season when the body is well-supplied with vitamin D. The aim of this study was to compare maternal and umbilical cord blood concentrations of vitamin D during two extreme seasons of the year in Poland—winter and summer. A total of 100 pregnant women with no history of chronic diseases before pregnancy were included in the study. Pre-delivery maternal venous blood and neonatal cord blood samples were collected and total 25(OH)D concentration was measured. Data on vitamin D consumption (collected with the use of Food Frequency Questionnaire) and lifestyle factors were taken. Both, maternal and umbilical cord blood concentrations of vitamin D were higher in the summer group as compared to the winter group (mean 22.2 ± 6.5 ng/mL vs. 16.5 ± 8.2 ng/mL (p < 0.001), respectively for the mothers and 31.3 ± 9.4 ng/mL vs. 22.7 ± 11.0 ng/mL (p < 0.0001), respectively for the neonates). However, only 16% of the pregnant women reached the optimal vitamin D concentration during summer. Therefore, summer improves the levels of vitamin D in the body but does not guarantee the recommended concentration and supplementation throughout the whole year is essential. Full article

(This article belongs to the Special Issue Maternal and Child Health 2018)

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22 pages, 298 KiB

Open AccessArticle

Are mHealth Interventions to Improve Child Restraint System Installation of Value? A Mixed Methods Study of Parents

by Linda Fleisher, Danielle Erkoboni, Katherine Halkyard, Emily Sykes, Marisol S. Norris, Lorrie Walker and Flaura Winston

Int. J. Environ. Res. Public Health 2017, 14(10), 1122; https://doi.org/10.3390/ijerph14101122 - 26 Sep 2017

Cited by 8 | Viewed by 4417

Abstract

Childhood death from vehicle crashes and the delivery of information about proper child restraint systems (CRS) use continues to be a critical public health issue. Safe Seat, a sequential, mixed-methods study identified gaps in parental knowledge about and perceived challenges in the use [...] Read more.

Childhood death from vehicle crashes and the delivery of information about proper child restraint systems (CRS) use continues to be a critical public health issue. Safe Seat, a sequential, mixed-methods study identified gaps in parental knowledge about and perceived challenges in the use of appropriate CRS and insights into the preferences of various technological approaches to deliver CRS education. Focus groups (eight groups with 21 participants) and a quantitative national survey (N = 1251) using MTurk were conducted. Although there were differences in the age, racial/ethnic background, and educational level between the focus group participants and the national sample, there was a great deal of consistency in the need for more timely and personalized information about CRS. The majority of parents did not utilize car seat check professionals although they expressed interest in and lack of knowledge about how to access these resources. Although there was some interest in an app that would be personalized and able to push just-in-time content (e.g., new guidelines, location and times of car seat checks), content that has sporadic relevance (e.g., initial installation) seemed more appropriate for a website. Stakeholder input is critical to guide the development and delivery of acceptable and useful child safety education. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

18 pages, 343 KiB

Open AccessArticle

How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China?

by Manli Wang and Hongbing Tao

Int. J. Environ. Res. Public Health 2017, 14(10), 1123; https://doi.org/10.3390/ijerph14101123 - 26 Sep 2017

Cited by 28 | Viewed by 4772

Abstract

Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured [...] Read more.

Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design: This research is a cross-sectional study. Methods: In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures: The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t-tests and X² tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results: A total of 56.49% of respondents were from surgical departments. The PPRs for “teamwork within units” and “organizational learning and continuous improvement” were ≥75%, which denoted strengths, and the PPRs for “staffing” and “non-punitive response to errors” were ≤50%, which denoted weaknesses in surgical units and other units. Three dimensions for surgical departments were weaker than those for other departments (p < 0.05). The staff from surgical units reported more events compared with the other units, but only a few respondents in surgical settings evaluated patient safety grade as good/excellent. Four dimensions influenced patient safety grade, and three dimensions influenced event reporting in surgical units. Conclusions: Strategies including recruiting workers, using the reporting system, and building a non-punitive culture should be adopted in the surgical units of county hospitals in China to improve safety culture. Supervisors should also prioritise patient safety. Full article

(This article belongs to the Special Issue Quality of Patient-Centered Care)

13 pages, 299 KiB

Open AccessArticle

Alcohol-Related Physical Abuse of Children in the Slums of Kampala, Uganda

by Monica H. Swahn, Rachel E. Culbreth, Catherine A. Staton, Shannon R. Self-Brown and Rogers Kasirye

Int. J. Environ. Res. Public Health 2017, 14(10), 1124; https://doi.org/10.3390/ijerph14101124 - 26 Sep 2017

Cited by 24 | Viewed by 5352

Abstract

This study examines the patterns of alcohol-related physical abuse and alcohol use and related behaviors among children living in the slums of Kampala, Uganda. The study is based on a cross-sectional survey, conducted in spring 2014, of service-seeking children ages 12 to 18 [...] Read more.

This study examines the patterns of alcohol-related physical abuse and alcohol use and related behaviors among children living in the slums of Kampala, Uganda. The study is based on a cross-sectional survey, conducted in spring 2014, of service-seeking children ages 12 to 18 years (n = 1134) attending Uganda Youth Development Link drop-in centers for vulnerable children in the slums. Descriptive statistics, chi-squares, and bivariate and multivariable logistic regression analyses were conducted to determine patterns of children’s alcohol-related behaviors, based on alcohol-related physical abuse and neglect. Nearly 34% of children (n = 380) reported experiencing physical abuse, and 12.4% (n = 140) reported experiencing alcohol-related physical abuse. Alcohol-related neglect was reported among 19.6% (n = 212) of the children. Past year alcohol use was significantly more prevalent among children who reported experiencing alcohol-related neglect (

χ^{2}

= 79.18, df = 1, p < 0.0001) and alcohol-related physical abuse (

χ^{2}

= 62.02, df = 1, p < 0.0001). Reporting physical abuse was also associated with parental alcohol use (OR: 1.85; 95% CI: 1.38, 2.48) and parental partner violence (OR: 5.51; 95% CI: 4.09, 7.43), after adjusting for other variables in the model. Given the high levels of alcohol-related abuse and neglect reported in this population, both primary and secondary prevention initiatives are needed to improve parenting strategies and to reduce alcohol-related harm. Similarly, strategies to reduce and delay alcohol use among these vulnerable children are also needed. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

14 pages, 2091 KiB

Open AccessArticle

Industrial Cooling Tower Disinfection Treatment to Prevent Legionella spp.

by Matteo Iervolino, Benedetta Mancini and Sandra Cristino

Int. J. Environ. Res. Public Health 2017, 14(10), 1125; https://doi.org/10.3390/ijerph14101125 - 26 Sep 2017

Cited by 20 | Viewed by 7632

Abstract

The contamination of industrial cooling towers has been identified as one cause of legionellosis, but the real risk has been underestimated. Two different disinfection treatments were tested on Legionella colonization in an industrial Cooling Tower System (CTS). Environmental monitoring of Legionella, P. [...] Read more.

The contamination of industrial cooling towers has been identified as one cause of legionellosis, but the real risk has been underestimated. Two different disinfection treatments were tested on Legionella colonization in an industrial Cooling Tower System (CTS). Environmental monitoring of Legionella, P. aeruginosa, and a heterotrophic plate count (HPC) at 36 °C was performed from June to October 2016. The disinfection procedures adopted were based on hydrogen peroxide (H₂O₂) and silver salts (Ag⁺), in addition to an anti-algal treatment, then using hyperclorination as a shock, and then continuous treatment by sodium hypochlorite (NaClO). L. pneumophila serogroup 8 was found at a concentration of 5.06 Log cfu/L after the CTS filling; a shock treatment performed by H₂O₂/Ag⁺ produced a rapid increase in contamination up to 6.14 Log cfu/L. The CTS activity was stopped and two subsequent shock treatments were performed using NaClO, followed by continuous hyperclorination. These procedures showed a significant decrease (p < 0.05) in Legionella concentration (1.77 Log cfu/L). The same trend was observed for P. aeruginosa (0.55 Log cfu/100 mL) and HPC (1.95 Log cfu/mL) at 36 °C. Environmental monitoring and the adoption of maintenance procedures, including anti-scale treatment, and physical, chemical, and microbiological control, ensure the good performance of a CTS, reducing the Legionella risk for public health. Full article

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21 pages, 339 KiB

Open AccessArticle

Prevalence and Correlates of Physical Inactivity during Leisure-Time and Commuting among Beneficiaries of Government Welfare Assistance in Poland

by Dorota Kaleta, Sylwia Kalucka, Franciszek Szatko and Teresa Makowiec-Dąbrowska

Int. J. Environ. Res. Public Health 2017, 14(10), 1126; https://doi.org/10.3390/ijerph14101126 - 26 Sep 2017

Cited by 10 | Viewed by 4058

Abstract

Physical activity (PA) has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA) and commuting (CPA) among adult social assistance beneficiaries in Piotrkowski [...] Read more.

Physical activity (PA) has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA) and commuting (CPA) among adult social assistance beneficiaries in Piotrkowski district. The studied sample consisted of 1817 respondents. Over 73% of the study population did not meet the recommended levels of LTPA. Fifty two % of the respondents had none leisure-time physical activity and 21.5% exercised occasionally. Main reasons for not taking up LTPA included: high general physical activity (36.4%), lack of time (28.1%), no willingness to exercise (25.4%). Close to 82% of the surveyed population did not practice commuting physical activity (CPA). The men had higher risk for inactivity during LTPA compared to the women (OR = 1.35; 95% CI: 1.11–1.65; p ≤ 0.05). Higher odds of CPA inactivity were associated with unemployment, moderate and heavy drinking and having a number of health problems. The prevalence of physical inactivity among the social assistance recipients is much higher than it is in the general population. Promotion of an active lifestyle should take into consideration substantial differences between the general population and disadvantaged individuals and their various needs. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

18 pages, 1377 KiB

Open AccessFeature PaperArticle

Socioeconomic Inequalities in Health and Perceived Unmet Needs for Healthcare among the Elderly in Germany

by Jens Hoebel, Alexander Rommel, Sara Lena Schröder, Judith Fuchs, Enno Nowossadeck and Thomas Lampert

Int. J. Environ. Res. Public Health 2017, 14(10), 1127; https://doi.org/10.3390/ijerph14101127 - 26 Sep 2017

Cited by 45 | Viewed by 9743

Abstract

Research into health inequalities in the elderly population of Germany is relatively scarce. This study examines socioeconomic inequalities in health and perceived unmet needs for healthcare and explores the dynamics of health inequalities with age among elderly people in Germany. Data were derived [...] Read more.

Research into health inequalities in the elderly population of Germany is relatively scarce. This study examines socioeconomic inequalities in health and perceived unmet needs for healthcare and explores the dynamics of health inequalities with age among elderly people in Germany. Data were derived from the Robert Koch Institute’s cross-sectional German Health Update study. The sample was restricted to participants aged 50–85 years (n = 11,811). Socioeconomic status (SES) was measured based on education, (former) occupation, and income. Odds ratios and prevalence differences were estimated using logistic regression and linear probability models, respectively. Our results show that self-reported health problems were more prevalent among men and women with lower SES. The extent of SES-related health inequalities decreased at older ages, predominantly among men. Although the prevalence of perceived unmet needs for healthcare was low overall, low SES was associated with higher perceptions of unmet needs in both sexes and for several kinds of health services. In conclusion, socioeconomic inequalities in health exist in a late working age and early retirement but may narrow at older ages, particularly among men. Socially disadvantaged elderly people perceive greater barriers to accessing healthcare services than those who are better off. Full article

(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)

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9 pages, 295 KiB

Open AccessArticle

Worsening Inequalities in Child Injury Deaths in the WHO European Region

by Dinesh Sethi, Emogene Aldridge, Ivo Rakovac and Akash Makhija

Int. J. Environ. Res. Public Health 2017, 14(10), 1128; https://doi.org/10.3390/ijerph14101128 - 26 Sep 2017

Cited by 21 | Viewed by 5068

Abstract

This article compares the mortality data for injuries in children aged 0–14 years in the World Health Organization WHO European region as estimated by the WHO Global Health Estimates for 2000 and 2015. While the region has seen a decline in child mortality [...] Read more.

This article compares the mortality data for injuries in children aged 0–14 years in the World Health Organization WHO European region as estimated by the WHO Global Health Estimates for 2000 and 2015. While the region has seen a decline in child mortality due to injuries over the years, inequality persists between the low- and middle-income countries and high-income countries in the region. The gap in child mortality due to unintentional injuries has widened over the years between these two socioeconomic regions, particularly in terms of road injuries. In contrast, mortality rate ratios due to intentional injuries have narrowed between 2000 and 2015. The low- and middle-income countries need to scale up their efforts in injury prevention by adopting stricter regulations and higher safety practices to narrow the East-West gap in unintentional injuries. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

9 pages, 1556 KiB

Open AccessArticle

The Study of Titanium and Zirconium Ions in Water by MPT-LTQ Mass Spectrometry in Negative Mode

by Junqing Yang, Mei Zheng, Qiuju Liu, Meiling Zhu Chushan Yang, Yan Zhang and Zhiqiang Zhu

Int. J. Environ. Res. Public Health 2017, 14(10), 1129; https://doi.org/10.3390/ijerph14101129 - 26 Sep 2017

Cited by 6 | Viewed by 4014

Abstract

Microwave plasma torches (MPTs) can be used as simple and low power-consumption ambient ion sources. When MPT-mass spectrometry (MPT-MS) is applied in the detection of some metal elements, the metallic ions exhibit some novel features which are significantly different with those obtained by [...] Read more.

Microwave plasma torches (MPTs) can be used as simple and low power-consumption ambient ion sources. When MPT-mass spectrometry (MPT-MS) is applied in the detection of some metal elements, the metallic ions exhibit some novel features which are significantly different with those obtained by the traditional inductively coupled plasma (ICP)-mass spectrometry (ICP-MS) and may be helpful for metal element analysis. As the representative elements of group IVA, titanium and zirconium are both of importance and value in modern industry, and they have impacts on human health. Here, we first provide a study on the complex anions of titanium and zirconium in water by using the MPT as ion source and a linear ion trap mass spectrometer (LTQ-MS). These complex anions were produced in the plasma flame by an aqueous solution flowing through the central tube of the MPT, and were introduced into the inlet of the mass spectrometry working in negative ion mode to get the feature mass spectrometric signals. Moreover, the feature fragment patterns of these ions in multi-step collision- induced dissociation processes have been explained. Under the optimized conditions, the limit of detection (LOD) using the MS² (the second tandem mass spectrometry) procedure was estimated to be at the level of 10μg/L for titanium and 20 μg/L for zirconium with linear dynamics ranges that cover at least two orders of magnitude, i.e., between 0–500 μg/L and 20–200 μg/L, respectively. These experimental data demonstrated that the MPT-MS is a promising and useful tool in field analysis of titanium and zirconium ions in water, and can be applied in many fields, such as environmental control, hydrogeology, and water quality inspection. In addition, MPT-MS could also be used as a supplement of ICP-MS for the rapid and on-site analysis of metal ions. Full article

(This article belongs to the Section Environmental Science and Engineering)

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10 pages, 321 KiB

Open AccessArticle

Developmental Assessments during Injury Research: Is Enrollment of Very Young Children in Crèches Associated with Better Scores?

by Divya Nair, Olakunle Alonge, Jena Derakhshani Hamadani, Shumona Sharmin Salam, Irteja Islam and Adnan A. Hyder

Int. J. Environ. Res. Public Health 2017, 14(10), 1130; https://doi.org/10.3390/ijerph14101130 - 26 Sep 2017

Cited by 8 | Viewed by 8068

Abstract

The Developmental Study is part of a larger intervention on “saving of lives from drowning (SoLiD)” where children were enrolled either into crèches (daycare centers) or playpens to prevent drowning in rural Bangladesh. Sampling ~1000 children between the ages of 9–17 months, we [...] Read more.

The Developmental Study is part of a larger intervention on “saving of lives from drowning (SoLiD)” where children were enrolled either into crèches (daycare centers) or playpens to prevent drowning in rural Bangladesh. Sampling ~1000 children between the ages of 9–17 months, we compared problem-solving, communication, motor and personal-social outcomes assessed by the Ages and Stages Questionnaire in the two interventions. After controlling for variables such as home stimulation in multivariate regressions, children in crèches performed about a quarter of a standard deviation better in total scores (p < 0.10) and 0.45 standard deviations higher in fine motor skills (p < 0.05). Moreover, once the sample was stratified by length of exposure to the intervention, then children in crèches performed significantly better in a number of domains: those enrolled the longest (about 5 months) have higher fine motor (1.47, p < 0.01), gross motor (0.40, p < 0.05) and personal-social skills (0.95, p < 0.01) than children in playpens. In addition, children in crèches with the longer exposure (about 5 months) have significantly higher personal-social and problem-solving scores than those in crèches with minimum exposure. Enrollment in crèches of very young children may be positively associated with psychosocial scores after accounting for important confounding variables. Full article

(This article belongs to the Collection A Million Person Household Survey: Understanding the Burden of Injuries in Bangladesh)

12 pages, 1130 KiB

Open AccessArticle

Self-Certified Sickness Absence among Young Municipal Employees—Changes from 2002 to 2016 and Occupational Class Differences

by Hilla Sumanen, Olli Pietiläinen and Minna Mänty

Int. J. Environ. Res. Public Health 2017, 14(10), 1131; https://doi.org/10.3390/ijerph14101131 - 26 Sep 2017

Cited by 4 | Viewed by 3419

Abstract

We examined changes in self-certified, one-to-three day sickness absence (SA) among young employees from 2002 to 2016 and the magnitude of occupational class differences during that period. All 18–34-year-old employees of the City of Helsinki, Finland were included (2002–2016, n = ~11,725 per [...] Read more.

We examined changes in self-certified, one-to-three day sickness absence (SA) among young employees from 2002 to 2016 and the magnitude of occupational class differences during that period. All 18–34-year-old employees of the City of Helsinki, Finland were included (2002–2016, n = ~11,725 per year). Employer’s personnel and SA registers were used. Occupational class was categorized to four groups. Changes in self-certified SA from 2002 to 2016 were analyzed with Joinpoint regression and the magnitudes of occupational class differences were estimated with the relative index of inequality (RII). Most of the trends first increased and turned to decrease in 2007/2010. Managers and professionals had the least amount of SA, but steadily increasing trends were observed among men. Self-certified SA followed only partially the typical socioeconomic gradient, as routine non-manuals had the highest levels of SA. The magnitude of occupational class differences in self-certified SA was stable during the study period only among women. Self-certified SA and occupational class differences have increased in recent years among men in the lower occupational classes. Socioeconomic differences exist in self-certified SA among young employees, but gradient is only partial. Overall, high amounts of self-certified SA especially in the lower occupational classes require further studies and preventive measures. Full article

(This article belongs to the Section Occupational Safety and Health)

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12 pages, 295 KiB

Open AccessArticle

Prenatal Exposure to Environmental Tobacco Smoke and Hyperactivity Behavior in Chinese Young Children

by Qingmei Lin, Xiang-Yu Hou, Xiao-Na Yin, Guo-Min Wen, Dengli Sun, Dan-Xia Xian, Lijun Fan, Hui Jiang, Jin Jing, Yu Jin, Chuan-An Wu and Wei-Qing Chen

Int. J. Environ. Res. Public Health 2017, 14(10), 1132; https://doi.org/10.3390/ijerph14101132 - 27 Sep 2017

Cited by 30 | Viewed by 5813

Abstract

This study aimed to examine the association between prenatal environmental tobacco smoke (ETS) exposure and hyperactivity behaviors in young children. A cross-sectional study was undertaken among 21,243 participants from all of the kindergartens in Longhua District of Shenzhen, China. Multivariate logistic regression models [...] Read more.

This study aimed to examine the association between prenatal environmental tobacco smoke (ETS) exposure and hyperactivity behaviors in young children. A cross-sectional study was undertaken among 21,243 participants from all of the kindergartens in Longhua District of Shenzhen, China. Multivariate logistic regression models and hierarchical linear models were employed to assess the associations. After adjusting for potential confounders of gender, preterm birth, birth asphyxiation, etc., prenatal ETS exposure was significantly associated with an increased risk of hyperactivity behaviors in young children (OR (95% CI) = 1.51 (1.28–1.77); β (95% CI) = 0.017 (0.013–0.020)). Along with increases in children’s prenatal ETS exposure dose (measured by daily ETS exposure duration, daily cigarette consumption by household members, and overall score of prenatal ETS exposure), the children were also increasingly more likely to exhibit hyperactivity behaviors. Furthermore, children whose mothers had prenatal ETS exposure in any one or more of the pregnancy trimesters were more likely to exhibit hyperactivity behaviors as compared with those born to non-exposure mothers (all p < 0.05). Overall, prenatal ETS exposure could be associated with a detrimental impact on offspring’s hyperactivity behaviors, and public health efforts are needed to reduce prenatal ETS exposure. Full article

(This article belongs to the Collection Health Behavior and Public Health)

11 pages, 504 KiB

Open AccessArticle

Discrete Choice Model of Food Store Trips Using National Household Food Acquisition and Purchase Survey (FoodAPS)

by Amy Hillier, Tony E. Smith, Eliza D. Whiteman and Benjamin W. Chrisinger

Int. J. Environ. Res. Public Health 2017, 14(10), 1133; https://doi.org/10.3390/ijerph14101133 - 27 Sep 2017

Cited by 26 | Viewed by 7638

Abstract

Where households across income levels shop for food is of central concern within a growing body of research focused on where people live relative to where they shop, what they purchase and eat, and how those choices influence the risk of obesity and [...] Read more.

Where households across income levels shop for food is of central concern within a growing body of research focused on where people live relative to where they shop, what they purchase and eat, and how those choices influence the risk of obesity and chronic disease. We analyzed data from the National Household Food Acquisition and Purchase Survey (FoodAPS) using a conditional logit model to determine where participants shop for food to be prepared and eaten at home and how individual and household characteristics of food shoppers interact with store characteristics and distance from home in determining store choice. Store size, whether or not it was a full-service supermarket, and the driving distance from home to the store constituted the three significant main effects on store choice. Overall, participants were more likely to choose larger stores, conventional supermarkets rather than super-centers and other types of stores, and stores closer to home. Interaction effects show that participants receiving Supplemental Nutrition Assistance Program (SNAP) were even more likely to choose larger stores. Hispanic participants were more likely than non-Hispanics to choose full-service supermarkets while White participants were more likely to travel further than non-Whites. This study demonstrates the value of explicitly spatial discrete choice models and provides evidence of national trends consistent with previous smaller, local studies. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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13 pages, 488 KiB

Open AccessArticle

An Efficient Test for Gene-Environment Interaction in Generalized Linear Mixed Models with Family Data

by Mauricio A. Mazo Lopera, Brandon J. Coombes and Mariza De Andrade

Int. J. Environ. Res. Public Health 2017, 14(10), 1134; https://doi.org/10.3390/ijerph14101134 - 27 Sep 2017

Cited by 5 | Viewed by 4484

Abstract

Gene-environment (GE) interaction has important implications in the etiology of complex diseases that are caused by a combination of genetic factors and environment variables. Several authors have developed GE analysis in the context of independent subjects or longitudinal data using a gene-set. In [...] Read more.

Gene-environment (GE) interaction has important implications in the etiology of complex diseases that are caused by a combination of genetic factors and environment variables. Several authors have developed GE analysis in the context of independent subjects or longitudinal data using a gene-set. In this paper, we propose to analyze GE interaction for discrete and continuous phenotypes in family studies by incorporating the relatedness among the relatives for each family into a generalized linear mixed model (GLMM) and by using a gene-based variance component test. In addition, we deal with collinearity problems arising from linkage disequilibrium among single nucleotide polymorphisms (SNPs) by considering their coefficients as random effects under the null model estimation. We show that the best linear unbiased predictor (BLUP) of such random effects in the GLMM is equivalent to the ridge regression estimator. This equivalence provides a simple method to estimate the ridge penalty parameter in comparison to other computationally-demanding estimation approaches based on cross-validation schemes. We evaluated the proposed test using simulation studies and applied it to real data from the Baependi Heart Study consisting of 76 families. Using our approach, we identified an interaction between BMI and the Peroxisome Proliferator Activated Receptor Gamma (PPARG) gene associated with diabetes. Full article

(This article belongs to the Special Issue Gene-Environment Interactions and Disease)

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9 pages, 268 KiB

Open AccessArticle

How Canada Changed from Exporting Asbestos to Banning Asbestos: The Challenges That Had to Be Overcome

by Kathleen Ruff

Int. J. Environ. Res. Public Health 2017, 14(10), 1135; https://doi.org/10.3390/ijerph14101135 - 27 Sep 2017

Cited by 23 | Viewed by 7937

Abstract

Less than ten years ago, the asbestos industry enjoyed the support of every Quebec and Canadian political party. The Chrysotile Institute and the International Chrysotile Association, both located in Quebec, aggressively marketed asbestos around the world, claiming scientific evidence showed that chrysotile asbestos [...] Read more.

Less than ten years ago, the asbestos industry enjoyed the support of every Quebec and Canadian political party. The Chrysotile Institute and the International Chrysotile Association, both located in Quebec, aggressively marketed asbestos around the world, claiming scientific evidence showed that chrysotile asbestos could be safely used. The industry created a climate of intimidation. Consequently, no groups advocating for victims of asbestos or campaigning for its outright ban existed in Quebec to challenge the industry. A campaign was launched to mobilize the scientific community to speak out. Working with scientists, activists, and asbestos victims around the world, a small group of Quebec scientists exposed the false arguments of the asbestos industry. They publicly and repeatedly challenged the unscientific and unethical asbestos policy of the government. By appealing to Quebec values and holding those in power accountable, the campaign won public support and succeeded against all odds in defeating the asbestos industry. Full article

(This article belongs to the Special Issue Global Panorama of National Experiences in Public Health Actions to Ban Asbestos)

16 pages, 2337 KiB

Open AccessArticle

Incidence of Cancer in Shenzhen, Guangdong Province during 2001–2015: A Retrospective Population-Based Study

by Zhongyu Xu, Haibin Zhou, Lin Lei, Hongyu Li, Weiye Yu, Zhen Fu, Nanjin Wu, Ji Peng and Ping Yin

Int. J. Environ. Res. Public Health 2017, 14(10), 1137; https://doi.org/10.3390/ijerph14101137 - 27 Sep 2017

Cited by 11 | Viewed by 5338

Abstract

Cancer is a serious public health issue and the leading cause of death around the world. This article aimed to estimate the cancer incidence and the trend in standardized cancer incidence in Shenzhen, Guangdong province, South China during 2001–2015 by analyzing the cancer [...] Read more.

Cancer is a serious public health issue and the leading cause of death around the world. This article aimed to estimate the cancer incidence and the trend in standardized cancer incidence in Shenzhen, Guangdong province, South China during 2001–2015 by analyzing the cancer data of the population-based cancer registry in Shenzhen. Data were collected from the cancer registry in Shenzhen, which was conducted during 2001–2015. In this registry, the crude incidence rates, age-specific incidence rates, age-standardized incidence rates and cumulative incidence rates were calculated in every five years. Trends for standardized incidence rates of cancers were analyzed by using the joinpoint regression analysis. In total, 33,374.3 thousand person-years (17,593.9 thousand for males and 15,780.4 thousand for females) were monitored over this time period. The number of new cancer cases during 2001–2015 was 59,218 (30,144 and 29,074 for males and females, respectively). The crude incidence during 2001–2005 was 136.44 per 100,000 persons, while the age-standardized rates by Chinese standard population (ASR-China) and by world standard population (ASR-world) were 165.13 and 212.48 per 100,000 persons, respectively. The crude incidence during 2006–2010 was 179.01 per 100,000 persons, while the ASR-China and ASR-world were 168.08 and 214.44 per 100,000 persons, respectively. The crude incidence during 2011–2015 was 196.53 per 100,000 persons, while the ASR-China and ASR-world were 171.44 and 219.99 per 100,000 persons, respectively. During 2001 and 2015, the joinpoint regression analysis showed that the ASR-China of cancer had an overall increase of 0.96% per year and 0.84% per year for males and females respectively, although both of these values (males and females) were non-significant increases. The leading cancer types during 2011–2015 were lung, colorectal, thyroid gland, breast, liver, stomach, cervix, nasopharynx, leukemia and lymphoma. For males, the top five common cancers were lung, liver, colorectal, stomach and thyroid gland. For females, the top five common cancers were breast, thyroid gland, lung, colorectal and cervix. The results of this study showed a heavy cancer burden among the population of Shenzhen, China. Future researches of the etiology and prevention of cancers should be planned in order to reduce the incidence associated with cancers in the future. Full article

(This article belongs to the Section Global Health)

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10 pages, 484 KiB

Open AccessArticle

LRBA Gene Polymorphisms and Risk of Coal Workers’ Pneumoconiosis: A Case–Control Study from China

by Yi Liu, Jingjin Yang, Qiuyun Wu, Ruhui Han, Weiwen Yan, Jiali Yuan, Xiaoming Ji, Yan Li, Wenxi Yao and Chunhui Ni

Int. J. Environ. Res. Public Health 2017, 14(10), 1138; https://doi.org/10.3390/ijerph14101138 - 27 Sep 2017

Cited by 11 | Viewed by 4576

Abstract

The lipopolysaccharide (LPS)-responsive beige-like anchor protein (LRBA) is a member of the WDL-BEACH-WD (WBW) gene family. Defects in this gene are associated with the disordered autoimmunity in various diseases, including pulmonary fibrosis. In this study, we investigated the association between the functional polymorphisms [...] Read more.

The lipopolysaccharide (LPS)-responsive beige-like anchor protein (LRBA) is a member of the WDL-BEACH-WD (WBW) gene family. Defects in this gene are associated with the disordered autoimmunity in various diseases, including pulmonary fibrosis. In this study, we investigated the association between the functional polymorphisms in LRBA and risk of coal workers’ pneumoconiosis (CWP) in a Chinese population. Three potentially functional polymorphisms (rs2290846, rs3749574, and rs1782360) in LRBA were genotyped and analyzed in a case–control study, including 703 CWP cases and 705 controls. Genotyping was performed by the ABI 7900HT Real Time PCR system. Our results suggested that genotype rs2290846 AA was significantly associated with decreased risk of CWP (Adjusted OR = 0.61, 95% CI = 0.41–0.92), and the recessive model also supported the protective role of the genotype (Adjusted OR = 0.60, 95% CI = 0.40–0.89). Further, the polymorphism of rs2290846 decreased the CWP risk among cases over 27 years of dust exposure (adjusted OR = 0.51, 95% CI = 0.28–0.94) and non-smokers (adjusted OR = 0.58, 95% CI = 0.34–1.00). A potential role of rs2290846 AA has been proposed by expression quantitative trait loci (eQTL) and The Cancer Genome Atlas (TCGA). The present results suggest that LRBA SNPs are associated with CWP susceptibility in a Chinese population. Further studies focused on detailed mechanism or larger cohorts are warranted to validate our findings. Full article

(This article belongs to the Special Issue Lung Diseases Associated with Environmental Pollutants)

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14 pages, 4675 KiB

Open AccessArticle

Occurrence, Ecological and Human Health Risks, and Seasonal Variations of Phenolic Compounds in Surface Water and Sediment of a Potential Polluted River Basin in China

by Mo Zhou, Jiquan Zhang and Caiyun Sun

Int. J. Environ. Res. Public Health 2017, 14(10), 1140; https://doi.org/10.3390/ijerph14101140 - 27 Sep 2017

Cited by 47 | Viewed by 4810

Abstract

Five phenolic compounds in water and sediment of Yinma River Basin were investigated. The average concentration of phenol was the highest in water samples as well as in sediment samples during the wet season, 101.68 ng/L and 127.76 ng/g, respectively. 2,4,6-Trichlorophenol (2,4,6-TCP) and [...] Read more.

Five phenolic compounds in water and sediment of Yinma River Basin were investigated. The average concentration of phenol was the highest in water samples as well as in sediment samples during the wet season, 101.68 ng/L and 127.76 ng/g, respectively. 2,4,6-Trichlorophenol (2,4,6-TCP) and pentachlorophenol (PCP) was not detected in some sampling sites. Shitou Koumen Reservoir and the neighboring area were the severest areas of phenolic pollution. The lower reach was more polluted in three water seasons than the middle reach and upper reach. Phenol had ecological risks in sediment during three water seasons. 2-Nitrophenol (2-NP) and 2,4-dichlorophenol (2,4-DCP) had ecological risks in sediment in both the normal and wet season. The concentrations of five phenolic compounds from high to low were in the wet season, normal season, and dry season in water and sediment, respectively. There were middle risks in water of total concentrations for five phenolic compounds in several sampling sites. Total concentrations for five phenolic compounds in sediment had high ecological risks in all sampling sites. However, there was no human health risk in the Yinma River Basin. Full article

(This article belongs to the Section Environmental Science and Engineering)

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15 pages, 295 KiB

Open AccessArticle

A Longitudinal Study of Child Maltreatment and Mental Health Predictors of Admission to Psychiatric Residential Treatment Facilities

by Roderick A. Rose and Paul Lanier

Int. J. Environ. Res. Public Health 2017, 14(10), 1141; https://doi.org/10.3390/ijerph14101141 - 28 Sep 2017

Cited by 19 | Viewed by 5257

Abstract

The child welfare system is an access point for children’s mental health services. Psychiatric residential treatment facilities (PRTFs) are the most restrictive, and most expensive setting for children to receive long-term care. Given the high rates of behavioral health concerns among maltreated children [...] Read more.

The child welfare system is an access point for children’s mental health services. Psychiatric residential treatment facilities (PRTFs) are the most restrictive, and most expensive setting for children to receive long-term care. Given the high rates of behavioral health concerns among maltreated children in out-of-home care, research is needed to examine the factors that predict entry in PRTFs among children investigated for maltreatment. This exploratory study used cross-sector administrative records linked across multiple systems, including child welfare records and Medicaid claims, from a single state over a five-year period (n = 105,982). Cox proportional hazards modeling was used to predict entry into a PRTF. After controlling for many factors, PRTF entry was predicted by diagnosis code indicating a trauma-related condition, antipsychotic medication prescriptions, and entry into lower levels of out-of-home care, supporting the view that youth are admitted to PRTFs largely due to clinical need. However, PRTF admission is also associated with characteristics of their experiences with the social service system, primarily foster care placement stability and permanency. Implications for practice and research are discussed. Full article

(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)

7 pages, 294 KiB

Open AccessArticle

Sun Exposure, Sun-Related Symptoms, and Sun Protection Practices in an African Informal Traditional Medicines Market

by Caradee Y. Wright, Tarylee Reddy, Angela Mathee and Renée A. Street

Int. J. Environ. Res. Public Health 2017, 14(10), 1142; https://doi.org/10.3390/ijerph14101142 - 28 Sep 2017

Cited by 11 | Viewed by 3799

Abstract

Informal workers in African market trade have little formal protection against sun exposure. We aimed to examine sun exposure, sun-related symptoms, and sun protection practices in an informal occupational setting. Trained fieldworkers asked 236 workers in the Warwick Junction market about their workplace, [...] Read more.

Informal workers in African market trade have little formal protection against sun exposure. We aimed to examine sun exposure, sun-related symptoms, and sun protection practices in an informal occupational setting. Trained fieldworkers asked 236 workers in the Warwick Junction market about their workplace, skin and eye sensitivity and skin colour, symptoms faced at work during the summer due to heat, and preventive measures. Data were analyzed using univariate logistic regression to assess the effect of gender and the risk of experiencing symptoms to sun exposure in relation to pre-existing diseases and perception of sun exposure as a hazard. Of the 236 participants, 234 were Black African and 141 (59.7%) were female. Portable shade was the most commonly used form of sun protection (69.9%). Glare from the sun (59.7%) and excessive sweating (57.6%) were commonly reported sun-related health symptoms. The use of protective clothing was more prevalent among those who perceived sun exposure as a hazard (p = 0.003). In an informal occupational setting, sun exposure was high. Protective clothing and portable shade to eliminate heat and bright light were self-implemented. Action by local authorities to protect informal workers should consider sun exposure to support workers in their efforts to cope in hot weather. Full article

(This article belongs to the Section Environmental Health)

11 pages, 1026 KiB

Open AccessArticle

Effect Modification by Environmental Quality on the Association between Heatwaves and Mortality in Alabama, United States

by Yun Jian, Connor Y. H. Wu and Julia M. Gohlke

Int. J. Environ. Res. Public Health 2017, 14(10), 1143; https://doi.org/10.3390/ijerph14101143 - 28 Sep 2017

Cited by 7 | Viewed by 4090

Abstract

Background: Previous studies have shown that heatwaves are associated with increased mortality. However, it remains unclear whether the associations between heatwaves and mortality are modified by the environmental quality. Methods: We used the United States (US) Environmental Protection Agency’s Environmental Quality [...] Read more.

Background: Previous studies have shown that heatwaves are associated with increased mortality. However, it remains unclear whether the associations between heatwaves and mortality are modified by the environmental quality. Methods: We used the United States (US) Environmental Protection Agency’s Environmental Quality Index (EQI) and its five domain indices (air, water, land, built, and sociodemographic) to represent the cumulative environmental quality. We applied a time-stratified case-crossover design to analyze the disparities in the association between heatwaves and non-accidental deaths (NAD) among counties with different environmental qualities, in metropolitan areas in Alabama (AL), United States. Results: We found significant associations between heatwaves and NAD and a significant effect modification of this relationship by EQI. There were higher odds ratios in counties with the worst cumulative environmental qualities compared to counties with the best cumulative environmental qualities. For example, the percent change in odds ratio (mean and (95% CI)) between heatwave days and non-heatwave days was −10.3% (−26.6, 9.6) in counties with an overall EQI of 1 (the best overall environment) and 13.2% (4.9, 22.2) in counties with an overall EQI of 3 (the worst overall environment). Among the five domains, air quality had the strongest effect modification on the association. Conclusion: Our findings provide evidence that the associations between heatwaves and NAD vary among areas with different environmental qualities. These findings suggest that integration of air quality and heatwave warning systems may provide greater protection to public health. Full article

(This article belongs to the Section Environmental Health)

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12 pages, 658 KiB

Open AccessArticle

by Jagnoor Jagnoor, Shankar Prinja, Aliki Christou, Jannah Baker, Belinda Gabbe and Rebecca Ivers

Int. J. Environ. Res. Public Health 2017, 14(10), 1144; https://doi.org/10.3390/ijerph14101144 - 28 Sep 2017

Cited by 8 | Viewed by 4493

Abstract

Paediatric injuries can lead to long-term functional impairment and reduced health-related quality of life, and are a growing public health issue in India. To date, however, the burden has been poorly characterized. This study assessed the impact of non-fatal injuries on health-related quality [...] Read more.

Paediatric injuries can lead to long-term functional impairment and reduced health-related quality of life, and are a growing public health issue in India. To date, however, the burden has been poorly characterized. This study assessed the impact of non-fatal injuries on health-related quality of life in a prospective cohort study of 373 children admitted to three hospitals in Chandigarh and Haryana states in India. The Pediatric Quality of Life Inventory (PedsQL) and King’s Outcome Scale for Childhood Head Injury (KOSCHI) were administered at baseline (pre-injury) and at 1, 2, 4, and 12 months post-injury by telephone interview. Follow-up at all-time points was completed for 277 (77%) of all living participants. Less than one percent reported ongoing disability at 4 months, and no disability was reported at 12 months. PedsQL physical health scores were below healthy child norms (83.4) at 1 month in the cohort for ages 8–12 years and 13–16 years. Although injuries are prevalent, ongoing impact on functioning and disability from most childhood injuries at 12 months was reported to be low. The results raise questions about reliability of generic, Western-centric tools in low- and middle-income settings, and highlight the need for local context-specific tools. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

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11 pages, 1403 KiB

Open AccessArticle

The Adsorption of Cd(II) on Manganese Oxide Investigated by Batch and Modeling Techniques

by Xiaoming Huang, Tianhu Chen, Xuehua Zou, Mulan Zhu, Dong Chen and Min Pan

Int. J. Environ. Res. Public Health 2017, 14(10), 1145; https://doi.org/10.3390/ijerph14101145 - 28 Sep 2017

Cited by 60 | Viewed by 5602

Abstract

Manganese (Mn) oxide is a ubiquitous metal oxide in sub-environments. The adsorption of Cd(II) on Mn oxide as function of adsorption time, pH, ionic strength, temperature, and initial Cd(II) concentration was investigated by batch techniques. The adsorption kinetics showed that the adsorption of [...] Read more.

Manganese (Mn) oxide is a ubiquitous metal oxide in sub-environments. The adsorption of Cd(II) on Mn oxide as function of adsorption time, pH, ionic strength, temperature, and initial Cd(II) concentration was investigated by batch techniques. The adsorption kinetics showed that the adsorption of Cd(II) on Mn oxide can be satisfactorily simulated by pseudo-second-order kinetic model with high correlation coefficients (R² > 0.999). The adsorption of Cd(II) on Mn oxide significantly decreased with increasing ionic strength at pH < 5.0, whereas Cd(II) adsorption was independent of ionic strength at pH > 6.0, which indicated that outer-sphere and inner-sphere surface complexation dominated the adsorption of Cd(II) on Mn oxide at pH < 5.0 and pH > 6.0, respectively. The maximum adsorption capacity of Mn oxide for Cd(II) calculated from Langmuir model was 104.17 mg/g at pH 6.0 and 298 K. The thermodynamic parameters showed that the adsorption of Cd(II) on Mn oxide was an endothermic and spontaneous process. According to the results of surface complexation modeling, the adsorption of Cd(II) on Mn oxide can be satisfactorily simulated by ion exchange sites (X₂Cd) at low pH and inner-sphere surface complexation sites (SOCd⁺ and (SO)₂CdOH⁻ species) at high pH conditions. The finding presented herein plays an important role in understanding the fate and transport of heavy metals at the water–mineral interface. Full article

(This article belongs to the Special Issue Environmental Cadmium Exposure and Public Health)

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15 pages, 530 KiB

Open AccessArticle

Multiple Gene-Environment Interactions on the Angiogenesis Gene-Pathway Impact Rectal Cancer Risk and Survival

by Noha Sharafeldin, Martha L. Slattery, Qi Liu, Conrado Franco-Villalobos, Bette J. Caan, John D. Potter and Yutaka Yasui

Int. J. Environ. Res. Public Health 2017, 14(10), 1146; https://doi.org/10.3390/ijerph14101146 - 28 Sep 2017

Cited by 6 | Viewed by 5013

Abstract

Characterization of gene-environment interactions (GEIs) in cancer is limited. We aimed at identifying GEIs in rectal cancer focusing on a relevant biologic process involving the angiogenesis pathway and relevant environmental exposures: cigarette smoking, alcohol consumption, and animal protein intake. We analyzed data from [...] Read more.

Characterization of gene-environment interactions (GEIs) in cancer is limited. We aimed at identifying GEIs in rectal cancer focusing on a relevant biologic process involving the angiogenesis pathway and relevant environmental exposures: cigarette smoking, alcohol consumption, and animal protein intake. We analyzed data from 747 rectal cancer cases and 956 controls from the Diet, Activity and Lifestyle as a Risk Factor for Rectal Cancer study. We applied a 3-step analysis approach: first, we searched for interactions among single nucleotide polymorphisms on the pathway genes; second, we searched for interactions among the genes, both steps using Logic regression; third, we examined the GEIs significant at the 5% level using logistic regression for cancer risk and Cox proportional hazards models for survival. Permutation-based test was used for multiple testing adjustment. We identified 8 significant GEIs associated with risk among 6 genes adjusting for multiple testing: TNF (OR = 1.85, 95% CI: 1.10, 3.11), TLR4 (OR = 2.34, 95% CI: 1.38, 3.98), and EGR2 (OR = 2.23, 95% CI: 1.04, 4.78) with smoking; IGF1R (OR = 1.69, 95% CI: 1.04, 2.72), TLR4 (OR = 2.10, 95% CI: 1.22, 3.60) and EGR2 (OR = 2.12, 95% CI: 1.01, 4.46) with alcohol; and PDGFB (OR = 1.75, 95% CI: 1.04, 2.92) and MMP1 (OR = 2.44, 95% CI: 1.24, 4.81) with protein. Five GEIs were associated with survival at the 5% significance level but not after multiple testing adjustment: CXCR1 (HR = 2.06, 95% CI: 1.13, 3.75) with smoking; and KDR (HR = 4.36, 95% CI: 1.62, 11.73), TLR2 (HR = 9.06, 95% CI: 1.14, 72.11), EGR2 (HR = 2.45, 95% CI: 1.42, 4.22), and EGFR (HR = 6.33, 95% CI: 1.95, 20.54) with protein. GEIs between angiogenesis genes and smoking, alcohol, and animal protein impact rectal cancer risk. Our results support the importance of considering the biologic hypothesis to characterize GEIs associated with cancer outcomes. Full article

(This article belongs to the Special Issue Gene-Environment Interactions and Disease)

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15 pages, 324 KiB

Open AccessArticle

Assessing and Validating an Educational Resource Package for Health Professionals to Improve Smoking Cessation Care in Aboriginal and Torres Strait Islander Pregnant Women

by Yael Bar-Zeev, Michelle Bovill, Billie Bonevski, Maree Gruppetta, Jennifer Reath, The ICAN QUIT in Pregnancy Pilot Group and Gillian S. Gould

Int. J. Environ. Res. Public Health 2017, 14(10), 1148; https://doi.org/10.3390/ijerph14101148 - 29 Sep 2017

Cited by 16 | Viewed by 6955

Abstract

Australian Aboriginal pregnant women have a high smoking prevalence (45%). Health professionals lack adequate educational resources to manage smoking. Resources need to be tailored to ensure saliency, cultural-sensitivity and account for diversity of Indigenous populations. As part of an intervention to improve health [...] Read more.

Australian Aboriginal pregnant women have a high smoking prevalence (45%). Health professionals lack adequate educational resources to manage smoking. Resources need to be tailored to ensure saliency, cultural-sensitivity and account for diversity of Indigenous populations. As part of an intervention to improve health professionals’ smoking cessation care in Aboriginal pregnant women, a resource package was developed collaboratively with two Aboriginal Medical Services. The purpose of this study was to assess and validate this resource package. A multi-centred community-based participatory 4-step process (with three Aboriginal Medical Services from three Australian states), included: (1) Scientific review by an expert panel (2) ‘Suitability of Materials’ scoring by two Aboriginal Health Workers (3) Readability scores (4) Focus groups with health professionals. Content was analysed using six pre-determined themes (attraction, comprehension, self-efficacy, graphics and layout, cultural acceptability, and persuasion), with further inductive analysis for emerging themes. Suitability of Material scoring was adequate or superior. Average readability was grade 6.4 for patient resources (range 5.1–7.2), and 9.8 for health provider resources (range 8.5–10.6). Emergent themes included ‘Getting the message right’; ‘Engaging with family’; ‘Needing visual aids’; and ‘Requiring practicality under a tight timeframe’. Results were presented back to a Stakeholder and Consumer Aboriginal Advisory Panel and resources were adjusted accordingly. This process ensured materials used for the intervention were culturally responsive, evidence-based and useful. This novel formative evaluation protocol could be adapted for other Indigenous and culturally diverse interventions. The added value of this time-consuming and costly process is yet to be justified in research, and might impact the potential adaption by other projects. Full article

(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)

14 pages, 1181 KiB

Open AccessArticle

A Marine Bacterium, Bacillus sp. Isolated from the Sediment Samples of Algoa Bay in South Africa Produces a Polysaccharide-Bioflocculant

by Ncedo Ntozonke, Kunle Okaiyeto, Arinze S. Okoli, Ademola O. Olaniran, Uchechukwu U. Nwodo and Anthony I. Okoh

Int. J. Environ. Res. Public Health 2017, 14(10), 1149; https://doi.org/10.3390/ijerph14101149 - 29 Sep 2017

Cited by 16 | Viewed by 4968

Abstract

Bioflocculants mediate the removal of suspended particles from solution and the efficiency of flocculation is dependent on the characteristics of the flocculant. Apart from the merits of biodegradability and harmlessness, bioflocculants could be viable as industrially relevant flocculants as they are a renewable [...] Read more.

Bioflocculants mediate the removal of suspended particles from solution and the efficiency of flocculation is dependent on the characteristics of the flocculant. Apart from the merits of biodegradability and harmlessness, bioflocculants could be viable as industrially relevant flocculants as they are a renewable resource. Additionally, the shortcomings associated with the conventionally used flocculants such as aluminium salts and acrylamide polymers, which include dementia and cancer, highlight more the need to use bioflocculants as an alternative. Consequently, in this study a marine sediment bacterial isolate was screened for bioflocculant production. Basic local alignment search tools (BLAST) analysis of 16S ribosomal deoxyribonucleic acid (rDNA) sequence of the bacterial isolate showed 98% similarity to Bacillus thuringiensis MR-R1. The bacteria produced bioflocculant optimally with inoculum size (4% v/v) (85%), glucose (85.65%) and mixed nitrogen source (urea, ammonium chloride and yeast extract) (75.9%) and the divalent cation (Ca²⁺) (62.3%). Under optimal conditions, a maximum flocculating activity of over 85% was attained after 60 h of cultivation. The purified polysaccharide-bioflocculant flocculated optimally at alkaline pH 12 (81%), in the presence of Mn²⁺ (73%) and Ca²⁺ (72.8%). The high flocculation activity shown indicates that the bioflocculant may contend favourably as an alternative to the conventionally used flocculants in water treatment. Full article

(This article belongs to the Special Issue Microbiological Evaluation of Wastewater Treatment)

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15 pages, 5619 KiB

Open AccessArticle

The Spatiotemporal Trend of City Parks in Mainland China between 1981 and 2014: Implications for the Promotion of Leisure Time Physical Activity and Planning

by Kai Wang and Jianjun Liu

Int. J. Environ. Res. Public Health 2017, 14(10), 1150; https://doi.org/10.3390/ijerph14101150 - 29 Sep 2017

Cited by 17 | Viewed by 4956

Abstract

City parks, important environments built for physical activity, play critical roles in preventing chronic diseases and promoting public health. We used five commonly used park indicators to investigate the spatiotemporal trend of city parks in mainland China between 1981 and 2014 at three [...] Read more.

City parks, important environments built for physical activity, play critical roles in preventing chronic diseases and promoting public health. We used five commonly used park indicators to investigate the spatiotemporal trend of city parks in mainland China between 1981 and 2014 at three scales: national, provincial and city class. City parks in China increased significantly with a turning point occurring around the year 2000. Up until the end of 2014, there were 13,074 city parks totaling 367,962 ha with 0.29 parks per 10,000 residents, 8.26 m² of park per capita and 2.00% of parkland as a percentage of urban area. However, there is still a large gap compared to the established American and Japanese city park systems, and only 5.4% of people aged above 20 access city parks for physical activity. The low number of parks per 10,000 residents brings up the issue of the accessibility to physical activity areas that public parks provide. The concern of spatial disparity, also apparent for all five city park indicators, differed strongly at provincial and city class scales. The southern and eastern coastal provinces of Guangdong, Fujian, Zhejiang and Shandong have abundant city park resources. At the scale of the city classes, mega-city II had the highest of the three ratio indicators and the large city class had the lowest. On one hand, the leading province Guangdong and its mega-cities Shenzhen and Dongguan had park indicators comparable to the United States and Japan. On the other hand, there were still five cities with no city parks and many cities with extremely low park indicators. In China, few cities have realized the importance of city parks for the promotion of leisure time physical activity. It is urgent that state and city park laws or guidelines are passed that can serve as baselines for planning a park system and determining a minimum standard for city parks with free, accessible and safe physical activity areas and sports facilities. Full article

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27 pages, 1150 KiB

Open AccessArticle

The Monetary Valuation of Lifetime Health Improvement and Life Expectancy Gains in Turkey

by Shihomi Ara and Cem Tekeşin

Int. J. Environ. Res. Public Health 2017, 14(10), 1151; https://doi.org/10.3390/ijerph14101151 - 29 Sep 2017

Cited by 3 | Viewed by 4368

Abstract

The main objective of this study is to estimate the monetary value of the gains of healthy days and life expectancy due to the ambient air quality standard that came into effect in 2014 by estimating the country-specific value of a life year [...] Read more.

The main objective of this study is to estimate the monetary value of the gains of healthy days and life expectancy due to the ambient air quality standard that came into effect in 2014 by estimating the country-specific value of a life year (VOLY) and the value of the healthier and longer life (VHLL) for Turkey. Contingent valuation method is adopted to reveal individuals’ willingness to pay for an improvement of health condition and the extension of their life expectancy by avoiding respiratory and lung related illnesses. VHLL is composed of two parts, WTP for an extension of one’s life years (VOLY) and for an increase in the number of healthy days throughout one’s life time (VHLL-VOLY). We found that close to 80% of WTP is allocated to the latter component of VHLL and only 20% is for VOLY mainly due to Islamic beliefs of the respondents. A total of 1314 observations are collected by face-to-face interviews from Afsin-Elbistan, Kutahya-Tavsanli and Ankara. The estimated VHLL and VOLY are [41,750 TL, 10,258 TL] with all the observations, [30,185 TL, 7132 TL] for Afsin-Elbistan, [31,718 TL, 7081 TL] for Kutahya-Tavsanli and [52,334 TL, 14,813 TL] for Ankara. The Inverse-U shaped relationship between Age and WTP is confirmed. The income elasticities of WTP is found to be close to 0.5 for all study areas while an Inverse-U shaped relationship between the household income and Income Elasticity of WTP is observed in the income group based analysis. Age and household income are the two prominent determinants of VHLL. Full article

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9 pages, 474 KiB

Open AccessArticle

Antibiotic Self-Medication among Non-Medical University Students in Punjab, Pakistan: A Cross-Sectional Survey

by Ali Hassan Gillani, Wenjing Ji, Waqar Hussain, Ali Imran, Jie Chang, Caijun Yang and Yu Fang

Int. J. Environ. Res. Public Health 2017, 14(10), 1152; https://doi.org/10.3390/ijerph14101152 - 29 Sep 2017

Cited by 46 | Viewed by 9856

Abstract

Background: Antibiotic resistance is a global threat. Scarce knowledge about safe and appropriate antibiotic use is coupled with frequent self-administration, e.g., in China. This repeated self-medication poses potential risk in terms of antibiotic resistance. Low-resource countries are facing an elevated burden of [...] Read more.

Background: Antibiotic resistance is a global threat. Scarce knowledge about safe and appropriate antibiotic use is coupled with frequent self-administration, e.g., in China. This repeated self-medication poses potential risk in terms of antibiotic resistance. Low-resource countries are facing an elevated burden of antibiotic self-medication as compared to developed ones. Thus, this study focused on evaluating the pervasiveness of antibiotic self-medication in 3 universities of Southern Punjab, Pakistan. Methods: We conducted a descriptive cross-sectional survey in three government sector universities of Southern Punjab, Pakistan. The study was carried out with self-administered paper-based questionnaires. Data was analyzed using SPSS version 18.0 (IBM, Chicago, IL, USA). Results: Seven hundred twenty-seven students out of 750 (response rate 97%) with a mean age ± SD of 23.0 ± 3.4 years agreed to participate in the study. The proportion of females was slightly greater (52%) compared with males (48%), and almost one-third of the respondents (36%) were in their 2nd year of university. Out of the total, 58.3% practiced self-medication in the preceding six months, and 326 (45%) confirmed the use of antibiotics. Metronidazole was the most frequently self-medicated antibiotic (48%). Out of the total, 72% demonstrated awareness regarding the side effects of antibiotics. Diarrhea was the well-known adverse effect (38%). Forty-three percent affirmed having antibiotic resistance knowledge, and 30% knew that the irregular use of antibiotics would lead to increased antibiotic resistance. Conclusion: Despite having ample awareness of the adverse antibiotic reactions, self-medication among the university students was high and antibiotic resistance was a fairly unknown term. Full article

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17 pages, 1242 KiB

Open AccessArticle

Interaction between Social/Psychosocial Factors and Genetic Variants on Body Mass Index: A Gene-Environment Interaction Analysis in a Longitudinal Setting

by Wei Zhao, Erin B. Ware, Zihuai He, Sharon L. R. Kardia, Jessica D. Faul and Jennifer A. Smith

Int. J. Environ. Res. Public Health 2017, 14(10), 1153; https://doi.org/10.3390/ijerph14101153 - 29 Sep 2017

Cited by 11 | Viewed by 6905

Abstract

Obesity, which develops over time, is one of the leading causes of chronic diseases such as cardiovascular disease. However, hundreds of BMI (body mass index)-associated genetic loci identified through large-scale genome-wide association studies (GWAS) only explain about 2.7% of BMI variation. Most common [...] Read more.

Obesity, which develops over time, is one of the leading causes of chronic diseases such as cardiovascular disease. However, hundreds of BMI (body mass index)-associated genetic loci identified through large-scale genome-wide association studies (GWAS) only explain about 2.7% of BMI variation. Most common human traits are believed to be influenced by both genetic and environmental factors. Past studies suggest a variety of environmental features that are associated with obesity, including socioeconomic status and psychosocial factors. This study combines both gene/regions and environmental factors to explore whether social/psychosocial factors (childhood and adult socioeconomic status, social support, anger, chronic burden, stressful life events, and depressive symptoms) modify the effect of sets of genetic variants on BMI in European American and African American participants in the Health and Retirement Study (HRS). In order to incorporate longitudinal phenotype data collected in the HRS and investigate entire sets of single nucleotide polymorphisms (SNPs) within gene/region simultaneously, we applied a novel set-based test for gene-environment interaction in longitudinal studies (LGEWIS). Childhood socioeconomic status (parental education) was found to modify the genetic effect in the gene/region around SNP rs9540493 on BMI in European Americans in the HRS. The most significant SNP (rs9540488) by childhood socioeconomic status interaction within the rs9540493 gene/region was suggestively replicated in the Multi-Ethnic Study of Atherosclerosis (MESA) (p = 0.07). Full article

(This article belongs to the Special Issue Gene-Environment Interactions and Disease)

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23 pages, 2315 KiB

Open AccessArticle

Playing Chemical Plant Environmental Protection Games with Historical Monitoring Data

by Zhengqiu Zhu, Bin Chen, Genserik Reniers, Laobing Zhang, Sihang Qiu and Xiaogang Qiu

Int. J. Environ. Res. Public Health 2017, 14(10), 1155; https://doi.org/10.3390/ijerph14101155 - 29 Sep 2017

Cited by 11 | Viewed by 4801

Abstract

The chemical industry is very important for the world economy and this industrial sector represents a substantial income source for developing countries. However, existing regulations on controlling atmospheric pollutants, and the enforcement of these regulations, often are insufficient in such countries. As a [...] Read more.

The chemical industry is very important for the world economy and this industrial sector represents a substantial income source for developing countries. However, existing regulations on controlling atmospheric pollutants, and the enforcement of these regulations, often are insufficient in such countries. As a result, the deterioration of surrounding ecosystems and a quality decrease of the atmospheric environment can be observed. Previous works in this domain fail to generate executable and pragmatic solutions for inspection agencies due to practical challenges. In addressing these challenges, we introduce a so-called Chemical Plant Environment Protection Game (CPEP) to generate reasonable schedules of high-accuracy air quality monitoring stations (i.e., daily management plans) for inspection agencies. First, so-called Stackelberg Security Games (SSGs) in conjunction with source estimation methods are applied into this research. Second, high-accuracy air quality monitoring stations as well as gas sensor modules are modeled in the CPEP game. Third, simplified data analysis on the regularly discharging of chemical plants is utilized to construct the CPEP game. Finally, an illustrative case study is used to investigate the effectiveness of the CPEP game, and a realistic case study is conducted to illustrate how the models and algorithms being proposed in this paper, work in daily practice. Results show that playing a CPEP game can reduce operational costs of high-accuracy air quality monitoring stations. Moreover, evidence suggests that playing the game leads to more compliance from the chemical plants towards the inspection agencies. Therefore, the CPEP game is able to assist the environmental protection authorities in daily management work and reduce the potential risks of gaseous pollutants dispersion incidents. Full article

(This article belongs to the Collection Environmental Risk Assessment)

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15 pages, 908 KiB

Open AccessArticle

Contributions of Work-Related Stress and Emotional Intelligence to Teacher Engagement: Additive and Interactive Effects

by Sergio Mérida-López, Natalio Extremera and Lourdes Rey

Int. J. Environ. Res. Public Health 2017, 14(10), 1156; https://doi.org/10.3390/ijerph14101156 - 29 Sep 2017

Cited by 48 | Viewed by 8738

Abstract

This study examined the additive and interactive effects of role stress and emotional intelligence for predicting engagement among 288 teachers. Emotional intelligence and engagement were positively associated. Role ambiguity and role conflict showed negative associations with vigor and dedication scores. The interaction of [...] Read more.

This study examined the additive and interactive effects of role stress and emotional intelligence for predicting engagement among 288 teachers. Emotional intelligence and engagement were positively associated. Role ambiguity and role conflict showed negative associations with vigor and dedication scores. The interaction of role ambiguity and emotional intelligence was significant in explaining engagement dimensions. Similar results were found considering overall teacher engagement. Emotional intelligence boosted engagement when the levels of role ambiguity were higher. Our findings suggest the need for future research examining the impact of job hindrances on the links between emotional intelligence and teachers’ occupational well-being indicators. Finally, the implications for emotional intelligence training in education are discussed. Full article

(This article belongs to the Section Occupational Safety and Health)

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12 pages, 1965 KiB

Open AccessArticle

Factors Affecting Transfer of Pyrethroid Residues from Herbal Teas to Infusion and Influence of Physicochemical Properties of Pesticides

by Jin-Jing Xiao, Yang Li, Qing-Kui Fang, Yan-Hong Shi, Min Liao, Xiang-Wei Wu, Ri-Mao Hua and Hai-Qun Cao

Int. J. Environ. Res. Public Health 2017, 14(10), 1157; https://doi.org/10.3390/ijerph14101157 - 30 Sep 2017

Cited by 30 | Viewed by 5593

Abstract

The transfer of pesticide residues from herbal teas to their infusion is a subject of particular interest. In this study, a multi-residue analytical method for the determination of pyrethroids (fenpropathrin, beta-cypermethrin, lambda-cyhalothrin, and fenvalerate) in honeysuckle, chrysanthemum, wolfberry, and licorice and their infusion [...] Read more.

The transfer of pesticide residues from herbal teas to their infusion is a subject of particular interest. In this study, a multi-residue analytical method for the determination of pyrethroids (fenpropathrin, beta-cypermethrin, lambda-cyhalothrin, and fenvalerate) in honeysuckle, chrysanthemum, wolfberry, and licorice and their infusion samples was validated. The transfer of pyrethroid residues from tea to infusion was investigated at different water temperatures, tea/water ratios, and infusion intervals/times. The results show that low amounts (0–6.70%) of pyrethroids were transferred under the different tea brewing conditions examined, indicating that the infusion process reduced the pyrethroid content in the extracted liquid by over 90%. Similar results were obtained for the different tea varieties, and pesticides with high water solubility and low octanol–water partition coefficients (log K_ow) exhibited high transfer rates. Moreover, the estimated values of the exposure risk to the pyrethroids were in the range of 0.0022–0.33, indicating that the daily intake of the four pyrethroid residues from herbal tea can be regarded as safe. The present results can support the identification of suitable tea brewing conditions for significantly reducing the pesticide residue levels in the infusion. Full article

(This article belongs to the Special Issue Dietary Exposures)

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17 pages, 2486 KiB

Open AccessArticle

Identification of Linkages between EDCs in Personal Care Products and Breast Cancer through Data Integration Combined with Gene Network Analysis

by Hyeri Jeong, Jongwoon Kim and Youngjun Kim

Int. J. Environ. Res. Public Health 2017, 14(10), 1158; https://doi.org/10.3390/ijerph14101158 - 30 Sep 2017

Cited by 6 | Viewed by 5844

Abstract

Approximately 1000 chemicals have been reported to possibly have endocrine disrupting effects, some of which are used in consumer products, such as personal care products (PCPs) and cosmetics. We conducted data integration combined with gene network analysis to: (i) identify causal molecular mechanisms [...] Read more.

Approximately 1000 chemicals have been reported to possibly have endocrine disrupting effects, some of which are used in consumer products, such as personal care products (PCPs) and cosmetics. We conducted data integration combined with gene network analysis to: (i) identify causal molecular mechanisms between endocrine disrupting chemicals (EDCs) used in PCPs and breast cancer; and (ii) screen candidate EDCs associated with breast cancer. Among EDCs used in PCPs, four EDCs having correlation with breast cancer were selected, and we curated 27 common interacting genes between those EDCs and breast cancer to perform the gene network analysis. Based on the gene network analysis, ESR1, TP53, NCOA1, AKT1, and BCL6 were found to be key genes to demonstrate the molecular mechanisms of EDCs in the development of breast cancer. Using GeneMANIA, we additionally predicted 20 genes which could interact with the 27 common genes. In total, 47 genes combining the common and predicted genes were functionally grouped with the gene ontology and KEGG pathway terms. With those genes, we finally screened candidate EDCs for their potential to increase breast cancer risk. This study highlights that our approach can provide insights to understand mechanisms of breast cancer and identify potential EDCs which are in association with breast cancer. Full article

(This article belongs to the Section Environmental Health)

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11 pages, 659 KiB

Open AccessArticle

Concentration Levels, Pollution Characteristics and Potential Ecological Risk of Dust Heavy Metals in the Metropolitan Area of Beijing, China

by Qiulin Xiong, Wenji Zhao, Jiayin Zhao, Wenhui Zhao and Lei Jiang

Int. J. Environ. Res. Public Health 2017, 14(10), 1159; https://doi.org/10.3390/ijerph14101159 - 30 Sep 2017

Cited by 24 | Viewed by 4676

Abstract

This study aims to investigate the concentration levels, pollution characteristics and the associated potential ecological risks of the heavy metals found in dust in the metropolitan area of Beijing, China during the winter. Dust samples were collected at 49 different spatial locations of [...] Read more.

This study aims to investigate the concentration levels, pollution characteristics and the associated potential ecological risks of the heavy metals found in dust in the metropolitan area of Beijing, China during the winter. Dust samples were collected at 49 different spatial locations of Beijing’s metropolitan area from November 2013 to January 2014, in which the concentration levels of Cd, Cr, Pb, Cu, Zn, Ni, Co, V, Bi and Mo were measured by Elan DRC II type inductively coupled plasma mass spectrometry (ICP-MS). Test results showed that the concentrations of dust heavy metals Pb, Cr, Cu and Zn in the urban areas (147.1 mg·kg⁻¹, 195.9 mg·kg⁻¹, 239.2 mg·kg⁻¹ and 713.2 mg·kg⁻¹) were significantly higher than those in the suburbs (91.6 mg·kg⁻¹, 125.1 mg·kg⁻¹, 131.9 mg·kg⁻¹ and 514.5 mg·kg⁻¹). Enrichment factors and the geo-accumulation index were used to describe the pollution characteristics of dust heavy metals in urban and suburban areas. Results indicated that Zn and Cu were moderately polluting in both urban and suburban areas, Cd was severely polluting in urban areas and heavily polluting in the suburbs. Furthermore, potential ecological risk assessment revealed that the degrees of ecological harm of dust heavy metals were very strong in both urban and suburban areas, but especially in urban areas. The potential ecological risk of heavy metal Cd, whose single factor of ecological damage was extremely strong, accounted for about 90% of the total ecological risk. Full article

(This article belongs to the Collection Environmental Risk Assessment)

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14 pages, 1146 KiB

Open AccessArticle

“It’s a Battle… You Want to Do It, but How Will You Get It Done?”: Teachers’ and Principals’ Perceptions of Implementing Additional Physical activity in School for Academic Performance

by Vera Van den Berg, Rosanne Salimi, Renate H. M. De Groot, Jelle Jolles, Mai J. M. Chinapaw and Amika S. Singh

Int. J. Environ. Res. Public Health 2017, 14(10), 1160; https://doi.org/10.3390/ijerph14101160 - 30 Sep 2017

Cited by 55 | Viewed by 8628

Abstract

School is an ideal setting to promote and increase physical activity (PA) in children. However, implementation of school-based PA programmes seems difficult, in particular due to schools’ focus on academic performance and a lack of involvement of school staff in program development. The [...] Read more.

School is an ideal setting to promote and increase physical activity (PA) in children. However, implementation of school-based PA programmes seems difficult, in particular due to schools’ focus on academic performance and a lack of involvement of school staff in program development. The potential cognitive and academic benefits of PA might increase chances of successful implementation. Therefore, the aim of this qualitative study was: (1) to explore the perceptions of teachers and principals with regard to implementation of additional PA aimed at improving cognitive and academic performance, and (2) to identify characteristics of PA programmes that according to them are feasible in daily school practice. Twenty-six face-to-face semi-structured interviews were conducted with primary school teachers (grades 5 and 6) and principals in The Netherlands, and analysed using inductive content analysis. Teachers and principals expressed their willingness to implement additional PA if it benefits learning. Time constraints appeared to be a major barrier, and strongly influenced participants’ perceptions of feasible PA programmes. Teachers and principals emphasised that additional PA needs to be short, executed in the classroom, and provided in “ready-to-use” materials, i.e., that require no or little preparation time (e.g., a movie clip). Future research is needed to strengthen the evidence on the effects of PA for academic purposes, and should examine the forms of PA that are both effective as well as feasible in the school setting. Full article

(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)

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10 pages, 606 KiB

Open AccessArticle

Higher Mortality in Trauma Patients Is Associated with Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia: A Cross-Sectional Analysis Based on a Propensity-Score Matching Approach

by Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Pao-Jen Kuo and Ching-Hua Hsieh

Int. J. Environ. Res. Public Health 2017, 14(10), 1161; https://doi.org/10.3390/ijerph14101161 - 30 Sep 2017

Cited by 42 | Viewed by 4076

Abstract

Background: Stress-induced hyperglycemia (SIH) is a form of hyperglycemia secondary to stress and commonly occurs in patients with trauma. Trauma patients with SIH have been reported to have an increased risk of mortality. However, information regarding whether these trauma patients with SIH represent [...] Read more.

Background: Stress-induced hyperglycemia (SIH) is a form of hyperglycemia secondary to stress and commonly occurs in patients with trauma. Trauma patients with SIH have been reported to have an increased risk of mortality. However, information regarding whether these trauma patients with SIH represent a distinct group with differential outcomes when compared to those with diabetic hyperglycemia (DH) remains limited. Methods: Diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) ≥6.5%. Non-diabetic normoglycemia (NDN) was determined by a serum glucose level <200 mg/dL in the patients without DM. Diabetic normoglycemia (DN) was determined by a serum glucose level <200 mg/dL in the patients with DM. DH and SIH was diagnosed by a serum glucose level ≥200 mg/dL in the patients with and without DM, respectively. Detailed data of these four groups of hospitalized patients, which included NDN (n = 7806), DN (n = 950), SIH (n = 493), and DH (n = 897), were retrieved from the Trauma Registry System at a level I trauma center between 1 January 2009 and 31 December 2015. Patients with incomplete registered data were excluded. Categorical data were compared with Pearson chi-square tests or two-sided Fisher exact tests. The unpaired Student’s t-test and the Mann–Whitney U-test were used to analyze normally distributed continuous data and non-normally distributed data, respectively. Propensity-score-matched cohorts in a 1:1 ratio were allocated using NCSS software with logistic regression to evaluate the effect of SIH and DH on the outcomes of patients. Results: The SIH (median [interquartile range: Q1–Q3], 13 [9–24]) demonstrated a significantly higher Injury Severity Score (ISS) than NDN (9 [4–10]), DN (9 [4–9]), and DH (9 [5–13]). SIH and DH had a 12.3-fold (95% confidence interval [CI] 9.31–16.14; p < 0.001) and 2.4-fold (95% CI 1.71–3.45; p < 0.001) higher odds of mortality, respectively, when compared to NDN. However, in the selected propensity-score-matched patient population, SIH had a 3.0-fold higher odd ratio of mortality (95% CI 1.96–4.49; p < 0.001) than NDN, but DH did not have a significantly higher mortality (odds ratio 1.2, 95% CI 0.99–1.38; p = 0.065). In addition, SIH had 2.4-fold higher odds of mortality (95% CI 1.46–4.04; p = 0.001) than DH. These results suggest that the characteristics and injury severity of the trauma patients contributed to the higher mortality of these patients with hyperglycemia upon admission, and that the pathophysiological effect of SIH was different from that of DH. Conclusions: Although there were worse mortality outcomes among trauma patients presenting with hyperglycemia, this effect was only seen in patients with SIH, but not DH when controlling for age, sex, pre-existed co-morbidities, and ISS. Full article

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21 pages, 392 KiB

Open AccessArticle

Living Close to Natural Outdoor Environments in Four European Cities: Adults’ Contact with the Environments and Physical Activity

by Margarita Triguero-Mas, David Donaire-Gonzalez, Edmund Seto, Antònia Valentín, Graham Smith, David Martínez, Glòria Carrasco-Turigas, Daniel Masterson, Magdalena Van den Berg, Albert Ambròs, Tania Martínez-Íñiguez, Audrius Dedele, Gemma Hurst, Naomi Ellis, Tomas Grazulevicius, Martin Voorsmit, Marta Cirach, Judith Cirac-Claveras, Wim Swart, Eddy Clasquin, Jolanda Maas, Wanda Wendel-Vos, Michael Jerrett, Regina Gražulevičienė, Hanneke Kruize, Christopher J. Gidlow and Mark J. Nieuwenhuijsen Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2017, 14(10), 1162; https://doi.org/10.3390/ijerph14101162 - 30 Sep 2017

Cited by 29 | Viewed by 6738

Abstract

This study investigated whether residential availability of natural outdoor environments (NOE) was associated with contact with NOE, overall physical activity and physical activity in NOE, in four different European cities using objective measures. A nested cross-sectional study was conducted in Barcelona (Spain); Stoke-on-Trent [...] Read more.

This study investigated whether residential availability of natural outdoor environments (NOE) was associated with contact with NOE, overall physical activity and physical activity in NOE, in four different European cities using objective measures. A nested cross-sectional study was conducted in Barcelona (Spain); Stoke-on-Trent (United Kingdom); Doetinchem (The Netherlands); and Kaunas (Lithuania). Smartphones were used to collect information on the location and physical activity (overall and NOE) of around 100 residents of each city over seven days. We used Geographic Information Systems (GIS) to determine residential NOE availability (presence/absence of NOE within 300 m buffer from residence), contact with NOE (time spent in NOE), overall PA (total physical activity), NOE PA (total physical activity in NOE). Potential effect modifiers were investigated. Participants spent around 40 min in NOE and 80 min doing overall PA daily, of which 11% was in NOE. Having residential NOE availability was consistently linked with higher NOE contact during weekdays, but not to overall PA. Having residential NOE availability was related to NOE PA, especially for our Barcelona participants, people that lived in a city with low NOE availability. Full article

12 pages, 3236 KiB

Open AccessArticle

Modeling of Chromium, Copper, Zinc, Arsenic and Lead Using Portable X-ray Fluorescence Spectrometer Based on Discrete Wavelet Transform

by Fang Li, Anxiang Lu and Jihua Wang

Int. J. Environ. Res. Public Health 2017, 14(10), 1163; https://doi.org/10.3390/ijerph14101163 - 30 Sep 2017

Cited by 17 | Viewed by 5015

Abstract

A modeling method based on discrete wavelet transform (DWT) was introduced to analyze the concentration of chromium, copper, zinc, arsenic and lead in soil with a portable X-ray fluorescence (XRF) spectrometer. A total of 111 soil samples were collected and observed. Denoising and [...] Read more.

A modeling method based on discrete wavelet transform (DWT) was introduced to analyze the concentration of chromium, copper, zinc, arsenic and lead in soil with a portable X-ray fluorescence (XRF) spectrometer. A total of 111 soil samples were collected and observed. Denoising and baseline correction were performed on each spectrum before modeling. The optimum conditions for pre-processing were denoising with Coiflet 3 on the 3rd level and baseline correction with Coiflet 3 on the 9th level. Calibration curves were established for the five heavy metals (HMs). The detection limits were compared before and after the application of DWT, the qualitative detection limits and the quantitative detection limits were calculated to be three and ten times as high as the standard deviation with silicon dioxide (blank), respectively. The results showed that the detection limits of the instrument using DWT were lower, and that they were below national soil standards; the determination coefficients (R²) based on DWT-processed spectra were higher, and ranged from 0.990 to 0.996, indicating a high degree of linearity between the contents of the HMs in soil and the XRF spectral characteristic peak intensity with the instrument measurement. Full article

(This article belongs to the Section Environmental Science and Engineering)

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18 pages, 4481 KiB

Open AccessArticle

Joint Toxicity of Different Heavy Metal Mixtures after a Short-Term Oral Repeated-Administration in Rats

by Hong Su, Zhou Li, Samuel Selorm Fiati Kenston, Hongbo Shi, Yafei Wang, Xin Song, Yuanliang Gu, Tabatha Barber, Joni Aldinger, Baobo Zou, Min Ding, Jinshun Zhao and Xialu Lin

Int. J. Environ. Res. Public Health 2017, 14(10), 1164; https://doi.org/10.3390/ijerph14101164 - 1 Oct 2017

Cited by 28 | Viewed by 4819

Abstract

The systemic toxicity of different combinations of heavy metal mixtures (HMMs) was studied according to equivalent proportions of the eight most common detectable heavy metals found in fish consumption in the Ningbo area of China. The ion mass proportions of Zn, Cu, Mn, [...] Read more.

The systemic toxicity of different combinations of heavy metal mixtures (HMMs) was studied according to equivalent proportions of the eight most common detectable heavy metals found in fish consumption in the Ningbo area of China. The ion mass proportions of Zn, Cu, Mn, Cr, Ni, Cd, Pb, and Hg were 1070.0, 312.6, 173.1, 82.6, 30.0, 13.3, 6.6, and 1.0, respectively. In this study, 10 experimental groups were set as follows: M8 (Pb + Cd + Hg + Ni + Cu + Zn + Mn + Cr); M5 (Pb + Cd + Hg + Ni + Cr); M4A (Pb + Cd + Hg + Ni); M4B (Cu + Zn + Mn + Cr); M3 (Cu + Zn + Mn); Cr; Cu; Zn; Mn; and control. Sprague Dawley (SD) rats were orally treated with a single dose of each group every three days (10 times in total) for 34 days. After Morris water maze test, blood and tissue samples were collected to obtain biochemical, histopathological and western blot analysis. Results show abnormalities could be observed in different treatment groups, the M4B combination had the most significant change compared to all other groups. In conclusion, combination HMMs may have adverse effects on the hematologic, hepatic, renal and neurobehavioral function, and may also disturb electrolyte and lipid balance. Why M4B combination generated much higher toxic effects than any other combination mixtures or individual heavy metal needs to be further evaluated. Full article

(This article belongs to the Section Environmental Health)

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35 pages, 603 KiB

Open AccessArticle

Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria

by Xiao-Wen Qi, Jun-Ling Zhang, Shu-Ping Zhao and Chang-Yong Liang

Int. J. Environ. Res. Public Health 2017, 14(10), 1165; https://doi.org/10.3390/ijerph14101165 - 2 Oct 2017

Cited by 10 | Viewed by 4589

Abstract

In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE [...] Read more.

In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS) to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager’s prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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14 pages, 2821 KiB

Open AccessArticle

Distance, Duration, and Velocity in Cycle Commuting: Analyses of Relations and Determinants of Velocity

by Peter Schantz

Int. J. Environ. Res. Public Health 2017, 14(10), 1166; https://doi.org/10.3390/ijerph14101166 - 2 Oct 2017

Cited by 24 | Viewed by 7980

Abstract

Background: The distance, duration, and velocity of cycling for transport purposes are used in health economic assessments, epidemiological studies, traffic modelling, and planning. It is therefore of value to determine relevant levels for them, and analyze how they relate, as well as [...] Read more.

Background: The distance, duration, and velocity of cycling for transport purposes are used in health economic assessments, epidemiological studies, traffic modelling, and planning. It is therefore of value to determine relevant levels for them, and analyze how they relate, as well as to what extent other relevant variables may affect cycling velocities. 1661 cycle commuters (34% males) in Greater Stockholm, Sweden have been studied for that purpose. Methods: The participants were recruited with advertisements. They received questionnaires and individually adjusted maps to draw their normal cycling route. Route distances were measured by a criterion method. Age, sex, weight, height, and cycling durations to work were self-reported. The commuting routes were positioned in relation to inner urban and/or suburban–rural areas. Linear multiple regression analyses were used. Results: Cycling speeds were positively related to commuting distances or durations, being male, of younger age, having higher body weight but lower body mass index (BMI), and using the last digits 1–4 or 6–9 in duration reports (as compared to 0 and 5), as well as cycling in suburban (versus inner urban) areas. Conclusions: The study provides new knowledge about how distance and duration, as well as other factors, relate to the velocity of commuter cycling. It thereby enables the use of more appropriate input values in, for instance, health economic assessments and epidemiological health studies. Full article

(This article belongs to the Special Issue Sustainable Transportation and Health)

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22 pages, 6381 KiB

Open AccessArticle

Arsenic Removal from Groundwater by Solar Driven Inline-Electrolytic Induced Co-Precipitation and Filtration—A Long Term Field Test Conducted in West Bengal

by Philipp Otter, Pradyut Malakar, Bana Bihari Jana, Thomas Grischek, Florian Benz, Alexander Goldmaier, Ulrike Feistel, Joydev Jana, Susmita Lahiri and Juan Antonio Alvarez

Int. J. Environ. Res. Public Health 2017, 14(10), 1167; https://doi.org/10.3390/ijerph14101167 - 2 Oct 2017

Cited by 20 | Viewed by 7638

Abstract

Arsenic contamination in drinking water resources is of major concern in the Ganga delta plains of West Bengal in India and Bangladesh. Here, several laboratory and field studies on arsenic removal from drinking water resources were conducted in the past and the application [...] Read more.

Arsenic contamination in drinking water resources is of major concern in the Ganga delta plains of West Bengal in India and Bangladesh. Here, several laboratory and field studies on arsenic removal from drinking water resources were conducted in the past and the application of strong-oxidant-induced co-precipitation of arsenic on iron hydroxides is still considered as the most promising mechanism. This paper suggests an autonomous, solar driven arsenic removal setting and presents the findings of a long term field test conducted in West Bengal. The system applies an inline-electrolytic cell for in situ chlorine production using the natural chloride content of the water and by that substituting the external dosing of strong oxidants. Co-precipitation of As(V) occurs on freshly formed iron hydroxide, which is removed by Manganese Greensand Plus^® filtration. The test was conducted for ten months under changing source water conditions considering arsenic (187 ± 45 µg/L), iron (5.5 ± 0.8 mg/L), manganese (1.5 ± 0.4 mg/L), phosphate (2.4 ± 1.3 mg/L) and ammonium (1.4 ± 0.5 mg/L) concentrations. Depending on the system setting removal rates of 94% for arsenic (10 ± 4 µg/L), >99% for iron (0.03 ± 0.03 mg/L), 96% for manganese (0.06 ± 0.05 mg/L), 72% for phosphate (0.7 ± 0.3 mg/L) and 84% for ammonium (0.18 ± 0.12 mg/L) were achieved—without the addition of any chemicals/adsorbents. Loading densities of arsenic on iron hydroxides averaged to 31 µgAs/mgFe. As the test was performed under field conditions and the here proposed removal mechanisms work fully autonomously, it poses a technically feasible treatment alternative, especially for rural areas. Full article

(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)

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19 pages, 1414 KiB

Open AccessArticle

Multi-Elements in Source Water (Drinking and Surface Water) within Five Cities from the Semi-Arid and Arid Region, NW China: Occurrence, Spatial Distribution and Risk Assessment

by Ting Wu, Xiaoping Li, Tao Yang, Xuemeng Sun, Howard W. Mielke, Yue Cai, Yuwei Ai, Yanan Zhao, Dongying Liu, Xu Zhang, Xiaoyun Li, Lijun Wang and Hongtao Yu

Int. J. Environ. Res. Public Health 2017, 14(10), 1168; https://doi.org/10.3390/ijerph14101168 - 2 Oct 2017

Cited by 9 | Viewed by 4541

Abstract

The purpose of this study was to identify the concentration of multi-elements (MEs) in source water (surface and drinking water) and assess their quality for sustainability. A total of 161 water samples including 88 tap drinking waters (DW) and 73 surface waters (SW) [...] Read more.

The purpose of this study was to identify the concentration of multi-elements (MEs) in source water (surface and drinking water) and assess their quality for sustainability. A total of 161 water samples including 88 tap drinking waters (DW) and 73 surface waters (SW) were collected from five cities in Xi’an, Yan’an, Xining, Lanzhou, and Urumqi in northwestern China. Eighteen parameters including pH, electrical conductivity (EC), total organic carbon (TOC) total nitrogen (TN), chemical compositions of anions (F⁻, Cl⁻, NO₃⁻,HCO₃⁻, SO₄²⁻), cations (NH₄⁺, K⁺, Na⁺, Ca²⁺,Mg²⁺), and metals (lead (Pb), chromium (Cr), cadmium (Cd), copper (Cu)) were analyzed in the first time at the five cities . The results showed that pH values and concentrations of Cl⁻, SO₄²⁻, Na⁺, K⁺, Ca²⁺, Mg²⁺ and Cd, Cr, Cu in DW were within the permissible limits of the Chinese Drinking Water Quality Criteria, whereas the concentrations of other ions (F⁻, NO₃⁻, NH₄⁺ and Pb) exceeded their permissible values. In terms of the SW, the concentrations of F⁻, Cl⁻, NO₃⁻, SO₄²⁻ were over the third range threshold i.e., water suitable for fishing and swimming of the Surface Water Quality Standards in China. The spatial distributions of most MEs in source water are similar, and there was no clear variation for all ions and metals. The metals in DW may be caused by water pipes, faucets and their fittings. The noncarcinogenic risk of metals in DW for local children are in decreasing order Cr > Cd > Pb > Cu. The carcinogenic risk from Cr exposure was at the acceptable level according to threshold of USEPA. Although the comprehensive index of potential ecological assessment of Cr, Cd, Pb and Cu in SW ranked at low risk level and was in the order of Huang River in Xining > Peaceful Canal in Urumqi > Yan River in Yan’an > Yellow River in Lanzhou, their adverse effects to ecology and human health at a low concentration in local semi-arid and arid areas should not be ignored in the long run. Full article

(This article belongs to the Section Environmental Health)

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8 pages, 302 KiB

Open AccessArticle

Tigecycline Resistant Klebsiella pneumoniae Isolated from Austrian River Water

by Alexander Hladicz, Clemens Kittinger and Gernot Zarfel

Int. J. Environ. Res. Public Health 2017, 14(10), 1169; https://doi.org/10.3390/ijerph14101169 - 3 Oct 2017

Cited by 14 | Viewed by 5246

Abstract

Abstract: Antibiotic-resistant bacteria are spreading worldwide in medical settings but also in the environment. These resistant bacteria illustrate a major health problem in our times, and last-line antibiotics such as tigecycline represent an ultimate therapy option. Reports on tigecycline non-susceptible Enterobacteriaceae are [...] Read more.

Abstract: Antibiotic-resistant bacteria are spreading worldwide in medical settings but also in the environment. These resistant bacteria illustrate a major health problem in our times, and last-line antibiotics such as tigecycline represent an ultimate therapy option. Reports on tigecycline non-susceptible Enterobacteriaceae are presented with regard to medical settings but are rare with that for the environment. The aim of this study was to characterize two tigecycline non-susceptible Klebsiella pneumoniae isolates from the river Mur, and to question the resistance mechanism. The screening for chromosomal mutations revealed a deletion and a silent point mutation in one isolate and a point mutation in the other isolate all within the ramR allele. RamR acts as repressor and prevents overexpression of ramA. These mutations are likely to cause a resistant phenotype due to the overexpression of AcrAB-TolC. MLST revealed that the isolates belonged to two unrelated MLST types (ST2392 and ST2394). Both isolates only revealed resistance to tigecycline and tetracycline. This is one of the rare reports of tigecycline-resistant Klebsiella pneumoniae from surface water. The presence of two genetically different isolates suggests that the river water may bear substances that favor mutations that can lead to this efflux pump-driven resistance. Full article

(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)

14 pages, 1228 KiB

Open AccessArticle

Housing as a Determinant of Tongan Children’s Health: Innovative Methodology Using Wearable Cameras

by Andrew Robinson, Sarah Hulme-Moir, Viliami Puloka, Moira Smith, James Stanley and Louise Signal

Int. J. Environ. Res. Public Health 2017, 14(10), 1170; https://doi.org/10.3390/ijerph14101170 - 4 Oct 2017

Cited by 5 | Viewed by 4823

Abstract

Housing is a significant determinant of health, particularly in developing countries such as Tonga. Currently, very little is known about the quality of the housing in Tonga, as is the case with many developing countries, nor about the interaction between children and the [...] Read more.

Housing is a significant determinant of health, particularly in developing countries such as Tonga. Currently, very little is known about the quality of the housing in Tonga, as is the case with many developing countries, nor about the interaction between children and the home environment. This study aimed to identify the nature and extent of health risk factors and behaviours in Tongan houses from a child’s perspective. An innovative methodology was used, Kids’Cam Tonga. Seventy-two Class 6 children (10 to 13-year-olds) were randomly selected from 12 randomly selected schools in Tongatapu, the main island. Each participating child wore a wearable camera on lanyards around their neck. The device automatically took wide-angled, 136° images of the child’s perspective every seven seconds. The children were instructed to wear the camera all day from Friday morning to Sunday evening, inclusive. The analysis showed that the majority of Tongan children in the study live in houses that have structural deficiencies and hazards, including water damage (42%), mould (36%), and electrical (89%) and burn risk factors (28%). The findings suggest that improvements to the housing stock may reduce the associated health burden and increase buildings’ resilience to natural hazards. A collaborative approach between communities, community leaders, government and non-governmental organisations (NGOs) is urgently needed. This research methodology may be of value to other developing countries. Full article

(This article belongs to the Special Issue Housing and Health)

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9 pages, 502 KiB

Open AccessArticle

Survey on Tuberculosis Patients in Rural Areas in China: Tracing the Role of Stigma in Psychological Distress

by Minlan Xu, Urban Markström, Juncheng Lyu and Lingzhong Xu

Int. J. Environ. Res. Public Health 2017, 14(10), 1171; https://doi.org/10.3390/ijerph14101171 - 4 Oct 2017

Cited by 32 | Viewed by 4812

Abstract

Depressed patients had risks of non-adherence to medication, which brought a big challenge for the control of tuberculosis (TB). The stigma associated with TB may be the reason for distress. This study aimed to assess the psychological distress among TB patients living in [...] Read more.

Depressed patients had risks of non-adherence to medication, which brought a big challenge for the control of tuberculosis (TB). The stigma associated with TB may be the reason for distress. This study aimed to assess the psychological distress among TB patients living in rural areas in China and to further explore the relation of experienced stigma to distress. This study was a cross-sectional study with multi-stage randomized sampling for recruiting TB patients. Data was collected by the use of interviewer-led questionnaires. A total of 342 eligible and accessible TB patients being treated at home were included in the survey. Psychological distress was measured using the Kessler Psychological Distress Scale (K10). Experienced stigma was measured using a developed nine-item stigma questionnaire. Univariate analysis and multiple logistic regression were used to analyze the variables related to distress, respectively. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to present the strength of the associations. Finally, the prediction of logistic model was assessed in form of the Receiver Operating Characteristic (ROC) curve and the area under the ROC curve (AUC). According to the referred cut-off point from K10, this study revealed that 65.2% (223/342) of the participants were categorized as having psychological distress. Both the stigma questionnaire and the K10 were proven to be reliable and valid in measurement. Further analysis found that experienced stigma and illness severity were significant variables to psychological distress in the model of logistic regression. The model was assessed well in predicting distress by use of experienced stigma and illness severity in form of ROC and AUC. Rural TB patients had a high prevalence of psychological distress. Experience of stigma played a significant role in psychological distress. To move the barrier of stigma from the surroundings could be a good strategy in reducing distress for the patients and TB controlling for public health management. Full article

(This article belongs to the Section Global Health)

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21 pages, 1014 KiB

Open AccessArticle

The Development of Three Questionnaires to Assess Beliefs about Green Exercise

by Elliott P. Flowers, Paul Freeman and Valerie F. Gladwell

Int. J. Environ. Res. Public Health 2017, 14(10), 1172; https://doi.org/10.3390/ijerph14101172 - 4 Oct 2017

Cited by 25 | Viewed by 6192

Abstract

Green exercise is physical activity that takes place in the presence of natural environments. Despite the promising evidence of the benefits, little is known about how individuals’ thoughts and feelings influence participation in green exercise and subsequent outcomes. The aim of the current [...] Read more.

Green exercise is physical activity that takes place in the presence of natural environments. Despite the promising evidence of the benefits, little is known about how individuals’ thoughts and feelings influence participation in green exercise and subsequent outcomes. The aim of the current research was to develop questionnaires using the Theory of Planned Behaviour as a framework that could both directly and indirectly assess attitudes, subjective norms and perceived behaviour control, along with intention toward green exercise. Confirmatory factor analyses confirmed that the indirect, direct, and intention measures all had good overall model fits when tested on a refinement (n = 253) and validation (n = 230) sample. The questionnaires will contribute towards helping to better understanding individuals’ beliefs about green exercise, how these influence behaviour, and ultimately to enable the development of effective interventions promoting green exercise. Full article

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13 pages, 1120 KiB

Open AccessArticle

Environmental Influences on Physical Activity among Rural Adults in Montana, United States: Views from Built Environment Audits, Resident Focus Groups, and Key Informant Interviews

by Brian K. Lo, Emily H. Morgan, Sara C. Folta, Meredith L. Graham, Lynn C. Paul, Miriam E. Nelson, Nicolette V. Jew, Laurel F. Moffat and Rebecca A. Seguin

Int. J. Environ. Res. Public Health 2017, 14(10), 1173; https://doi.org/10.3390/ijerph14101173 - 4 Oct 2017

Cited by 31 | Viewed by 6826

Abstract

Rural populations in the United States have lower physical activity levels and are at a higher risk of being overweight and suffering from obesity than their urban counterparts. This paper aimed to understand the environmental factors that influence physical activity among rural adults [...] Read more.

Rural populations in the United States have lower physical activity levels and are at a higher risk of being overweight and suffering from obesity than their urban counterparts. This paper aimed to understand the environmental factors that influence physical activity among rural adults in Montana. Eight built environment audits, 15 resident focus groups, and 24 key informant interviews were conducted between August and December 2014. Themes were triangulated and summarized into five categories of environmental factors: built, social, organizational, policy, and natural environments. Although the existence of active living features was documented by environmental audits, residents and key informants agreed that additional indoor recreation facilities and more well-maintained and conveniently located options were needed. Residents and key informants also agreed on the importance of age-specific, well-promoted, and structured physical activity programs, offered in socially supportive environments, as facilitators to physical activity. Key informants, however, noted that funding constraints and limited political will were barriers to developing these opportunities. Since building new recreational facilities and structures to support active transportation pose resource challenges, especially for rural communities, our results suggest that enhancing existing features, making small improvements, and involving stakeholders in the city planning process would be more fruitful to build momentum towards larger changes. Full article

(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)

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12 pages, 682 KiB

Open AccessArticle

Simple vs. Complex Carbohydrate Dietary Patterns and the Global Overweight and Obesity Pandemic

by Fabrizio Ferretti and Michele Mariani

Int. J. Environ. Res. Public Health 2017, 14(10), 1174; https://doi.org/10.3390/ijerph14101174 - 4 Oct 2017

Cited by 29 | Viewed by 13576

Abstract

Nowadays, obesity and being overweight are among the major global health concerns. Many, diet-related diseases impose high tangible and intangible costs, and threaten the sustainability of health-care systems worldwide. In this study, we model, at the macroeconomic level, the impact of energy intake [...] Read more.

Nowadays, obesity and being overweight are among the major global health concerns. Many, diet-related diseases impose high tangible and intangible costs, and threaten the sustainability of health-care systems worldwide. In this study, we model, at the macroeconomic level, the impact of energy intake from different types of carbohydrates on the population’s BMI (body mass index). We proceed in three steps. First, we develop a framework to analyse both the consumption choices between simple and complex carbohydrates and the effects of these choices on people health conditions. Second, we collect figures for 185 countries (over the period 2012–2014) regarding the shares of simple (sugar and sweetener) and complex (cereal) carbohydrates in each country’s total dietary energy supply. Third, we use regression techniques to: (1) estimate the impact of these shares on the country’s prevalence of obesity and being overweight; (2) compute for each country an indicator of dietary pattern based on the ratio between simple and complex carbohydrates, weighted by their estimated effects on the prevalence of obesity and being overweight; and (3) measure the elasticity of the prevalence of obesity and being overweight with respect to changes in both carbohydrate dietary pattern and income per capita. We find that unhealthy eating habits and the associated prevalence of excessive body fat accumulation tend to behave as a ‘normal good’ in low, medium- and high-HDI (Human Development Index) countries, but as an ‘inferior good’ in very high-HDI countries. Full article

(This article belongs to the Special Issue The International Healthcare Industry Supply in a Changing Global Demand)

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10 pages, 313 KiB

Open AccessArticle

Development and Preliminary Validation of Refugee Trauma History Checklist (RTHC)—A Brief Checklist for Survey Studies

by Erika Sigvardsdotter, Henrik Nilsson, Andreas Malm, Petter Tinghög, Maria Gottvall, Marjan Vaez and Fredrik Saboonchi

Int. J. Environ. Res. Public Health 2017, 14(10), 1175; https://doi.org/10.3390/ijerph14101175 - 4 Oct 2017

Cited by 34 | Viewed by 6858

Abstract

A high proportion of refugees have been subjected to potentially traumatic experiences (PTEs), including torture. PTEs, and torture in particular, are powerful predictors of mental ill health. This paper reports the development and preliminary validation of a brief refugee trauma checklist applicable for [...] Read more.

A high proportion of refugees have been subjected to potentially traumatic experiences (PTEs), including torture. PTEs, and torture in particular, are powerful predictors of mental ill health. This paper reports the development and preliminary validation of a brief refugee trauma checklist applicable for survey studies. Methods: A pool of 232 items was generated based on pre-existing instruments. Conceptualization, item selection and item refinement was conducted based on existing literature and in collaboration with experts. Ten cognitive interviews using a Think Aloud Protocol (TAP) were performed in a clinical setting, and field testing of the proposed checklist was performed in a total sample of n = 137 asylum seekers from Syria. Results: The proposed refugee trauma history checklist (RTHC) consists of 2 × 8 items, concerning PTEs that occurred before and during the respondents’ flight, respectively. Results show low item non-response and adequate psychometric properties Conclusion: RTHC is a usable tool for providing self-report data on refugee trauma history surveys of community samples. The core set of included events can be augmented and slight modifications can be applied to RTHC for use also in other refugee populations and settings. Full article

(This article belongs to the Special Issue Refugee Health)

13 pages, 770 KiB

Open AccessArticle

Commuting, Life-Satisfaction and Internet Addiction

by Bernd Lachmann, Rayna Sariyska, Christopher Kannen, Maria Stavrou and Christian Montag

Int. J. Environ. Res. Public Health 2017, 14(10), 1176; https://doi.org/10.3390/ijerph14101176 - 5 Oct 2017

Cited by 30 | Viewed by 7601

Abstract

The focus of the present work was on the association between commuting (business and private), life satisfaction, stress, and (over-) use of the Internet. Considering that digital devices are omnipresent in buses and trains, no study has yet investigated if commuting contributes to [...] Read more.

The focus of the present work was on the association between commuting (business and private), life satisfaction, stress, and (over-) use of the Internet. Considering that digital devices are omnipresent in buses and trains, no study has yet investigated if commuting contributes to the development of Internet addiction. Overall, N = 5039 participants (N = 3477 females, age M = 26.79, SD = 10.68) took part in an online survey providing information regarding their commuting behavior, Internet addiction, personality, life satisfaction, and stress perception. Our findings are as follows: Personality seems to be less suitable to differentiate between commuter and non-commuter groups, which is possibly due to commuters often not having a choice but simply must accept offered job opportunities at distant locations. Second, the highest levels of satisfaction were found with income and lodging in the group commuting for business purposes. This might be related to the fact that commuting results in higher salaries (hence also better and more expensive housing style) due to having a job in another city which might exceed job opportunities at one’s own living location. Third, within the business-commuters as well as in the private-commuter groups, females had significantly higher levels of stress than males. This association was not present in the non-commuter group. For females, commuting seems to be a higher burden and more stressful than for males, regardless of whether they commute for business or private reasons. Finally, we observed an association between higher stress perception (more negative attitude towards commuting) and Internet addiction. This finding suggests that some commuters try to compensate their perceived stress with increased Internet use. Full article

(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)

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12 pages, 1754 KiB

Open AccessArticle

Inhibitory Effects of 3,4-Dimethylpyrazole Phosphate on CH4 and N2O Emissions in Paddy Fields of Subtropical China

by Shan Yin, Xianxian Zhang, Zaidi Jiang, Penghua Zhu, Changsheng Li and Chunjiang Liu

Int. J. Environ. Res. Public Health 2017, 14(10), 1177; https://doi.org/10.3390/ijerph14101177 - 5 Oct 2017

Cited by 15 | Viewed by 4102

Abstract

3,4-Dimethylpyrazole phosphate (DMPP) has been widely employed to reduce nitrogen leaching and greenhouse gas emissions in the soils of dry farmlands. However, the effects of DMPP on the dynamics of nitrogen in paddy fields remain unclear. For this study, treatments with 0%, 0.25%, [...] Read more.

3,4-Dimethylpyrazole phosphate (DMPP) has been widely employed to reduce nitrogen leaching and greenhouse gas emissions in the soils of dry farmlands. However, the effects of DMPP on the dynamics of nitrogen in paddy fields remain unclear. For this study, treatments with 0%, 0.25%, 0.5%, 1%, or 1.5% DMPP levels of nitrogen fertilization plus urea were designed to determine the effects on greenhouse gas emissions in paddy fields of subtropical China. All DMPP treatments significantly reduced CH4 and N2O emissions, from 54% to 34%, and 94% to 39%, respectively, compared with a urea fertilizer treatment alone. The soil NH4+ content decreased and NO3− increased more slowly with the application of DMPP. The crop yields under the various DMPP treatments showed no significant difference (p < 0.05). We concluded that the application of 0.5% and 1% DMPP may significantly reduce CH4 and N2O emissions in contrast to other treatments. This has important implications for the maintenance of rice yields, while reducing greenhouse gas emissions in paddy fields. Full article

(This article belongs to the Section Environmental Health)

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18 pages, 347 KiB

Open AccessArticle

The Impact of a School-Based Weight Management Program Involving Parents via mHealth for Overweight and Obese Children and Adolescents with Intellectual Disability: A Randomized Controlled Trial

by Regina Lai-Tong Lee, Cynthia Leung, Hong Chen, Lobo H. T. Louie, Michael Brown, Jyu-Lin Chen, Gordon Cheung and Paul H. Lee

Int. J. Environ. Res. Public Health 2017, 14(10), 1178; https://doi.org/10.3390/ijerph14101178 - 5 Oct 2017

Cited by 27 | Viewed by 6903

Abstract

There is a scarcity of resources and studies that utilize targeted weight management interventions to engage parents via mHealth tools targeting obese children and adolescents with mild intellectual disabilities (MIDs) extended from school to a home setting. To test the feasibility and acceptability [...] Read more.

There is a scarcity of resources and studies that utilize targeted weight management interventions to engage parents via mHealth tools targeting obese children and adolescents with mild intellectual disabilities (MIDs) extended from school to a home setting. To test the feasibility and acceptability of a school-based weight program (SBWMP) involving parents via mHealth tools designed to reduce weight, enhance knowledge and adopt healthy lifestyles, and thereby achieve better psychosocial well-being among children and adolescents with MIDs. Four special schools were randomly assigned as intervention or control schools. Students from the intervention group (n = 63) were compared to those in the control group (n = 52), which comprised those with usual school planned activities and no parental involvement. Demographics were considered as covariates in a general linear model, an ordinal regression model and a binary logistic regression model analyzing the relationships between the SBWMP and the outcome variables at baseline (T0) and six months later (T1). Body weight, body mass index, and triceps and subscapular skinfold thickness were lower in the intervention group compared to the control group, although the differences were not statistically significant. There was a positive and direct impact of the SBWMP on students’ health knowledge and psychological impacts in the intervention group. The SBWMP extended to the home involving parents via mHealth tools is a feasible and acceptable program for this group with MIDs and their parents. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

21 pages, 2433 KiB

Open AccessArticle

Restructuring the Production of Medicines: An Investigation on the Pharmaceutical Sector in China and the Role of Mergers and Acquisitions

by Elisa Barbieri, Manli Huang, Shenglei Pi and Mattia Tassinari

Int. J. Environ. Res. Public Health 2017, 14(10), 1179; https://doi.org/10.3390/ijerph14101179 - 5 Oct 2017

Cited by 14 | Viewed by 6430

Abstract

In places like China, an ageing population coupled with changes in living standards and increases in disposable income, imply a shift of the demand for health-related goods and services which is likely to affect the whole organization of the industries that supply such [...] Read more.

In places like China, an ageing population coupled with changes in living standards and increases in disposable income, imply a shift of the demand for health-related goods and services which is likely to affect the whole organization of the industries that supply such goods and services at the global level. One of the industries most likely to be affected is the pharmaceutical sector. In the early 2000s China was already the second largest global producer of pharmaceutical ingredients. The pharmaceutical sector has become one of the most important industries promoted by the Chinese government and Five-Year Plan of China’s Strategic Emerging Sectors, mergers and acquisition (M&A) activity has been the key strategy to restructure the sector and increase its competitiveness. This paper firstly provides an updated picture of the evolution of M&As in the pharmaceutical sector, compared to other sectors, in China in the period 2005–2013. Secondly, we develop a composite indicator to measure the industrial performance of all Chinese industrial sectors over time, which allows us to assess the performance of the pharmaceutical industry compared to that of other sectors of the Chinese economy. Finally, we develop and estimate an empirical model that tests the relationship between the number of M&A in a sector and its performance, with a particular focus on the pharmaceutical case. The results offer some initial evidence of positive effects from the process of restructuring of the pharmaceutical sector in China. Full article

(This article belongs to the Special Issue The International Healthcare Industry Supply in a Changing Global Demand)

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12 pages, 323 KiB

Open AccessArticle

Negative Peer Relationships on Piracy Behavior: A Cross-Sectional Study of the Associations between Cyberbullying Involvement and Digital Piracy

by Santiago Yubero, Elisa Larrañaga, Beatriz Villora and Raúl Navarro

Int. J. Environ. Res. Public Health 2017, 14(10), 1180; https://doi.org/10.3390/ijerph14101180 - 5 Oct 2017

Cited by 12 | Viewed by 7329

Abstract

The present study examines the relationship between different roles in cyberbullying behaviors (cyberbullies, cybervictims, cyberbullies-victims, and uninvolved) and self-reported digital piracy. In a region of central Spain, 643 (49.3% females, 50.7% males) students (grades 7–10) completed a number of self-reported measures, including cyberbullying [...] Read more.

The present study examines the relationship between different roles in cyberbullying behaviors (cyberbullies, cybervictims, cyberbullies-victims, and uninvolved) and self-reported digital piracy. In a region of central Spain, 643 (49.3% females, 50.7% males) students (grades 7–10) completed a number of self-reported measures, including cyberbullying victimization and perpetration, self-reported digital piracy, ethical considerations of digital piracy, time spent on the Internet, and leisure activities related with digital content. The results of a series of hierarchical multiple regression models for the whole sample indicate that cyberbullies and cyberbullies-victims are associated with more reports of digital piracy. Subsequent hierarchical multiple regression analyses, done separately for males and females, indicate that the relationship between cyberbullying and self-reported digital piracy is sustained only for males. The ANCOVA analysis show that, after controlling for gender, self-reported digital piracy and time spent on the Internet, cyberbullies and cyberbullies-victims believe that digital piracy is a more ethically and morally acceptable behavior than victims and uninvolved adolescents believe. The results provide insight into the association between two deviant behaviors. Full article

(This article belongs to the Special Issue Youth Violence as a Public Health Issue)

12 pages, 1581 KiB

Open AccessArticle

Foster Care Dynamics and System Science: Implications for Research and Policy

by Fred Wulczyn and John Halloran

Int. J. Environ. Res. Public Health 2017, 14(10), 1181; https://doi.org/10.3390/ijerph14101181 - 5 Oct 2017

Cited by 11 | Viewed by 4989

Abstract

Although system is a word frequently invoked in discussions of foster care policy and practice, there have been few if any attempts by child welfare researchers to understand the ways in which the foster care system is a system. As a consequence, insights [...] Read more.

Although system is a word frequently invoked in discussions of foster care policy and practice, there have been few if any attempts by child welfare researchers to understand the ways in which the foster care system is a system. As a consequence, insights from system science have yet to be applied in meaningful ways to the problem of making foster care systems more effective. In this study, we draw on population biology to organize a study of admissions and discharges to foster care over a 15-year period. We are interested specifically in whether resource constraints, which are conceptualized here as the number of beds, lead to a coupling of admissions and discharges within congregate care. The results, which are descriptive in nature, are consistent with theory that ties admissions and discharges together because of a resource constraint. From the data, it is clear that the underlying system exerts an important constraint on what are normally viewed as individual-level decisions. Our discussion calls on extending efforts to understand the role of system science in studies of child welfare systems, with a particular emphasis on the role of feedback as a causal influence. Full article

(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)

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10 pages, 280 KiB

Open AccessArticle

Changing the Smoking Trajectory: Evaluating the Impact of School-Based Tobacco Interventions on Changes to Susceptibility to Future Smoking

by Adam G. Cole, Wei Qian and Scott T. Leatherdale

Int. J. Environ. Res. Public Health 2017, 14(10), 1182; https://doi.org/10.3390/ijerph14101182 - 5 Oct 2017

Cited by 8 | Viewed by 5410

Abstract

School-based programs and policies can reduce student smoking rates. However, their impact on never-smoking students has not been investigated despite the clear transition between non-susceptible, susceptible, and ever tried smoking statuses. The objective of this paper was to examine the longitudinal student-level impact [...] Read more.

School-based programs and policies can reduce student smoking rates. However, their impact on never-smoking students has not been investigated despite the clear transition between non-susceptible, susceptible, and ever tried smoking statuses. The objective of this paper was to examine the longitudinal student-level impact of six changes in school-based tobacco control programs and policies on student transitions in susceptibility to smoking over one year. Two multinomial logistic regression models identified the relative risk of a change in self-reported susceptibility to smoking or in trying a cigarette among never-smoking students in each of the six intervention schools compared to the relative risk among never-smoking students in control schools. Model 1 identified the relative risk of a change in smoking susceptibility status among baseline non-susceptible never smoking students, while Model 2 identified the relative risk of a change in smoking susceptibility status among baseline susceptible never smoking students. Students at some intervention schools were at increased risk of becoming susceptible to or trying a cigarette at one year follow-up. Intervention studies should examine changes to susceptibility to future smoking when evaluating impact to ensure that school-based tobacco control programs and policies do not negatively change the risk status of never-smoking students. Full article

11 pages, 926 KiB

Open AccessArticle

Effect of Health Messages on Alcohol Attitudes and Intentions in a Sample of 16–17-Year-Old Underage Drinkers

by Antony C. Moss, Stephen Evans and Ian P. Albery

Int. J. Environ. Res. Public Health 2017, 14(10), 1183; https://doi.org/10.3390/ijerph14101183 - 5 Oct 2017

Cited by 7 | Viewed by 4865

Abstract

Background: Responsible drinking messages (RDMs) are a key component of many education-based interventions for reducing alcohol harms. The evidence base for the effectiveness of RDMs is extremely limited, with some recent research suggesting iatrogenic effects of such messages. Objective: To examine [...] Read more.

Background: Responsible drinking messages (RDMs) are a key component of many education-based interventions for reducing alcohol harms. The evidence base for the effectiveness of RDMs is extremely limited, with some recent research suggesting iatrogenic effects of such messages. Objective: To examine the effects of exposure to health messages on attitudes towards drinking and drunkenness, and intentions to drink and get drunk, amongst underage drinkers. Methods: Ninety-four underage drinkers were recruited from colleges in the UK. Participants were either actively or passively exposed to one of two health messages (RDM or general wellbeing). Measures of attitudes and intentions towards drinking and drunkenness were obtained one week before and immediately after participation in the study. A unit estimation task was also included. Results: Active exposure to RDMs led to more positive attitude towards drunkenness, while passive exposure led to more negative attitudes. Passive RDM exposure led to increased intentions to get drunk in future. Wellbeing posters produced the opposite effect in some but not all of these measures. Conclusions: Exposure to RDMs may have some beneficial effects in terms of creating more negative attitudes towards alcohol consumption, but we also identified potential iatrogenic effects regarding attitudes and intentions towards drunkenness amongst an underage sample of drinkers. Further research is required to better understand optimal ways of framing RDMs to produce positive changes in attitudes, intentions, and prospective drinking behaviour. Full article

(This article belongs to the Special Issue Alcohol and Health)

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7 pages, 247 KiB

Open AccessArticle

Subsistence Food Production Practices: An Approach to Food Security and Good Health

by Sejabaledi A. Rankoana

Int. J. Environ. Res. Public Health 2017, 14(10), 1184; https://doi.org/10.3390/ijerph14101184 - 5 Oct 2017

Cited by 10 | Viewed by 4900

Abstract

Food security is a prerequisite for health. Availability and accessibility of food in rural areas is mainly achieved through subsistence production in which community members use local practices to produce and preserve food. Subsistence food production ensures self-sufficiency and reduction of poverty and [...] Read more.

Food security is a prerequisite for health. Availability and accessibility of food in rural areas is mainly achieved through subsistence production in which community members use local practices to produce and preserve food. Subsistence food production ensures self-sufficiency and reduction of poverty and hunger. The main emphasis with the present study is examining subsistence farming and collection of edible plant materials to fulfill dietary requirements, thereby ensuring food security and good health. Data collected from a purposive sample show that subsistence crops produced in the home-gardens and fields, and those collected from the wild, are sources of grain, vegetables and legumes. Sources of grain and legumes are produced in the home-gardens and fields, whereas vegetables sources are mostly collected in the wild and fewer in the home-gardens. These food sources have perceived health potential in child and maternal care of primary health care. Full article

(This article belongs to the Section Global Health)

10 pages, 619 KiB

Open AccessArticle

Histopathology of Cervical Cancer and Arsenic Concentration in Well Water: An Ecological Analysis

by Mohammad Golam Mostafa, Zarat Jahin Queen and Nicola Cherry

Int. J. Environ. Res. Public Health 2017, 14(10), 1185; https://doi.org/10.3390/ijerph14101185 - 6 Oct 2017

Cited by 5 | Viewed by 4781

Abstract

Arsenic in drinking water is causally linked with cancer of the skin, lung, and urinary bladder, but there is very little data on a possible role for arsenic in the etiology of cervical cancer, a disease in which human papilloma virus is held [...] Read more.

Arsenic in drinking water is causally linked with cancer of the skin, lung, and urinary bladder, but there is very little data on a possible role for arsenic in the etiology of cervical cancer, a disease in which human papilloma virus is held to be a necessary but not sufficient cause. All histopathology results from cervical specimens from the National Institute of Cancer Research and Hospital (NICRH), Dhaka (1997–2015), and the Anowara Medical Services (2003–2015), both serving the whole of Bangladesh, were classified by cell type. Arsenic concentrations in well water in the thana of residence were estimated from systematic sampling carried out by the British Geological Survey. In a case-referent analysis arsenic estimates for cases of cervical cancer were compared with those found to have benign lesions. In this study, 3464 NICRH (CH) cervical specimens and 30,050 community medical service (CMS) specimens were available: 3329 (CH) and 899 (CMS) were recorded as malignant. Most were squamous cell carcinoma, of which 4.9% were poorly differentiated. Overall, there was no increase in cervical cancer with increasing arsenic concentration. Among those with squamous cell histology, a strong dose response was seen for poorly differentiated cancer with increasing arsenic exposure. The odds ratio increased monotonically, compared with exposure <10 μg/L, from 1.58 at 10 < 50 μg/L to 8.11 at >200 μg/L (p < 0.001). Given the high proportion of Bangladeshis using drinking water containing >50 μg/L of arsenic, the evidence that arsenic is implicated in cancer grade suggests a need for further investigation and the introduction of cervical screening in high arsenic areas. Full article

(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)

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10 pages, 1845 KiB

Open AccessArticle

Contribution of Drinking Water Softeners to Daily Phosphate Intake in Slovenia

by Gregor Jereb, Borut Poljšak and Ivan Eržen

Int. J. Environ. Res. Public Health 2017, 14(10), 1186; https://doi.org/10.3390/ijerph14101186 - 6 Oct 2017

Cited by 8 | Viewed by 7191

Abstract

The cumulative phosphate intake in a typical daily diet is high and, according to several studies, already exceeds recommended values. The exposure of the general population to phosphorus via drinking water is generally not known. One of the hidden sources of phosphorus in [...] Read more.

The cumulative phosphate intake in a typical daily diet is high and, according to several studies, already exceeds recommended values. The exposure of the general population to phosphorus via drinking water is generally not known. One of the hidden sources of phosphorus in a daily diet is sodium polyphosphate, commonly used as a drinking water softener. In Slovenia, softening of drinking water is carried out exclusively within the internal (household) drinking water supply systems to prevent the accumulation of limescale. The aim of the study was to determine the prevalence of sodium phosphates in the drinking water in Slovenia in different types of buildings, to determine residents’ awareness of the presence of chemical softeners in their drinking water, and to provide an exposure assessment on the phosphorus intake from drinking water. In the current study, the presence of phosphates in the samples of drinking water was determined using a spectrophotometric method with ammonium molybdate. In nearly half of the samples, the presence of phosphates as water softeners was confirmed. The measured concentrations varied substantially from 0.2 mg PO4/L to 24.6 mg PO4/L. Nearly 70% of the respondents were not familiar with the exact data on water softening in their buildings. It follows that concentrations of added phosphates should be controlled and the consumers should be informed of the added chemicals in their drinking water. The health risks of using sodium polyphosphate as a drinking water softener have not been sufficiently investigated and assessed. It is highly recommended that proper guidelines and regulations are developed and introduced to protect human health from adverse effects of chemicals in water intended for human consumption. Full article

(This article belongs to the Section Environmental Science and Engineering)

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14 pages, 3791 KiB

Open AccessArticle

A Novel and Native Microcystin-Degrading Bacterium of Sphingopyxis sp. Isolated from Lake Taihu

by Juan Zhang, Qingqing Lu, Qin Ding, Lihong Yin and Yuepu Pu

Int. J. Environ. Res. Public Health 2017, 14(10), 1187; https://doi.org/10.3390/ijerph14101187 - 6 Oct 2017

Cited by 32 | Viewed by 5215

Abstract

A native, highly efficient microcystin-LR (MC-LR)-degrading bacterium named a7 was isolated from Lake Taihu and identified as Sphingopyxis sp. by 16S rDNA sequence analysis. The strain a7 could totally degrade MC-LR at a rate of 3.33 mg/(L•h), as detected by high-performance liquid chromatography [...] Read more.

A native, highly efficient microcystin-LR (MC-LR)-degrading bacterium named a7 was isolated from Lake Taihu and identified as Sphingopyxis sp. by 16S rDNA sequence analysis. The strain a7 could totally degrade MC-LR at a rate of 3.33 mg/(L•h), as detected by high-performance liquid chromatography (HPLC). The mlrA, mlrC, and mlrD genes were detected in the strain a7 by sequence analysis. Tetrapeptide and Adda—which are the middle metabolites of MC-LR—were analyzed via liquid chromatography time-of-flight mass spectrometry (LC-TOF-MS) during degradation. These metabolites were degraded completely, which suggested that the native Sphingopyxis sp. a7 was highly efficient in MC-LR degradation under bench conditions. Thus, strain a7 exhibited a significant potential application for bioremediation in water bodies contaminated by MC-LR produced by harmful cyanobacterial blooms. Full article

(This article belongs to the Special Issue Microbiological Evaluation of Wastewater Treatment)

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13 pages, 317 KiB

Open AccessArticle

Baseline Assessment of a Healthy Corner Store Initiative: Associations between Food Store Environments, Shopping Patterns, Customer Purchases, and Dietary Intake in Eastern North Carolina

by Stephanie B. Jilcott Pitts, Qiang Wu, Kimberly P. Truesdale, Melissa N. Laska, Taras Grinchak, Jared T. McGuirt, Lindsey Haynes-Maslow, Ronny A. Bell and Alice S. Ammerman

Int. J. Environ. Res. Public Health 2017, 14(10), 1189; https://doi.org/10.3390/ijerph14101189 - 7 Oct 2017

Cited by 20 | Viewed by 6110

Abstract

In 2016, the North Carolina (NC) Legislature allocated $250,000 to the NC Department of Agriculture, to identify and equip small food retailers to stock healthier foods and beverages in eastern NC food deserts (the NC Healthy Food Small Retailer Program, HFSRP). The purpose [...] Read more.

In 2016, the North Carolina (NC) Legislature allocated $250,000 to the NC Department of Agriculture, to identify and equip small food retailers to stock healthier foods and beverages in eastern NC food deserts (the NC Healthy Food Small Retailer Program, HFSRP). The purpose of this study was to examine associations between food store environments, shopping patterns, customer purchases, and dietary consumption among corner store customers. We surveyed 479 customers in 16 corner stores regarding demographics, food purchased, shopping patterns, and self-reported fruit, vegetable, and soda consumption. We objectively assessed fruit and vegetable consumption using a non-invasive reflection spectroscopy device to measure skin carotenoids. We examined associations between variables of interest, using Pearson’s correlation coefficients and adjusted linear regression analyses. A majority (66%) of participants were African American, with a mean age of 43 years, and a mean body mass index (BMI) of 30.0 kg/m². There were no significant associations between the healthfulness of food store offerings, customer purchases, or dietary consumption. Participants who said they had purchased fruits and vegetables at the store previously reported higher produce intake (5.70 (4.29) vs. 4.60 (3.28) servings per day, p = 0.021) versus those who had not previously purchased fresh produce. The NC Legislature has allocated another $250,000 to the HFSRP for the 2018 fiscal year. Thus, evaluation results will be important to inform future healthy corner store policies and initiatives. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

12 pages, 3319 KiB

Open AccessArticle

Investigation of Oxidation Methods for Waste Soy Sauce Treatment

by Hyun-Hee Jang, Gyu-Tae Seo and Dae-Woon Jeong

Int. J. Environ. Res. Public Health 2017, 14(10), 1190; https://doi.org/10.3390/ijerph14101190 - 7 Oct 2017

Cited by 7 | Viewed by 4722

Abstract

To obtain a suitable oxidation method for removing the color and lowering the chemical oxygen demand (COD) of waste soy sauce, Fenton (Fe²⁺), Fenton-like (Fe³⁺), and ozone (O₃) oxidation methods are used as the target reactions. In [...] Read more.

To obtain a suitable oxidation method for removing the color and lowering the chemical oxygen demand (COD) of waste soy sauce, Fenton (Fe²⁺), Fenton-like (Fe³⁺), and ozone (O₃) oxidation methods are used as the target reactions. In experimental conditions for Fenton oxidation, the dose of Fe²⁺ and Fe³⁺ was varied between 100 mg/L and 300 mg/L. The dose of hydrogen peroxide for the reaction was injected from 100–1000 mg/L. For ozone oxidation, the pH was increased from 3 to 14 and the O₃-containing gas was supplied continuously for 30 min through a gas diffuser at the bottom of the reactor at different applied O₃ doses (10–90 mg/L). We subjected it to a simple 1:20 dilution with deionized water to identify the comparison result in detail. O₃oxidation shows the highest efficiencies of color removal (81.1%) and COD lowering (64.9%) among the three oxidation methods. This is mainly due to the fact that it has a relatively large amount of hydroxyl radical, resulting in the degradation of organics. Thus, O₃ oxidation could be a promising method for removing the color and lowering the COD of waste soy sauce. The critical parameters (pH and applied O₃ dose) were varied systematically to optimize O₃ oxidation. It was found that the optimum pH and applied O₃ dose are 11.0 mg/L and 50.0 mg/L, respectively (color removal = 34.2%, COD removal = 27.4%). Full article

(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)

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11 pages, 304 KiB

Open AccessArticle

Impact of Living Alone on Depressive Symptoms in Older Korean Widows

by Gyeong-Suk Jeon, Kyungwon Choi and Sung-Il Cho

Int. J. Environ. Res. Public Health 2017, 14(10), 1191; https://doi.org/10.3390/ijerph14101191 - 7 Oct 2017

Cited by 24 | Viewed by 4282

Abstract

We examined the relationship between living alone and the prevalence of depressive symptoms in older Korean widows and assessed the individual contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. The study was a secondary analysis using data [...] Read more.

We examined the relationship between living alone and the prevalence of depressive symptoms in older Korean widows and assessed the individual contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. The study was a secondary analysis using data from widows, 65 years of age and older, who participated in the Living Profiles of Older People Survey (LPOPS). A logistic regression analysis was used to evaluate the contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. Working status and equivalent household income were significantly associated with depressive symptoms in both those living with others and those living alone. Adjustment for health status and social ties did not change the impact of living alone on the prevalence of depressive symptoms. However, adjustment for equivalent household income eliminated the negative association between living alone and depressive symptoms. Our findings indicate that economic resources are more important than health and social ties for alleviating the negative impact of living alone on the development of depressive symptoms in older widows. Full article

14 pages, 812 KiB

Open AccessArticle

Analysis of Transmission and Control of Tuberculosis in Mainland China, 2005–2016, Based on the Age-Structure Mathematical Model

by Yu Zhao, Mingtao Li and Sanling Yuan

Int. J. Environ. Res. Public Health 2017, 14(10), 1192; https://doi.org/10.3390/ijerph14101192 - 7 Oct 2017

Cited by 67 | Viewed by 6741

Abstract

Tuberculosis (TB), an air-borne infectious disease, is a major public-health problem in China. The reported number of the active tuberculosis cases is about one million each year. The morbidity data for 2005–2012 reflect that the difference in morbidity based on age group is [...] Read more.

Tuberculosis (TB), an air-borne infectious disease, is a major public-health problem in China. The reported number of the active tuberculosis cases is about one million each year. The morbidity data for 2005–2012 reflect that the difference in morbidity based on age group is significant, thus the role of age-structure on the transmission of TB needs to be further developed. In this work, based on the reported data and the observed morbidity characteristics, we propose a susceptible-exposed-infectious-recovered (SEIR) epidemic model with age groupings, involving three categories: children, the middle-aged, and senior to investigate the role of age on the transmission of tuberculosis in Mainland China from 2005 to 2016. Then, we evaluated the parameters by the Least Square method and simulated the model and it had good alignment with the reported infected TB data in Mainland China. Furthermore, we estimated the basic reproduction number R₀ of 1.7858, with an obtained 95% confidence interval for R₀ of (1.7752, 1.7963) by Latin hypercube sampling, and we completed a sensitivity analysis of R₀ in terms of some parameters. Our study demonstrates that diverse age groups have different effects on TB. Two effective measures were found that would help reach the goals of theWorld Health Organization (WHO) End TB Strategy: an increase in the recovery rate and the reduction in the infectious rate of the senior age group. Full article

(This article belongs to the Special Issue Natural Hazards and Public Health: A Systems Approach)

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14 pages, 1710 KiB

Open AccessArticle

Comparison of Health Risk Assessments of Heavy Metals and As in Sewage Sludge from Wastewater Treatment Plants (WWTPs) for Adults and Children in the Urban District of Taiyuan, China

by Baoling Duan, Wuping Zhang, Haixia Zheng, Chunyan Wu, Qiang Zhang and Yushan Bu

Int. J. Environ. Res. Public Health 2017, 14(10), 1194; https://doi.org/10.3390/ijerph14101194 - 8 Oct 2017

Cited by 63 | Viewed by 5363

Abstract

Abstract: To compare the human health risk of heavy metals and As in sewage sludge between adults and children, samples were collected from five wastewater treatment plants (WWTPs) located in the urban district of Taiyuan, the capital of Shanxi. Heavy metals and [...] Read more.

Abstract: To compare the human health risk of heavy metals and As in sewage sludge between adults and children, samples were collected from five wastewater treatment plants (WWTPs) located in the urban district of Taiyuan, the capital of Shanxi. Heavy metals and As in sewage sludge can be ranked according to the mean concentration in the following order: Cu > Cr > Zn > Pb > As > Hg > Cd. Compared with the concentration limit set by different countries, the heavy metals contents in sewage sludge were all within the standard limits, except for the content of As, which was higher than the threshold limit established by Canada. A health risk assessment recommended by the United States Environmental Protection Agency (USEPA) was used to compare the non-cancer risk and cancer risk between adults and children. Based on the mean and 95% upper confidence limit (UCL) of the average daily dose (ADD), heavy metals and As can be ranked in the order of Cu > Cr > Zn > Pb > As > Hg > Cd for adults, and Cu > Cr > Zn > Pb > Hg > As > Cd for children. Moreover, results of ADD_ingest and ADD_inhale indicated that ingestion was the main pathway for heavy metals and As exposure for both adults and children, and the sum of ADD implied that the exposure to all heavy metals and As for children was 8.65 and 9.93 times higher, respectively, than that for adults according to the mean and 95% UCL. For the non-carcinogenic risk, according to the hazard quotient (HQ), the risk of Cu, Hg and Cr was higher than the risk of Zn and Pb. The hazard index (HI) for adults was 0.144 and 0.208 for the mean and 95% UCL, which was less than the limit value of 1; for children, the HI was 1.26 and 2.25, which is higher than the limit value of 1. This result indicated that children had non-carcinogenic risk, but adults did not. Furthermore, ingestion was the main pathway for non-carcinogenic risk exposure by the HQ_ingest and HQ_inhale. For the carcinogenic risk, Cd and As were classified as carcinogenic pollutants. The values of RISK for the mean and 95% UCL for adults and children all exceeded the limit value of 1 × 10⁻⁵, which implied that adults and children had a carcinogenic risk, and this risk was higher for children than for adults. The results of RISK for As and Cd implied that As was the main pollutant for carcinogenic risk. Moreover, the results of RISK_ingest and RISK_inhale indicated that ingestion was the main pathway. Uncertainty analysis was performed, and the risk ranges of it were greater than certainty analysis, which implied that uncertainty analysis was more conservative than certainty analysis. A comparison of the non-carcinogenic risk and carcinogenic risk for adults and children indicated that children were more sensitive and vulnerable than adults when exposed to the same pollutant in the environment. Full article

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16 pages, 9037 KiB

Open AccessArticle

Relationships among Environment, Climate, and Longevity in China

by Yi Huang, Mark Rosenberg, Lingli Hou and Mengjin Hu

Int. J. Environ. Res. Public Health 2017, 14(10), 1195; https://doi.org/10.3390/ijerph14101195 - 8 Oct 2017

Cited by 24 | Viewed by 5976

Abstract

Human longevity is influenced by environment and nutrition. We considered environmental and nutritional factors relating to longevity in Chinese cities. We found higher 85+/65+ distribution ratios, indicating enhanced longevity, in the coastal and southern regions of China. These areas also featured higher humidity, [...] Read more.

Human longevity is influenced by environment and nutrition. We considered environmental and nutritional factors relating to longevity in Chinese cities. We found higher 85+/65+ distribution ratios, indicating enhanced longevity, in the coastal and southern regions of China. These areas also featured higher humidity, low standard deviation of monthly temperature, higher levels of selenium (Se) distribution in soil, and greater sea fish consumption. Moderate climate is more conducive to longevity, however, there is no significant difference in longevity between different sub-climatic types within moderate climate; the relation between humidity and longevity is not always positive, the relation between altitude and longevity is not always negative. Nutritional factors like Se and omega-3 fatty acids contained in sea fish were crucial to longevity. In contrast, the consumption of meat and freshwater fish were less related to longevity. Taken together, humidity, altitude, and per capita sea fish consumption, when evaluated via geographically weighted regression, explained 66% and 68% of longevity among Chinese individuals in 2000 and 2010, respectively. Other factors require further discussion. Full article

(This article belongs to the Section Environmental Health)

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15 pages, 2253 KiB

Open AccessArticle

Modelling the Ozone-Based Treatments for Inactivation of Microorganisms

by Agnieszka Joanna Brodowska, Agnieszka Nowak, Alina Kondratiuk-Janyska, Marcin Piątkowski and Krzysztof Śmigielski

Int. J. Environ. Res. Public Health 2017, 14(10), 1196; https://doi.org/10.3390/ijerph14101196 - 9 Oct 2017

Cited by 27 | Viewed by 4931

Abstract

The paper presents the development of a model for ozone treatment in a dynamic bed of different microorganisms (Bacillus subtilis, B. cereus, B. pumilus, Escherichia coli, Pseudomonas fluorescens, Aspergillus niger, Eupenicillium cinnamopurpureum) on a heterogeneous [...] Read more.

The paper presents the development of a model for ozone treatment in a dynamic bed of different microorganisms (Bacillus subtilis, B. cereus, B. pumilus, Escherichia coli, Pseudomonas fluorescens, Aspergillus niger, Eupenicillium cinnamopurpureum) on a heterogeneous matrix (juniper berries, cardamom seeds) initially treated with numerous ozone doses during various contact times was studied. Taking into account various microorganism susceptibility to ozone, it was of great importance to develop a sufficiently effective ozone dose to preserve food products using different strains based on the microbial model. For this purpose, we have chosen the Weibull model to describe the survival curves of different microorganisms. Based on the results of microorganism survival modelling after ozone treatment and considering the least susceptible strains to ozone, we selected the critical ones. Among tested strains, those from genus Bacillus were recognized as the most critical strains. In particular, B. subtilis and B. pumilus possessed the highest resistance to ozone treatment because the time needed to achieve the lowest level of its survival was the longest (up to 17.04 min and 16.89 min for B. pumilus reduction on juniper berry and cardamom seed matrix, respectively). Ozone treatment allow inactivate microorganisms to achieving lower survival rates by ozone dose (20.0 g O₃/m³ O₂, with a flow rate of 0.4 L/min) and contact time (up to 20 min). The results demonstrated that a linear correlation between parameters p and k in Weibull distribution, providing an opportunity to calculate a fitted equation of the process. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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11 pages, 288 KiB

Open AccessFeature PaperArticle

Predicting Child Protective Services (CPS) Involvement among Low-Income U.S. Families with Young Children Receiving Nutritional Assistance

by Kristen S. Slack, Sarah Font, Kathryn Maguire-Jack and Lawrence M. Berger

Int. J. Environ. Res. Public Health 2017, 14(10), 1197; https://doi.org/10.3390/ijerph14101197 - 11 Oct 2017

Cited by 29 | Viewed by 5881

Abstract

This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065 [...] Read more.

This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065 parents who received the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) benefits in late 2010 and early 2011, we find that relying on either work in the absence of other means-tested welfare benefits, or a combination of work and welfare benefits, reduces the likelihood of CPS involvement compared to parents who rely on welfare benefits in the absence of work. Additionally, we find that housing instability increases the risk of CPS involvement in this population. The findings from this investigation may be useful to programs serving low-income families with young children, as they attempt to identify safety net resources for their clientele. Full article

(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)

19 pages, 1927 KiB

Open AccessArticle

Distributions and Sources of Polycyclic Aromatic Hydrocarbons (PAHs) in Soils around a Chemical Plant in Shanxi, China

by Haihua Jiao, Qi Wang, Nana Zhao, Bo Jin, Xuliang Zhuang and Zhihui Bai

Int. J. Environ. Res. Public Health 2017, 14(10), 1198; https://doi.org/10.3390/ijerph14101198 - 9 Oct 2017

Cited by 95 | Viewed by 6033

Abstract

Background: Yearly the Shanxi coal chemical industry extracts many coal resources, producing at the same time many polycyclic aromatic hydrocarbons (PAHs) that are emitted as by-products of coal incomplete combustion. Methods: Sixty-six soil samples collected from 0 to 100 cm vertical [...] Read more.

Background: Yearly the Shanxi coal chemical industry extracts many coal resources, producing at the same time many polycyclic aromatic hydrocarbons (PAHs) that are emitted as by-products of coal incomplete combustion. Methods: Sixty-six soil samples collected from 0 to 100 cm vertical sections of three different agricultural (AS), roadside (RS) and park (PS) functional soils around a chemical plant in Shanxi, China were analyzed for the presence of the 16 priority control PAHs. Results: The total concentrations (∑16PAHs) varied in a range of 35.4–116 mg/kg, 5.93–66.5 mg/kg and 3.87–76.0 mg/kg for the RS, PS and AS surface soil, respectively, and 5-ring PAHs were found to be dominant (44.4–49.0%), followed by 4-ring PAHs (15.9–24.5%). Moreover, the average value of ∑16PAHs decreased with the depth, 7.87 mg/kg (0–25 cm), 4.29 mg/kg (25–50 cm), 3.00 mg/kg (50–75 cm), 2.64 mg/kg (75–100 cm) respectively, in PS and AS soil vertical sections. Conclusions: The PAH levels in the studied soils were the serious contamination level (over 1.00 mg/kg) according to the Soils Quality Guidelines. The carcinogenic PAHs (ΣBPAHsBapeq) were approximately 14.8 times higher than the standard guideline level (0.60 mg/kg) and 90.3% of PAHs were produced by coal/wood/grass combustion processes. Full article

(This article belongs to the Section Environmental Science and Engineering)

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15 pages, 325 KiB

Open AccessArticle

Associations between Perceived Neighborhood Walkability and Walking Time, Wellbeing, and Loneliness in Community-Dwelling Older Chinese People in Hong Kong

by Ruby Yu, Osbert Cheung, Kevin Lau and Jean Woo

Int. J. Environ. Res. Public Health 2017, 14(10), 1199; https://doi.org/10.3390/ijerph14101199 - 9 Oct 2017

Cited by 67 | Viewed by 9157

Abstract

This study examined the cross-sectional associations between perceived neighborhood walkability and walking time, physical activity, wellbeing, and loneliness, and examined which components of walkability were most strongly associated with better wellbeing and less loneliness in older adults. Participants were community-dwelling Chinese adults aged [...] Read more.

This study examined the cross-sectional associations between perceived neighborhood walkability and walking time, physical activity, wellbeing, and loneliness, and examined which components of walkability were most strongly associated with better wellbeing and less loneliness in older adults. Participants were community-dwelling Chinese adults aged 60+ (n = 181). Walkability was measured using nine items selected from the Chinese version of the abbreviated Neighborhood Environment Walkability Scales (NEWS) and NEWS for Chinese Seniors. Outcomes were walking time, physical activity, wellbeing (life satisfaction, happiness, sense of purpose and meaning in life), and loneliness. The mean age of the participants was 71.7 ± 7.8 years. Walkability was positively associated with walking time (p = 0.001, p for trend <0.001) but not with physical activity. After adjusting for socio-demographic characteristics, health conditions, lifestyle, and negative life events, those who perceived their neighborhoods as walkable had higher scores for life satisfaction (p = 0.002) and happiness (p = 0.002), and lower scores for loneliness (p = 0.019), compared with those who perceived their neighborhoods as less walkable. However, perceived neighborhood walkability was not associated with sense of purpose and meaning in life. Among components of walkability, land use mix-access, infrastructure and safety for walking, and traffic safety showed the strongest associations with the measures of wellbeing. The results of this study support the importance of neighborhood walkability for health behavior and wellbeing of older adults. The wellbeing of older adults may be enhanced through the improvement of land use mix-access, infrastructure for walking, and traffic safety. Full article

(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)

17 pages, 318 KiB

Open AccessFeature PaperArticle

The Prevalence and Characteristics of E-Cigarette Users in the U.S.

by David T. Levy, Zhe Yuan and Yameng Li

Int. J. Environ. Res. Public Health 2017, 14(10), 1200; https://doi.org/10.3390/ijerph14101200 - 11 Oct 2017

Cited by 98 | Viewed by 7651

Abstract

Studies have examined the characteristics of individuals who use e-cigarettes, including sociodemographic and smoking characteristics, and the relationship of e-cigarette use to tobacco control policies. While most studies consider a subset of these characteristics with weak measures of regular e-cigarette use, this study [...] Read more.

Studies have examined the characteristics of individuals who use e-cigarettes, including sociodemographic and smoking characteristics, and the relationship of e-cigarette use to tobacco control policies. While most studies consider a subset of these characteristics with weak measures of regular e-cigarette use, this study uses a large, recent U.S. survey to simultaneously consider the association of each of these factors with different use measures. Data from the May 2014 Tobacco Use Supplement-Current Population Survey is supplemented with information on tobacco control policies. The prevalence of ever, current (at least 1 of the last 30 days), and regular (at least 20 of the last 30 days) e-cigarette use were 7.7%, 2.1% and 0.9%, implying that 27.0% of ever users were current users of which 45.3% were regular users. E-cigarette use varied by socio-demographic characteristics and by smoking status, and depended on the measure of use adopted. However, regardless of measures, e-cigarette use was higher among those smokers who smoked more cigarettes. The association with policies was generally weak, but we found more regular use by smokers in low tax and low tobacco control spending states. The results indicate that the user characteristics differ depending on the e-cigarette use measure. The measure of use should be carefully considered in analyzing how e-cigarette use affects cigarette use. Full article

(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)

13 pages, 1937 KiB

Open AccessArticle

Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis

by Kaiwen Wang, Shuang Zhong, Xiaoye Wang, Zhe Wang, Lianping Yang, Qiong Wang, Suhan Wang, Rongrong Sheng, Rui Ma, Shao Lin, Wenyu Liu, Rongqiang Zu and Cunrui Huang

Int. J. Environ. Res. Public Health 2017, 14(10), 1201; https://doi.org/10.3390/ijerph14101201 - 10 Oct 2017

Cited by 10 | Viewed by 5851

Abstract

(1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on [...] Read more.

(1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing’s Center for Disease Control and Prevention (CDC) and Funing People’s Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3) Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33) and injury (RR = 31.80; 95% CI = 17.26, 58.61), and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29). Of the 337 injuries, 274 injuries (81%) were minor. Most deaths occurred indoors (87%) and the head (74%) was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4) Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China. Full article

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

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10 pages, 304 KiB

Open AccessArticle

Blood Lead Levels and Learning Disabilities: A Cross-Sectional Study of the 2003–2004 National Health and Nutrition Examination Survey (NHANES)

by David A. Geier, Janet K. Kern and Mark R. Geier

Int. J. Environ. Res. Public Health 2017, 14(10), 1202; https://doi.org/10.3390/ijerph14101202 - 10 Oct 2017

Cited by 28 | Viewed by 5016

Abstract

Difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities are present among persons diagnosed with learning disabilities (LDs). Previous studies suggest a significant relationship between lead (Pb) exposure and LDs. This study evaluated the potential dose-response relationship [...] Read more.

Difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities are present among persons diagnosed with learning disabilities (LDs). Previous studies suggest a significant relationship between lead (Pb) exposure and LDs. This study evaluated the potential dose-response relationship between blood Pb levels and the risk of LDs. This cross-sectional study examined 1411 children (32,788,743 weighted-persons) between 6 and 15 years old from the 2003–2004 National Health and Nutrition Examination Survey (NHANES) by analyzing demographics, health related-questions, and laboratory tests using survey logistic and frequency modeling in SAS. On a µg Pb/dL basis, a significant dose-dependent relationship between increasing blood Pb levels and increasing risk of LDs was observed (odds ratio (OR) = 1.21, 95% confidence interval (CI) = 1.03–1.43). The relationship remained significant when examining covariates such as gender and race (OR = 1.19, 95% CI = 1.00–1.40). By contrast, no dose-dependence was observed between increasing blood Pb levels and the risk of hay fever in the last year (OR = 0.77, 95% CI = 0.56–1.056), a non-plausibly biologically related outcome of blood Pb levels. Persons in the 50th–75th (12.80%) and 75th–100th (17.14%) percentiles of blood Pb were significantly more likely to have LDs than persons in the 0–50th percentile of blood Pb (8.78%). An estimated 1 million persons born in the US from 1989 to 1998 developed LDs from elevated blood Pb levels. Overall, this study revealed a significant dose-dependent association between increasing childhood blood Pb levels and the risk of a LD diagnosis, but it was not possible to ascribe a direct cause-effect relationship between blood Pb exposure and LD diagnosis. Childhood Pb exposure should be considered when evaluating children with LDs, and continuing efforts should be made to reduce Pb exposure. Full article

16 pages, 1049 KiB

Open AccessArticle

Priority of a Hesitant Fuzzy Linguistic Preference Relation with a Normal Distribution in Meteorological Disaster Risk Assessment

by Lihong Wang and Zaiwu Gong

Int. J. Environ. Res. Public Health 2017, 14(10), 1203; https://doi.org/10.3390/ijerph14101203 - 10 Oct 2017

Cited by 20 | Viewed by 4356

Abstract

As meteorological disaster systems are large complex systems, disaster reduction programs must be based on risk analysis. Consequently, judgment by an expert based on his or her experience (also known as qualitative evaluation) is an important link in meteorological disaster risk assessment. In [...] Read more.

As meteorological disaster systems are large complex systems, disaster reduction programs must be based on risk analysis. Consequently, judgment by an expert based on his or her experience (also known as qualitative evaluation) is an important link in meteorological disaster risk assessment. In some complex and non-procedural meteorological disaster risk assessments, a hesitant fuzzy linguistic preference relation (HFLPR) is often used to deal with a situation in which experts may be hesitant while providing preference information of a pairwise comparison of alternatives, that is, the degree of preference of one alternative over another. This study explores hesitation from the perspective of statistical distributions, and obtains an optimal ranking of an HFLPR based on chance-restricted programming, which provides a new approach for hesitant fuzzy optimisation of decision-making in meteorological disaster risk assessments. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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12 pages, 307 KiB

Open AccessArticle

“He’s the Number One Thing in My World”: Application of the PRECEDE-PROCEED Model to Explore Child Car Seat Use in a Regional Community in New South Wales

by Kate Hunter, Lisa Keay, Kathleen Clapham, Julie Brown, Lynne E. Bilston, Marilyn Lyford, Celeste Gilbert and Rebecca Q. Ivers

Int. J. Environ. Res. Public Health 2017, 14(10), 1206; https://doi.org/10.3390/ijerph14101206 - 10 Oct 2017

Cited by 6 | Viewed by 5782

Abstract

We explored the factors influencing the use of age-appropriate car seats in a community with a high proportion of Aboriginal families in regional New South Wales. We conducted a survey and three focus groups with parents of children aged 3–5 years enrolled at [...] Read more.

We explored the factors influencing the use of age-appropriate car seats in a community with a high proportion of Aboriginal families in regional New South Wales. We conducted a survey and three focus groups with parents of children aged 3–5 years enrolled at three early learning centres on the Australian south-east coast. Survey data were triangulated with qualitative data from focus groups and analysed using the PRECEDE-PROCEED conceptual framework. Of the 133 eligible families, 97 (73%) parents completed the survey including 31% of parents who reported their children were Aboriginal. Use of age-appropriate car seats was reported by 80 (83%) of the participants, and awareness of the child car seat legislation was high (91/97, 94%). Children aged 2–3 years were less likely reported to be restrained in an age-appropriate car seat than were older children aged 4–5 years (60% versus 95%: χ² = 19.14, p < 0.001). Focus group participants highlighted how important their child’s safety was to them, spoke of the influence grandparents had on their use of child car seats and voiced mixed views on the value of authorised child car seat fitters. Future programs should include access to affordable car seats and target community members as well as parents with clear, consistent messages highlighting the safety benefits of using age-appropriate car seats. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

16 pages, 356 KiB

Open AccessArticle

Social Hazards as Manifested Workplace Discrimination and Health (Vietnamese and Ukrainian Female and Male Migrants in Czechia)

by Dušan Drbohlav and Dagmar Dzúrová

Int. J. Environ. Res. Public Health 2017, 14(10), 1207; https://doi.org/10.3390/ijerph14101207 - 10 Oct 2017

Cited by 9 | Viewed by 4462

Abstract

Social hazards as one of the dimensions of workplace discrimination are a potential social determinant of health inequalities. The aim of this study was to investigate relations between self-reported health and social hazard characteristics (defined as—discrimination as such, violence or threat of violence, [...] Read more.

Social hazards as one of the dimensions of workplace discrimination are a potential social determinant of health inequalities. The aim of this study was to investigate relations between self-reported health and social hazard characteristics (defined as—discrimination as such, violence or threat of violence, time pressure or work overload and risk of accident) among Vietnamese and Ukrainian migrants (males and females) in Czechia by age, education level and marital status. This study is based on data from a survey of 669 immigrants in Czechia in 2013. Logistic regression analysis indicates that the given independent variables (given social hazards and socio-demographic characteristics), as predictors of a quality of self-reported health are more important for immigrant females than for males, irrespective of citizenship, albeit only for some of them and to differing extents. We found out that being exposed to the selected social hazards in the workplace leads to worsening self-rated health, especially for females. On the other hand, there was no statistically significant relationship found between poor self-rated health and discrimination as such. Reality calls for more research and, consequently, better policies and practices in the field of health inequalities. Full article

(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)

9 pages, 309 KiB

Open AccessArticle

Association of Waist Circumference Gain and Incident Prediabetes Defined by Fasting Glucose: A Seven-Year Longitudinal Study in Beijing, China

by Li-Xin Tao, Kun Yang, Fang-Fang Huang, Xiang-Tong Liu, Xia Li, Yan-Xia Luo, Li-Juan Wu and Xiu-Hua Guo

Int. J. Environ. Res. Public Health 2017, 14(10), 1208; https://doi.org/10.3390/ijerph14101208 - 10 Oct 2017

Cited by 9 | Viewed by 4019

Abstract

The risk of incident prediabetes with gain in waist circumference (WC) has not been addressed among Chinese adults. A total of 7951 participants who underwent health check-ups at the Beijing Physical Examination Center and Beijing Xiaotangshan hospital were recruited in 2009 and followed [...] Read more.

The risk of incident prediabetes with gain in waist circumference (WC) has not been addressed among Chinese adults. A total of 7951 participants who underwent health check-ups at the Beijing Physical Examination Center and Beijing Xiaotangshan hospital were recruited in 2009 and followed up in 2016. Participants were classified into four groups according to categories of percent WC gain: ≤−2.5%, −2.5–2.5%, 2.5–5%, and >5%. The effect of WC gain on prediabetes was evaluated using modified Poisson regression models. Over seven years of follow-up, we identified 1034 prediabetes cases (413 women). Compared with a WC gain of ≤−2.5%, participants with a WC gain of >5% have a higher risk of prediabetes, be they male (non-abdominal obesity at baseline group: RR = 1.57, 95% CI: 1.10–2.24, abdominal obesity at baseline group: RR = 1.66, 95% CI: 1.20–2.30) or female (non-abdominal obesity at baseline group: RR = 1.74, 95% CI: 1.14–2.64, abdominal obesity at baseline group: RR = 2.47, 95% CI: 1.43–4.28). In conclusion, the risk of prediabetes increased significantly with increasing WC for both genders in the Chinese population. Lifestyle interventions aiming at preventing abdominal obesity are urgently needed to reduce the increasing burden of prediabetes, diabetes, and its complications. Full article

9 pages, 284 KiB

Open AccessArticle

Toxic Elements in Different Medicinal Plants and the Impact on Human Health

by Eid I. Brima

Int. J. Environ. Res. Public Health 2017, 14(10), 1209; https://doi.org/10.3390/ijerph14101209 - 11 Oct 2017

Cited by 61 | Viewed by 6141

Abstract

Local medicinal plants from Madina, Saudi Arabia, are used to cure various diseases. However, some can cause adverse health effects. Five different medicinal plants were collected in the city of Madina: mahareeb (Cymbopogon), sheeh (Artemisia), harjal (Cynanchum argel [...] Read more.

Local medicinal plants from Madina, Saudi Arabia, are used to cure various diseases. However, some can cause adverse health effects. Five different medicinal plants were collected in the city of Madina: mahareeb (Cymbopogon), sheeh (Artemisia), harjal (Cynanchum argel delile), nabipoot (Equisetum), and kafmariam (Vitex agnus-castus). In total, four toxic elements including Al, Pb, As, and Cd were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). The range of recoveries fell between 86.1% and 90.6% for all measured elements. Al levels were the highest of any of the studied elements in all plant samples, with Cymbopogon showing the highest levels. The range of concentrations of Al was 156–1609 mg/kg. Cd appeared at the lowest levels in all plants samples, with Vitex agnus-castus containing this element at the highest levels. Cd concentrations were in the range of 0.01–0.10 mg/kg. A washing process lowered the toxic elements in all plants; average % recoveries were Al (47.32%), As (59.1%), Cd (62.03%), and Pb (32.40%). The calculated human health risk assessment in one dose for toxic elements in all plants was as follows: Al (1.33 × 10⁻³–5.57 × 10⁻² mg/kg.bw), Pb (0–8.86 × 10⁻⁵ mg/kg.bw), As (3.43 × 10⁻⁷–1.33 × 10⁻⁵ mg/kg.bw), and Cd (0–3.14 × 10⁻⁶ mg/kg.bw). Medicinal plants are a source of exposure to toxic elements. However, none of the plants in this study exceeded the daily guideline set by the WHO for any element based on conventional use by the local population. We may cautiously conclude that these medicinal plants pose no risk to users based on conventional use. Full article

(This article belongs to the Special Issue Dietary Exposures)

16 pages, 311 KiB

Open AccessArticle

Socioeconomic Differences and Trends in the Place of Death among Elderly People in China

by Jiaoli Cai, Hongzhong Zhao and Peter C. Coyte

Int. J. Environ. Res. Public Health 2017, 14(10), 1210; https://doi.org/10.3390/ijerph14101210 - 11 Oct 2017

Cited by 31 | Viewed by 4471

Abstract

China is facing a dramatic aging of its population. Little is known about the factors that influence the place of death and the trends in the place of death for elderly people in China. The purposes of this study were: (1) to examine [...] Read more.

China is facing a dramatic aging of its population. Little is known about the factors that influence the place of death and the trends in the place of death for elderly people in China. The purposes of this study were: (1) to examine the impact of the socioeconomic status (SES) on place of death for elderly Chinese residents; and (2) to assess temporal trends in the place of death over the last 15 years. Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998–2012). Place-of-death as an outcome was dichotomized into either death at home or death outside the home. Logistic regression analyses were used to examine the impact of SES on place of death. The results showed that, of the 23,098 deaths during the study period, 87.78% occurred at home. The overall trend in home death has increased since 2005. SES was shown to be an important factor affecting place of death. The elderly with higher SES were more likely to die where health resources were concentrated, i.e., in a hospital or other type of institution. Our finding suggests that the trend towards a greater emphasis on death at home may call for the development of more supportive home care programs in China. Our finding also suggests that the socioeconomic differences in the place of death may be related to the availability of or access to health care services. Full article

15 pages, 1149 KiB

Open AccessArticle

Validation and Assessment of Three Methods to Estimate 24-h Urinary Sodium Excretion from Spot Urine Samples in High-Risk Elder Patients of Stroke from the Rural Areas of Shaanxi Province

by Wenxia Ma, Xuejun Yin, Ruijuan Zhang, Furong Liu, Danrong Yang, Yameng Fan, Jie Rong, Maoyi Tian and Yan Yu

Int. J. Environ. Res. Public Health 2017, 14(10), 1211; https://doi.org/10.3390/ijerph14101211 - 11 Oct 2017

Cited by 34 | Viewed by 5018

Abstract

Background: 24-h urine collection is regarded as the “gold standard” for monitoring sodium intake at the population level, but ensuring high quality urine samples is difficult to achieve. The Kawasaki, International Study of Sodium, Potassium, and Blood Pressure (INTERSALT) and Tanaka methods [...] Read more.

Background: 24-h urine collection is regarded as the “gold standard” for monitoring sodium intake at the population level, but ensuring high quality urine samples is difficult to achieve. The Kawasaki, International Study of Sodium, Potassium, and Blood Pressure (INTERSALT) and Tanaka methods have been used to estimate 24-h urinary sodium excretion from spot urine samples in some countries, but few studies have been performed to compare and validate these methods in the Chinese population. Objective: To compare and validate the Kawasaki, INTERSALT and Tanaka formulas in predicting 24-h urinary sodium excretion using spot urine samples in 365 high-risk elder patients of strokefrom the rural areas of Shaanxi province. Methods: Data were collected from a sub-sample of theSalt Substitute and Stroke Study. 365 high-risk elder patients of stroke from the rural areas of Shaanxi province participated and their spot and 24-h urine specimens were collected. The concentrations of sodium, potassium and creatinine in spot and 24-h urine samples wereanalysed. Estimated 24-h sodium excretion was predicted from spot urine concentration using the Kawasaki, INTERSALT, and Tanaka formulas. Pearson correlation coefficients and agreement by Bland-Altman method were computed for estimated and measured 24-h urinary sodium excretion. Results: The average 24-h urinary sodium excretion was 162.0 mmol/day, which representing a salt intake of 9.5 g/day. Three predictive equations had low correlation with the measured 24-h sodium excretion (r = 0.38, p < 0.01; ICC = 0.38, p < 0.01 for the Kawasaki; r = 0.35, p < 0.01; ICC = 0.31, p < 0.01 for the INTERSALT; r = 0.37, p < 0.01; ICC = 0.34, p < 0.01 for the Tanaka). Significant biases between estimated and measured 24-h sodium excretion were observed (all p < 0.01 for three methods). Among the three methods, the Kawasaki method was the least biased compared with the other two methods (mean bias: 31.90, 95% Cl: 23.84, 39.97). Overestimation occurred when the Kawasaki and Tanaka methods were used while the INTERSALT method underestimated 24-h sodium excretion. Conclusion: The Kawasaki, INTERSALT and Tanaka methods for estimation of 24-h urinary sodium excretion from spot urine specimens were inadequate for the assessment of sodium intake at the population level in high-risk elder patients of stroke from the rural areas of Shaanxi province, although the Kawasaki method was the least biased compared with the other two methods. Full article

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17 pages, 3267 KiB

Open AccessArticle

Adsorption Removal of 17β-Estradiol from Water by Rice Straw-Derived Biochar with Special Attention to Pyrolysis Temperature and Background Chemistry

by Xiaohua Wang, Ni Liu, Yunguo Liu, Luhua Jiang, Guangming Zeng, Xiaofei Tan, Shaobo Liu, Zhihong Yin, Sirong Tian and Jiang Li

Int. J. Environ. Res. Public Health 2017, 14(10), 1213; https://doi.org/10.3390/ijerph14101213 - 11 Oct 2017

Cited by 42 | Viewed by 5438

Abstract

Rice straw biochar that produced at three pyrolysis temperatures (400, 500 and 600 °C) were used to investigate the adsorption properties of 17β-estradiol (E2). The biochar samples were characterized by scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), elemental analysis and BET surface [...] Read more.

Rice straw biochar that produced at three pyrolysis temperatures (400, 500 and 600 °C) were used to investigate the adsorption properties of 17β-estradiol (E2). The biochar samples were characterized by scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), elemental analysis and BET surface area measurements. The influences of pyrolysis temperature, E2 concentration, pH, ionic strength, background electrolyte and humic acid were studied. Kinetic and isotherm results illustrated that the adsorption process could be well described by pseudo-second-order and Freundlich models. Experimental results showed that ionic strength had less influence on the adsorption of E2 by 500 and 600 °C rice straw biochar. Further, multivalent ions had positive impact on E2 removal than monovalent ions and the influence of the pyrolysis temperature was unremarkable when background electrolyte existed in solutions. The adsorption capacity of E2 decreased with the pH ranged from 3.0 to 12.0 and the humic acid concentration from 2 to 10 mg L^–1. Electrostatic attractions and π-π interaction were involved in the adsorption mechanisms. Compared to low-temperature biochar, high-temperature biochar exhibited a better adsorption capacity for E2 in aqueous solution, indicated it had a greater potential for E2 pollution control. Full article

(This article belongs to the Section Environmental Science and Engineering)

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11 pages, 444 KiB

Open AccessArticle

Trends and Comparisons of Utilization of Emergency Departments Due to Traumatic or Non-Traumatic Causes among the HIV-Positive Population in Taiwan, 2006–2011

by Ching-Heng Lin, Ting Lin, Pesus Chou and Nan-Ping Yang

Int. J. Environ. Res. Public Health 2017, 14(10), 1214; https://doi.org/10.3390/ijerph14101214 - 11 Oct 2017

Cited by 1 | Viewed by 3355

Abstract

It is important that the utilization of emergency departments (EDs) among people living with the human immunodeficiency virus (HIV) be epidemiologically evaluated in order to assess and improve the HIV care continuum. All participants newly-diagnosed with HIV in Taiwan registered in the National [...] Read more.

It is important that the utilization of emergency departments (EDs) among people living with the human immunodeficiency virus (HIV) be epidemiologically evaluated in order to assess and improve the HIV care continuum. All participants newly-diagnosed with HIV in Taiwan registered in the National Health Insurance Database from 2000 to 2005 were enrolled in this study and followed-up from 2006 to 2011. In total, 3500 participants newly-diagnosed with HIV in 2000–2005 were selected as a fixed-cohort population and followed-up from 2006 to 2011. Overall, 704, 645, 591, 573, 578, and 568 cases made 1322, 1275, 1050, 1061, 1136, and 992 ED visits in 2006, 2007, 2008, 2009, 2010 and 2011, respectively, with an average number of ED visits ranging from 1.75 to 1.98 per person, accounting for 20.1–22.6% of the whole HIV-positive population. Fewer ED visits were due to traumatic reasons, accounting for 19.6–24.4% of all cases. The incidence of traumatic and non-traumatic ED visits among the HIV-positive participants ranged from 7.2–9.3 and 27.0–33.9 per 100 people, respectively. The average direct medical cost of traumatic and non-traumatic ED visits ranged from $89.3–112.0 and $96.6–120.0, respectively. In conclusion, a lower incidence of ED visits for all reasons and fewer ED visits owing to traumatic causes were observed in the population living with HIV in comparison with the general population; however, the direct medical cost of each ED visit owing to both traumatic and non-traumatic causes was greater among those living with HIV than in the general population. Full article

(This article belongs to the Special Issue Insurance and Health)

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12 pages, 264 KiB

Open AccessFeature PaperArticle

The Role of the Social Network in Access to Psychosocial Services for Migrant Elderly—A Qualitative Study

by Daphne Schoenmakers, Majda Lamkaddem and Jeanine Suurmond

Int. J. Environ. Res. Public Health 2017, 14(10), 1215; https://doi.org/10.3390/ijerph14101215 - 11 Oct 2017

Cited by 20 | Viewed by 5675

Abstract

Abstract: Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of [...] Read more.

Abstract: Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusions: Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems. Full article

(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)

14 pages, 6314 KiB

Open AccessArticle

The Effects of Data Collection Method and Monitoring of Workers’ Behavior on the Generation of Demolition Waste

by Gi-Wook Cha, Young-Chan Kim, Hyeun Jun Moon and Won-Hwa Hong

Int. J. Environ. Res. Public Health 2017, 14(10), 1216; https://doi.org/10.3390/ijerph14101216 - 12 Oct 2017

Cited by 5 | Viewed by 4291

Abstract

The roles of both the data collection method (including proper classification) and the behavior of workers on the generation of demolition waste (DW) are important. By analyzing the effect of the data collection method used to estimate DW, and by investigating how workers’ [...] Read more.

The roles of both the data collection method (including proper classification) and the behavior of workers on the generation of demolition waste (DW) are important. By analyzing the effect of the data collection method used to estimate DW, and by investigating how workers’ behavior can affect the total amount of DW generated during an actual demolition process, it was possible to identify strategies that could improve the prediction of DW. Therefore, this study surveyed demolition waste generation rates (DWGRs) for different types of building by conducting on-site surveys immediately before demolition in order to collect adequate and reliable data. In addition, the effects of DW management strategies and of monitoring the behavior of workers on the actual generation of DW were analyzed. The results showed that when monitoring was implemented, the estimates of DW obtained from the DWGRs that were surveyed immediately before demolition and the actual quantities of DW reported by the demolition contractors had an error rate of 0.63% when the results were compared. Therefore, this study has shown that the proper data collection method (i.e., data were collected immediately before demolition) applied in this paper and monitoring on the demolition site have a significant impact on waste generation. Full article

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9 pages, 453 KiB

Open AccessArticle

Effect of Early Pelvic Binder Use in the Emergency Management of Suspected Pelvic Trauma: A Retrospective Cohort Study

by Sheng-Der Hsu, Cheng-Jueng Chen, Yu-Ching Chou, Sheng-Hao Wang and De-Chuan Chan

Int. J. Environ. Res. Public Health 2017, 14(10), 1217; https://doi.org/10.3390/ijerph14101217 - 12 Oct 2017

Cited by 50 | Viewed by 12071 | Correction

Abstract

Background: We aimed to evaluate the effect of early pelvic binder use in the emergency management of suspected pelvic trauma, compared with the conventional stepwise approach. Methods: We enrolled trauma patients with initial stabilization using a pelvic binder when suspecting pelvic injury. The [...] Read more.

Background: We aimed to evaluate the effect of early pelvic binder use in the emergency management of suspected pelvic trauma, compared with the conventional stepwise approach. Methods: We enrolled trauma patients with initial stabilization using a pelvic binder when suspecting pelvic injury. The inclusion criteria were traumatic injury requiring a trauma team and at least one of the following: a loss of consciousness or a Glasgow coma score (GCS) of <13; systolic blood pressure of <90 mmHg; falling from ≥6 m; injury to multiple vital organs; and suspected pelvic injury. Various parameters, including gender, age, mechanism of injury, GCS, mortality, hospital stay, initial vital signs, revised trauma score, injury severity score, and outcome, were assessed and compared with historical controls. Results: A total of 204 patients with high-energy multiple-trauma from a single level I trauma center in North Taiwan were enrolled in the study from August 2013 to July 2014. The two group baseline patient characteristics were all collected and compared. The trauma patients with suspected pelvic fractures initially stabilized with a pelvic binder had shorter hospital and intensive care unit (ICU) stays. The study group achieved statistically significantly improved survival and lower mean blood transfusion volume and mortality rate, although they were more severe in the trauma score. Conclusions: We recommend prompt pelvic binder use for suspected pelvic injury before definitive imaging is available, as a cervical spine collar is used to protect the cervical spine from further injury prior to definitive identification and characterization of an injury. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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10 pages, 269 KiB

Open AccessArticle

Peer Victimization among Classmates—Associations with Students’ Internalizing Problems, Self-Esteem, and Life Satisfaction

by Sara B. Låftman and Bitte Modin

Int. J. Environ. Res. Public Health 2017, 14(10), 1218; https://doi.org/10.3390/ijerph14101218 - 13 Oct 2017

Cited by 14 | Viewed by 5387

Abstract

Bullying is a major problem in schools and a large number of studies have demonstrated that victims have a high excess risk of poor mental health. It may however also affect those who are not directly victimized by peers. The present study investigates [...] Read more.

Bullying is a major problem in schools and a large number of studies have demonstrated that victims have a high excess risk of poor mental health. It may however also affect those who are not directly victimized by peers. The present study investigates whether peer victimization among classmates is linked to internalizing problems, self-esteem, and life satisfaction at the individual level, when the student’s own victimization has been taken into account. The data were derived from the first wave of the Swedish part of Youth in Europe Study (YES!), including information on 4319 students in grade 8 (14–15 years of age) distributed across 242 classes. Results from multilevel analyses show a significant association between classes with a high proportion of students being victimized and higher levels of internalizing problems, lower self-esteem, and lower life satisfaction at the student level. This association holds when the student’s own victimization has been taken into account. This suggests that peer victimization negatively affects those who are directly exposed, as well as their classmates. We conclude that efficient methods and interventions to reduce bullying in school are likely to benefit not only those who are victimized, but all students. Full article

(This article belongs to the Special Issue Youth Violence as a Public Health Issue)

18 pages, 2123 KiB

Open AccessArticle

Regional Sustainable Development Analysis Based on Information Entropy—Sichuan Province as an Example

by Xuedong Liang, Dongyang Si and Xinli Zhang

Int. J. Environ. Res. Public Health 2017, 14(10), 1219; https://doi.org/10.3390/ijerph14101219 - 13 Oct 2017

Cited by 32 | Viewed by 4867

Abstract

According to the implementation of a scientific development perspective, sustainable development needs to consider regional development, economic and social development, and the harmonious development of society and nature, but regional sustainable development is often difficult to quantify. Through an analysis of the structure [...] Read more.

According to the implementation of a scientific development perspective, sustainable development needs to consider regional development, economic and social development, and the harmonious development of society and nature, but regional sustainable development is often difficult to quantify. Through an analysis of the structure and functions of a regional system, this paper establishes an evaluation index system, which includes an economic subsystem, an ecological environmental subsystem and a social subsystem, to study regional sustainable development capacity. A sustainable development capacity measure model for Sichuan Province was established by applying the information entropy calculation principle and the Brusselator principle. Each subsystem and entropy change in a calendar year in Sichuan Province were analyzed to evaluate Sichuan Province’s sustainable development capacity. It was found that the established model could effectively show actual changes in sustainable development levels through the entropy change reaction system, at the same time this model could clearly demonstrate how those forty-six indicators from the three subsystems impact on the regional sustainable development, which could make up for the lack of sustainable development research. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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15 pages, 1174 KiB

Open AccessFeature PaperArticle

Cusp Catastrophe Regression and Its Application in Public Health and Behavioral Research

by Ding-Geng Chen and Xinguang Chen

Int. J. Environ. Res. Public Health 2017, 14(10), 1220; https://doi.org/10.3390/ijerph14101220 - 13 Oct 2017

Cited by 17 | Viewed by 5795

Abstract

The cusp catastrophe model is an innovative approach for investigating a phenomenon that consists of both continuous and discrete changes in one modeling framework. However, its application to empirical health and behavior data has been hindered by the complexity in data-model fit. In [...] Read more.

The cusp catastrophe model is an innovative approach for investigating a phenomenon that consists of both continuous and discrete changes in one modeling framework. However, its application to empirical health and behavior data has been hindered by the complexity in data-model fit. In this study, we reported our work in the development of a new modeling method—cusp catastrophe regression (RegCusp in short) by casting the cusp catastrophe into a statistical regression. With the RegCusp approach, unbiased model parameters can be estimated with the maximum likelihood estimation method. To validate the RegCusp method, a series of simulations were conducted to demonstrate the unbiasedness of parameter estimation. Since the estimated residual variance with the Fisher information matrix method was over-dispersed, a bootstrap re-sampling procedure was developed and used as a remedy. We also demonstrate the practical applicability of the RegCusp with empirical data from an NIH-funded project to evaluate an HIV prevention intervention program to educate adolescents in the Bahamas for condom use. Study findings indicated that the model parameters estimated with RegCusp were practically more meaningful than those estimated with comparable methods, especially the estimated cusp point. Full article

(This article belongs to the Special Issue Innovations in Biostatistical Methods and Data for Public Health Research)

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13 pages, 4547 KiB

Open AccessArticle

Nicotine Component of Cigarette Smoke Extract (CSE) Decreases the Cytotoxicity of CSE in BEAS-2B Cells Stably Expressing Human Cytochrome P450 2A13

by Minghui Ji, Yudong Zhang, Na Li, Chao Wang, Rong Xia, Zhan Zhang and Shou-Lin Wang

Int. J. Environ. Res. Public Health 2017, 14(10), 1221; https://doi.org/10.3390/ijerph14101221 - 13 Oct 2017

Cited by 22 | Viewed by 7785

Abstract

Cytochrome P450 2A13 (CYP2A13), an extrahepatic enzyme mainly expressed in the human respiratory system, has been reported to mediate the metabolism and toxicity of cigarette smoke. We previously found that nicotine inhibited 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) metabolism by CYP2A13, but its influence on other components [...] Read more.

Cytochrome P450 2A13 (CYP2A13), an extrahepatic enzyme mainly expressed in the human respiratory system, has been reported to mediate the metabolism and toxicity of cigarette smoke. We previously found that nicotine inhibited 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) metabolism by CYP2A13, but its influence on other components of cigarette smoke remains unclear. The nicotine component of cigarette smoke extract (CSE) was separated, purified, and identified using high-performance liquid chromatography (HPLC) and ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS), splitting CSE into a nicotine section (CSE-N) and nicotine-free section (CSE-O). Cell viability and apoptosis by Cell Counting Kit-8 (CCK-8) and flow cytometry assays were conducted on immortalized human bronchial epithelial (BEAS-2B) cells stably expressing CYP2A13 (B-2A13) or vector (B-V), respectively. Interestingly, CSE and CSE-O were toxic to BEAS-2B cells whereas CSE-N showed less cytotoxicity. CSE-O was more toxic to B-2A13 cells than to B-V cells (IC₅₀ of 2.49% vs. 7.06%), which was flatted by 8-methoxypsoralen (8-MOP), a CYP inhibitor. CSE-O rather than CSE or CSE-N increased apoptosis of B-2A13 cells rather than B-V cells. Accordingly, compared to CSE-N and CSE, CSE-O significantly changed the expression of three pairs of pro- and anti-apoptotic proteins, Bcl-2 Associated X Protein/B cell lymphoma-2 (Bax/Bcl-2), Cleaved Poly (Adenosine Diphosphate-Ribose) Polymerase/Poly (Adenosine Diphosphate-Ribose) Polymerase (C-PARP/PARP), and C-caspase-3/caspase-3, in B-2A13 cells. In addition, recombination of CSE-N and CSE-O (CSE-O/N) showed similar cytotoxicity and apoptosis to the original CSE. These results demonstrate that the nicotine component decreases the metabolic activation of CYP2A13 to CSE and aids in understanding the critical role of CYP2A13 in human respiratory diseases caused by cigarette smoking. Full article

(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)

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39 pages, 6296 KiB

Open AccessArticle

To Facilitate or Curb? The Role of Financial Development in China’s Carbon Emissions Reduction Process: A Novel Approach

by Tiancai Xing, Qichuan Jiang and Xuejiao Ma

Int. J. Environ. Res. Public Health 2017, 14(10), 1222; https://doi.org/10.3390/ijerph14101222 - 13 Oct 2017

Cited by 94 | Viewed by 7399

Abstract

With the Paris Agreement coming into effect, China, as the largest CO₂ emitter in the world, will be facing greater pressure to reduce its carbon emissions. This paper discusses how to solve this issue from the perspective of financial development in China. [...] Read more.

With the Paris Agreement coming into effect, China, as the largest CO₂ emitter in the world, will be facing greater pressure to reduce its carbon emissions. This paper discusses how to solve this issue from the perspective of financial development in China. Although many studies have analyzed its impact on carbon emissions, the conclusions are contradictory. A major criticism of the existing studies is the reasonability of the selection of appropriate indicators and panel estimation techniques. Almost all studies use only one or limited indicators to represent the financial development and ignore the cross-sectional dependence. To fulfil the gaps mentioned above, a financial development index system is built, and with the framework of the STIRPAT (Stochastic impacts by regression on population, affluence, and technology) model, this paper applies an ARDL approach to investigating the long-run relationship between financial development and carbon emissions and a dynamic panel error-corrected model to capture the short-run impact. The empirical results show that financial development can improve carbon emissions, and such impact not only shows a regional difference but also reflects the features of stage differences. Additionally, based on the discussion on seven specific aspects of financial development, our findings can be helpful for policy makers to enact corresponding policies to realize the goal of reducing carbon emissions in China. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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15 pages, 332 KiB

Open AccessArticle

How Can Data Drive Policy and Practice in Child Welfare? Making the Link in Canada

by Barbara Fallon, Joanne Filippelli, Tara Black, Nico Trocmé and Tonino Esposito

Int. J. Environ. Res. Public Health 2017, 14(10), 1223; https://doi.org/10.3390/ijerph14101223 - 14 Oct 2017

Cited by 26 | Viewed by 6051

Abstract

Formal university–child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between [...] Read more.

Formal university–child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between the University of Toronto, clinicians, policy analysts, and researchers from child welfare agencies across Ontario. The key objectives of the grant included: (1) enhancing the capacity of service providers to access and analyze child welfare data to inform service and policy decisions; (2) integrating clinical expertise in service and policy decisions; and (3) developing a joint research agenda addressing high-priority knowledge gaps. This partnership was an opportunity to advance the evidence base with respect to service provision in Ontario and to create a culture of knowledge and evidence that would eventually support more complex research initiatives. Administrative data was analyzed for this partnership through the Ontario Child Abuse and Neglect Data System (OCANDS)—the first child welfare data system in Ontario to track child welfare-involved children and their families. Child welfare agencies identified recurrence as an important priority and agency-driven analyses were subsequently conducted on OCANDS generated recurrence Service Performance Indicators (SPI’s). Using an urgent versus chronic investigative taxonomy for analyses, findings revealed that the majority of cases did not recur within 12 months and cases identified as chronic needs are more likely to return to the attention of child welfare authorities. One of the key outcomes of the partnership — helping agencies to understand their administrative data is described, as are considerations for next steps for future partnerships and research. Full article

(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)

15 pages, 498 KiB

Open AccessFeature PaperArticle

Fairness and Eligibility to Long-Term Care: An Analysis of the Factors Driving Inequality and Inequity in the Use of Home Care for Older Europeans

by Stefania Ilinca, Ricardo Rodrigues and Andrea E. Schmidt

Int. J. Environ. Res. Public Health 2017, 14(10), 1224; https://doi.org/10.3390/ijerph14101224 - 14 Oct 2017

Cited by 52 | Viewed by 7052

Abstract

In contrast with the case of health care, distributional fairness of long-term care (LTC) services in Europe has received limited attention. Given the increased relevance of LTC in the social policy agenda it is timely to evaluate the evidence on inequality and horizontal [...] Read more.

In contrast with the case of health care, distributional fairness of long-term care (LTC) services in Europe has received limited attention. Given the increased relevance of LTC in the social policy agenda it is timely to evaluate the evidence on inequality and horizontal inequity by socio-economic status (SES) in the use of LTC and to identify the socio-economic factors that drive them. We address both aspects and reflect on the sensitivity of inequity estimates to adopting different definitions of legitimate drivers of care need. Using Survey of Health, Ageing and Retirement in Europe (SHARE)data collected in 2013, we analyse differences in home care utilization between community-dwelling Europeans in nine countries. We present concentration indexes and horizontal inequity indexes for each country and results from a decomposition analysis across income, care needs, household structures, education achievement and regional characteristics. We find pro-poor inequality in home care utilization but little evidence of inequity when accounting for differential care needs. Household characteristics are an important contributor to inequality, while education and geographic locations hold less explanatory power. We discuss the findings in light of the normative assumptions surrounding different definitions of need in LTC and the possible regressive implications of policies that make household structures an eligibility criterion to access services. Full article

(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)

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12 pages, 1725 KiB

Open AccessArticle

A Novel Vaping Machine Dedicated to Fully Controlling the Generation of E-Cigarette Emissions

by Sébastien Soulet, Charly Pairaud and Hélène Lalo

Int. J. Environ. Res. Public Health 2017, 14(10), 1225; https://doi.org/10.3390/ijerph14101225 - 14 Oct 2017

Cited by 16 | Viewed by 6996

Abstract

The accurate study of aerosol composition and nicotine release by electronic cigarettes is a major issue. In order to fully and correctly characterize aerosol, emission generation has to be completely mastered. This study describes an original vaping machine named Universal System for Analysis [...] Read more.

The accurate study of aerosol composition and nicotine release by electronic cigarettes is a major issue. In order to fully and correctly characterize aerosol, emission generation has to be completely mastered. This study describes an original vaping machine named Universal System for Analysis of Vaping (U-SAV), dedicated to vaping product study, enabling the control and real-time monitoring of applied flow rate and power. Repeatability and stability of the machine are demonstrated on flow rate, power regulation and e-liquid consumption. The emission protocol used to characterize the vaping machine is based on the AFNOR-XP-D90-300-3 standard (15 W power, 1 Ω atomizer resistance, 100 puffs collected per session, 1.1 L/min airflow rate). Each of the parameters has been verified with two standardized liquids by studying mass variations, power regulation and flow rate stability. U-SAV presents the required and necessary stability for the full control of emission generation. The U-SAV is recognised by the French association for standardization (AFNOR), European Committee for Standardization (CEN) and International Standards Organisation (ISO) as a vaping machine. It can be used to highlight the influence of the e-liquid composition, user behaviour and nature of the device, on the e-liquid consumption and aerosol composition. Full article

(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)

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10 pages, 269 KiB

Open AccessArticle

School Leadership and Cyberbullying—A Multilevel Analysis

by Sara B. Låftman, Viveca Östberg and Bitte Modin

Int. J. Environ. Res. Public Health 2017, 14(10), 1226; https://doi.org/10.3390/ijerph14101226 - 15 Oct 2017

Cited by 18 | Viewed by 6259

Abstract

Cyberbullying is a relatively new form of bullying, with both similarities and differences to traditional bullying. While earlier research has examined associations between school-contextual characteristics and traditional bullying, fewer studies have focused on the links to students’ involvement in cyberbullying behavior. The aim [...] Read more.

Cyberbullying is a relatively new form of bullying, with both similarities and differences to traditional bullying. While earlier research has examined associations between school-contextual characteristics and traditional bullying, fewer studies have focused on the links to students’ involvement in cyberbullying behavior. The aim of the present study is to assess whether school-contextual conditions in terms of teachers’ ratings of the school leadership are associated with the occurrence of cyberbullying victimization and perpetration among students. The data are derived from two separate data collections performed in 2016: The Stockholm School Survey conducted among students in the second grade of upper secondary school (ages 17–18 years) in Stockholm municipality, and the Stockholm Teacher Survey which was carried out among teachers in the same schools. The data include information from 6067 students distributed across 58 schools, linked with school-contextual information based on reports from 1251 teachers. Cyberbullying victimization and perpetration are measured by students’ self-reports. Teachers’ ratings of the school leadership are captured by an index based on 10 items; the mean value of this index was aggregated to the school level. Results from binary logistic multilevel regression models show that high teacher ratings of the school leadership are associated with less cyberbullying victimization and perpetration. We conclude that a strong school leadership potentially prevents cyberbullying behavior among students. Full article

(This article belongs to the Special Issue Cyber Pathology: Cyber Victimization and Cyber Bullying)

11 pages, 798 KiB

Open AccessArticle

by Chao Wu, Xiaofang Guo, Jun Zhao, Quan Lv, Hongbin Li, Edward B. McNeil, Virasakdi Chongsuvivatwong and Hongning Zhou

Int. J. Environ. Res. Public Health 2017, 14(10), 1227; https://doi.org/10.3390/ijerph14101227 - 15 Oct 2017

Cited by 8 | Viewed by 4503

Abstract

Background: In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this [...] Read more.

Background: In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this region. Methods: A stratified two-stage cluster sampling technique with probability proportional to size was used in Mengla County, Xishuangbanna Prefecture, Yunnan. Twelve villages were used to recruit adult (≥18 years old) and eight schools were used for children (<18 years old). A questionnaire on behaviors and environment variables related to mosquito-borne diseases was devised. Results: Multiple correspondence analysis (MCA) grouped 20 behaviors into three domains, namely, environmental condition, bed net use behaviors, and repellent use behaviors, respectively. The Han ethnicity had the lowest odds of rearing pigs, their odds being significantly lower than those of Yi and Yao. For bed net use, Dai and other ethnic minority groups were less likely to use bed nets compared to Yi and Yao. The odds of repellent use in the Han ethnicity was lower than in Yi, but higher than in Dai. The Dai group was the most likely ethnicity to use repellents. Farmers were at a higher risk for pig rearing and not using repellents. Education of less than primary school held the lowest odds of pig rearing. Those with low income were at a higher risk for not using bed nets and repellent except in pig rearing. Those with a small family size were at a lower risk for pig rearing. Conclusion: Different ethnic and socioeconomic groups in the study areas require different specific emphases for the prevention of mosquito-borne diseases. Full article

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12 pages, 2259 KiB

Open AccessArticle

Identification of Genetic Interaction with Risk Factors Using a Time-To-Event Model

by Mariza De Andrade, Sebastian M. Armasu, Bryan M. McCauley, Tanya M. Petterson and John A. Heit

Int. J. Environ. Res. Public Health 2017, 14(10), 1228; https://doi.org/10.3390/ijerph14101228 - 15 Oct 2017

Cited by 1 | Viewed by 4398

Abstract

Background: Certain diseases can occur with and without a trigger. We use Venous Thromboembolism (VTE) as our example to identify genetic interaction with pregnancy in women with VTE during pre- or postpartum. Pregnancy is one of the major risk factors for VTE as [...] Read more.

Background: Certain diseases can occur with and without a trigger. We use Venous Thromboembolism (VTE) as our example to identify genetic interaction with pregnancy in women with VTE during pre- or postpartum. Pregnancy is one of the major risk factors for VTE as it accounts for 10% of maternal deaths. Methods: We performed a whole genome association analysis using the Cox Proportional Hazard (CoxPH) model adjusted for covariates to identify genetic variants associated with the time-to-event of VTE related to pre- or postpartum during the childbearing age of 18–45 years using a case-only design in a cohort of women with VTE. Women with a VTE event after 45 years of age were censored and contributed only follow-up time. Results: We identified two intragenic single nucleotide polymorphisms (SNPs) at genome-wide significance in the PURB gene located on chromosome 7, and two additional intragenic SNPs, one in the LINGO2 gene on chromosome 9 and one in RDXP2 on chromosome X. Conclusions: We showed that the time-to-event model is a useful approach for identifying potential hazard-modification of the genetic variants when the event of interest (VTE) occurs due to a risk factor (pre- or post-partum). Full article

(This article belongs to the Special Issue Gene-Environment Interactions and Disease)

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17 pages, 712 KiB

Open AccessArticle

Barriers and Facilitators for Health Behavior Change among Adults from Multi-Problem Households: A Qualitative Study

by Gera E. Nagelhout, Lette Hogeling, Renate Spruijt, Nathalie Postma and Hein De Vries

Int. J. Environ. Res. Public Health 2017, 14(10), 1229; https://doi.org/10.3390/ijerph14101229 - 15 Oct 2017

Cited by 15 | Viewed by 10583

Abstract

Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults [...] Read more.

Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults from multi-problem households, as well as to identify ideas for a health promotion program. A qualitative study involving 25 semi-structured interviews was conducted among Dutch adults who received intensive family home care for multi-problem households. Results were discussed with eight social workers in a focus group interview. Data were analyzed using the Framework Method. The results revealed that the main reason for not engaging in sports were the costs. Physical activity was facilitated by physically active (transport to) work and by dog ownership. Respondents who received a food bank package reported this as a barrier for healthy eating. Those with medical conditions such as diabetes indicated that this motivated them to eat healthily. Smokers and former smokers reported that stress was a major barrier for quitting smoking but that medical conditions could motivate them to quit smoking. A reported reason for not using alcohol was having difficult past experiences such as violence and abuse by alcoholics. Mentioned intervention ideas were: something social, an outdoor sports event, cooking classes, a walking group, and children’s activities in nature. Free or cheap activities that include social interaction and reduce stress are in line with the identified barriers and facilitators. Besides these activities, it may be important to influence the target group’s environment by educating social workers and ensuring healthier food bank packages. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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11 pages, 2892 KiB

Open AccessArticle

Design of Research on Performance of a New Iridium Coordination Compound for the Detection of Hg²⁺

by Hailing Ma and Sang-Bing Tsai

Int. J. Environ. Res. Public Health 2017, 14(10), 1232; https://doi.org/10.3390/ijerph14101232 - 16 Oct 2017

Cited by 32 | Viewed by 4226

Abstract

Heavy metal pollution has become one of the most significant pollution problems encountered by our country in terms of environment protection. In addition to the significant effects of heavy metals on the human body and other organisms through water, food chain enrichment and [...] Read more.

Heavy metal pollution has become one of the most significant pollution problems encountered by our country in terms of environment protection. In addition to the significant effects of heavy metals on the human body and other organisms through water, food chain enrichment and other routes, heavy metals involved in daily necessities beyond the level limit could also affect people’s lives, so the detection of heavy metals is extremely important. Ir (III) coordination compound, considered to be one of the best phosphorescent sensing materials, is characterized by high luminous efficiency, easy modification of the ligand and so on, and it has potential applications in the field of heavy metal detection. This project aims to product a new Ir (III) functional coordination compound by designing a new auxiliary ligand and a main ligand with a sulfur identification unit, in order to systematically investigate the application of iridium coordination compound in the detection of the heavy metal Hg²⁺. With the introduction of the sulfur identification unit, selective sensing of Hg²⁺ could be achieved. Additionally, a new auxiliary ligand is also introduced to produce a functional iridium coordination compound with high quantum efficiency, and to diversify the application of iridium coordination compound in this field. Full article

(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)

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11 pages, 287 KiB

Open AccessArticle

“Their Packaging Has Always Been Like a Power”: A Qualitative Study of U.S. Smokers’ Perceptions of Cigarette Pack Visual Design Features to Inform Product Regulation

by Joseph G. L. Lee, Paige E. Averett, Tiffany Blanchflower, Nunzio Landi and Kyle R. Gregory

Int. J. Environ. Res. Public Health 2017, 14(10), 1234; https://doi.org/10.3390/ijerph14101234 - 17 Oct 2017

Cited by 10 | Viewed by 5195

Abstract

Cigarette packaging matters to consumer behavior. However, it is less clear which changes to packaging design would be salient for adult smokers. Such information is critically important to regulators in the United States who are charged with reviewing new tobacco products for their [...] Read more.

Cigarette packaging matters to consumer behavior. However, it is less clear which changes to packaging design would be salient for adult smokers. Such information is critically important to regulators in the United States who are charged with reviewing new tobacco products for their impact on population health. In this qualitative study, U.S. adult smokers (n = 33) participated in six telephone-based focus groups in March 2017. Separate groups were comprised of lesbian, gay, and bisexual (LGB) participants; participants with less than four years of post-secondary education; a mix of LGB and straight participants; and, the general population. All groups were purposely selected for diversity. Open thematic coding identified salient design elements used on cigarette packaging. Smokers articulated design elements’ use, meaning, and links with consumer behaviors. Three themes were identified: (1) the power of color, (2) supporting color with other design elements (e.g., logos/images, typography, the pack itself), and (3) the combined product brand experience of multiple design elements. Participants linked design elements to product characteristics and to consumer behavior (e.g., purchase). As the Food and Drug Administration is charged with regulating tobacco products, these findings suggest the importance of considering the cigarette pack part of the characteristics of a product. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

10 pages, 2692 KiB

Open AccessArticle

Physiological and Perceptual Responses to Nordic Walking in a Natural Mountain Environment

by Alessandro Grainer, Livio Zerbini, Carlo Reggiani, Giuseppe Marcolin, James Steele, Gaspare Pavei and Antonio Paoli

Int. J. Environ. Res. Public Health 2017, 14(10), 1235; https://doi.org/10.3390/ijerph14101235 - 17 Oct 2017

Cited by 15 | Viewed by 5364

Abstract

Background: Interest around Nordic Walking (NW) has increased in recent years. However, direct comparisons of NW with normal walking (W), particularly in ecologically valid environments is lacking. The aim of our study was to compare NW and W, over long distances in a [...] Read more.

Background: Interest around Nordic Walking (NW) has increased in recent years. However, direct comparisons of NW with normal walking (W), particularly in ecologically valid environments is lacking. The aim of our study was to compare NW and W, over long distances in a natural mountain environment. Methods: Twenty one subjects (13 male/8 female, aged 41 ± 12 years, body mass index BMI 24.1 ± 3.7), walked three distinct uphill paths (length 2.2/3.4/7 km) with (NW) or without (W) walking poles over two separate days. Heart rate (HR), energy expenditure (EE), step length (SL), walking speed (WS), total steps number (SN) and rating of perceived exertion (RPE) were monitored. Results: HR (+18%) and EE (+20%) were higher in NW than in W whilst RPE was similar. SN (−12%) was lower and SL (+15%) longer in NW. WS was higher (1.64 vs. 1.53 m s⁻¹) in NW. Conclusions: Our data confirm that, similarly to previous laboratory studies, differences in a range of walking variables are present between NW and W when performed in a natural environment. NW appears to increase EE compared to W, despite a similar RPE. Thus, NW could be a useful as aerobic training modality for weight control and cardiorespiratory fitness. Full article

(This article belongs to the Section Environmental Health)

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7 pages, 243 KiB

Open AccessArticle

Comparison of Two Sources of Clinical Audit Data to Assess the Delivery of Diabetes Care in Aboriginal Communities

by Timothy Regan, Christine Paul, Paul Ishiguchi, Catherine D’Este, Claudia Koller, Kristy Forshaw, Natasha Noble, Christopher Oldmeadow, Alessandra Bisquera and Sandra Eades

Int. J. Environ. Res. Public Health 2017, 14(10), 1236; https://doi.org/10.3390/ijerph14101236 - 17 Oct 2017

Cited by 1 | Viewed by 3594

Abstract

The objective of this study was to determine the concordance between data extracted from two Clinical Decision Support Systems regarding diabetes testing and monitoring at Aboriginal Community Controlled Health Services in Australia. De-identified PenCAT and Communicare Systems data were extracted from the services [...] Read more.

The objective of this study was to determine the concordance between data extracted from two Clinical Decision Support Systems regarding diabetes testing and monitoring at Aboriginal Community Controlled Health Services in Australia. De-identified PenCAT and Communicare Systems data were extracted from the services allocated to the intervention arm of a diabetes care trial, and intra-class correlations for each extracted item were derived at a service level. Strong to very strong correlations between the two data sources were found regarding the total number of patients with diabetes per service (Intra-class correlation [ICC] = 0.99), as well as the number (ICC = 0.98–0.99) and proportion (ICC = 0.96) of patients with diabetes by gender. The correlation was moderate for the number and proportion of Type 2 diabetes patients per service in the group aged 18–34 years (ICC = 0.65 and 0.8–0.82 respectively). Strong to very strong correlations were found for numbers and proportions of patients being tested for diabetes, and for appropriate monitoring of patients known to have diabetes (ICC = 0.998–1.00). This indicated a generally high degree of concordance between whole-service data extracted by the two Clinical Decision Support Systems. Therefore, the less expensive or less complex option (depending on the individual circumstances of the service) may be appropriate for monitoring diabetes testing and care. However, the extraction of data about subgroups of patients may not be interchangeable. Full article

11 pages, 265 KiB

Open AccessArticle

Housing and Health of Kiribati Migrants Living in New Zealand

by Mary Anne Teariki

Int. J. Environ. Res. Public Health 2017, 14(10), 1237; https://doi.org/10.3390/ijerph14101237 - 17 Oct 2017

Cited by 10 | Viewed by 5201

Abstract

Settlement is a complex process of adjustment for migrants and refugees. Drawing on recent research on the settlement experiences of Kiribati migrants and their families living in New Zealand, this article examines the role of housing as an influencer of the settlement and [...] Read more.

Settlement is a complex process of adjustment for migrants and refugees. Drawing on recent research on the settlement experiences of Kiribati migrants and their families living in New Zealand, this article examines the role of housing as an influencer of the settlement and health of Kiribati migrants. Using qualitative methodology, in-depth interviews were conducted with fourteen Kiribati migrants (eight women and six men) representing 91 family members about the key issues and events that shaped their settlement in New Zealand. The stories told by participants affirm the association between housing and health. The study serves as an important reminder that children bear a great cost from living in poorly insulated and damp housing, and adults bear the mental costs, including social isolation resulting from inadequate rental housing. Detailed information about how this migrant group entered the private rental housing market, by taking over the rental leases of other Kiribati migrants vacating their rental properties, indicated some of the unintended consequences related to a lack of incentives for landlords to make improvements. With the most vulnerable families most at risk from inadequate housing, this research concludes that there is a need for minimum housing standards to protect tenants. Full article

(This article belongs to the Special Issue Housing and Health)

14 pages, 314 KiB

Open AccessArticle

China’s Insurance Regulatory Reform, Corporate Governance Behavior and Insurers’ Governance Effectiveness

by Huicong Li, Hongliang Zhang, Sang-Bing Tsai and Aichao Qiu

Int. J. Environ. Res. Public Health 2017, 14(10), 1238; https://doi.org/10.3390/ijerph14101238 - 17 Oct 2017

Cited by 12 | Viewed by 4735

Abstract

External regulation is an important mechanism to improve corporate behavior in emerging markets. China’s insurance governance regulation, which began to supervise and guide insurance corporate governance behavior in 2006, has experienced a complex process of reform. This study tested our hypotheses with a [...] Read more.

External regulation is an important mechanism to improve corporate behavior in emerging markets. China’s insurance governance regulation, which began to supervise and guide insurance corporate governance behavior in 2006, has experienced a complex process of reform. This study tested our hypotheses with a sample of 85 firms during 2010–2011, which was obtained by providing a questionnaire to all of China’s shareholding insurance companies. The empirical study results generally show that China’s insurance governance effectiveness has significantly improved through strict regulation. Insurance corporate governance can improve business acumen and risk-control ability, but no significant evidence was found to prove its influence on profitability, as a result of focusing less attention on governance than on management. State ownership is associated with higher corporate governance effectiveness than non-state ownership. Listed companies tend to outperform non-listed firms, and life insurance corporate governance is more effective than that of property insurers. This study not only contributes to the comprehensive understanding of corporate governance effectiveness but also to the literature by highlighting the effect of corporate governance regulation in China’s insurance industry and other emerging economies of the financial sector. Full article

(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)

10 pages, 481 KiB

Open AccessArticle

Transnational Dynamics Amid Poor Regulations: Taiwan’s Asbestos Ban Actions and Experiences

by Harry Yi-Jui Wu, Ro-Ting Lin, Jung-Der Wang and Yawen Cheng

Int. J. Environ. Res. Public Health 2017, 14(10), 1240; https://doi.org/10.3390/ijerph14101240 - 17 Oct 2017

Cited by 10 | Viewed by 7546

Abstract

This article describes the history of the asbestos use regulation process in Taiwan and the associated factors leading to its total ban in 2018. Despite the long history of asbestos mining and manufacturing since the Japanese colonial period, attempts to understand the impact [...] Read more.

This article describes the history of the asbestos use regulation process in Taiwan and the associated factors leading to its total ban in 2018. Despite the long history of asbestos mining and manufacturing since the Japanese colonial period, attempts to understand the impact of asbestos on the health of the population and to control its use did not emerge until the early 1980s. We attempted to investigate the driving forces and obstructions involved in asbestos regulations by reviewing available public sources and scientific journal articles and conducting interviews with key propagators of the asbestos regulation and ban. Correlation between asbestos exposure and asbestos-related diseases has already been established; however, authorities have been unable to effectively regulate the extensive application of asbestos in various light industries that support economic growth since the 1960s. More stringent regulations on asbestos use in industries and an eventual ban were caused indirectly by appeals made by visionary scholars and healthcare professionals but also due to the subsidence of asbestos-related industries. With the elucidation of factors that affect asbestos regulation and ban, a thorough long-term healthcare plan for the neglected victims of asbestos-related diseases and upstream measures for policy change must be developed. Full article

(This article belongs to the Special Issue Global Panorama of National Experiences in Public Health Actions to Ban Asbestos)

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12 pages, 1366 KiB

Open AccessArticle

Dampness and Moisture Problems in Norwegian Homes

by Rune Becher, Anja Hortemo Høie, Jan Vilhelm Bakke, Sverre Bjørn Holøs and Johan Øvrevik

Int. J. Environ. Res. Public Health 2017, 14(10), 1241; https://doi.org/10.3390/ijerph14101241 - 17 Oct 2017

Cited by 15 | Viewed by 4302

Abstract

The occurrence of dampness and mold in the indoor environment is associated with respiratory-related disease outcomes. Thus, it is pertinent to know the magnitude of such indoor environment problems to be able to estimate the potential health impact in the population. In the [...] Read more.

The occurrence of dampness and mold in the indoor environment is associated with respiratory-related disease outcomes. Thus, it is pertinent to know the magnitude of such indoor environment problems to be able to estimate the potential health impact in the population. In the present study, the moisture damage in 10,112 Norwegian dwellings was recorded based on building inspection reports. The levels of moisture damage were graded based on a condition class (CC), where CC0 is immaculate and CC1 acceptable (actions not required), while CC2 and CC3 indicate increased levels of damage that requires action. Of the 10,112 dwellings investigated, 3125 had verified moisture or mold damage. This amounts to 31% of the surveyed dwellings. Of these, 27% had CC2 as the worst grade, whereas 4% had CC3 as the worst grade level. The room types and building structures most prone to moisture damage were (in rank order) crawl spaces, basements, un-insulated attics, cooling rooms, and bathrooms. The high proportion of homes with moisture damage indicate a possible risk for respiratory diseases in a relatively large number of individuals, even if only the more extensive moisture damages and those located in rooms where occupants spend the majority of their time would have a significant influence on adverse health effects. Full article

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12 pages, 639 KiB

Open AccessArticle

Food and Beverage Availability in Small Food Stores Located in Healthy Food Financing Initiative Eligible Communities

by Chelsea R. Singleton, Yu Li, Ana Clara Duran, Shannon N. Zenk, Angela Odoms-Young and Lisa M. Powell

Int. J. Environ. Res. Public Health 2017, 14(10), 1242; https://doi.org/10.3390/ijerph14101242 - 18 Oct 2017

Cited by 17 | Viewed by 6533

Abstract

Food deserts are a major public health concern. This study aimed to assess food and beverage availability in four underserved communities eligible to receive funding from the Healthy Food Financing Initiative (HFFI). Data analyzed are part of a quasi-experimental study evaluating the impact [...] Read more.

Food deserts are a major public health concern. This study aimed to assess food and beverage availability in four underserved communities eligible to receive funding from the Healthy Food Financing Initiative (HFFI). Data analyzed are part of a quasi-experimental study evaluating the impact of the HFFI on the retail food environment in selected Illinois communities. In 2015, 127 small grocery and limited service stores located in the four selected communities were audited. All communities had a large percentage of low-income and African-American residents. Differences in food and beverage item availability (e.g., produce, milk, bread, snack foods) were examined by store type and community location. Food stores had, on average, 1.8 fresh fruit and 2.9 fresh vegetable options. About 12% of stores sold low-fat milk while 86% sold whole milk. Only 12% of stores offered 100% whole wheat bread compared to 84% of stores offering white bread. Almost all (97%) stores offered soda and/or fruit juice. In summary, we found limited availability of healthier food and beverage items in the communities identified for HFFI support. Follow up findings will address how the introduction of new HFFI-supported supermarkets will affect food and beverage availability in these communities over time. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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24 pages, 2614 KiB

Open AccessArticle

Disease and Health Inequalities Attributable to Air Pollutant Exposure in Detroit, Michigan

by Sheena E. Martenies, Chad W. Milando, Guy O. Williams and Stuart A. Batterman

Int. J. Environ. Res. Public Health 2017, 14(10), 1243; https://doi.org/10.3390/ijerph14101243 - 19 Oct 2017

Cited by 56 | Viewed by 10273

Abstract

The environmental burden of disease is the mortality and morbidity attributable to exposures of air pollution and other stressors. The inequality metrics used in cumulative impact and environmental justice studies can be incorporated into environmental burden studies to better understand the health disparities [...] Read more.

The environmental burden of disease is the mortality and morbidity attributable to exposures of air pollution and other stressors. The inequality metrics used in cumulative impact and environmental justice studies can be incorporated into environmental burden studies to better understand the health disparities of ambient air pollutant exposures. This study examines the diseases and health disparities attributable to air pollutants for the Detroit urban area. We apportion this burden to various groups of emission sources and pollutants, and show how the burden is distributed among demographic and socioeconomic subgroups. The analysis uses spatially-resolved estimates of exposures, baseline health rates, age-stratified populations, and demographic characteristics that serve as proxies for increased vulnerability, e.g., race/ethnicity and income. Based on current levels, exposures to fine particulate matter (PM_2.5), ozone (O₃), sulfur dioxide (SO₂), and nitrogen dioxide (NO₂) are responsible for more than 10,000 disability-adjusted life years (DALYs) per year, causing an annual monetized health impact of $6.5 billion. This burden is mainly driven by PM_2.5 and O₃ exposures, which cause 660 premature deaths each year among the 945,000 individuals in the study area. NO₂ exposures, largely from traffic, are important for respiratory outcomes among older adults and children with asthma, e.g., 46% of air-pollution related asthma hospitalizations are due to NO₂ exposures. Based on quantitative inequality metrics, the greatest inequality of health burdens results from industrial and traffic emissions. These metrics also show disproportionate burdens among Hispanic/Latino populations due to industrial emissions, and among low income populations due to traffic emissions. Attributable health burdens are a function of exposures, susceptibility and vulnerability (e.g., baseline incidence rates), and population density. Because of these dependencies, inequality metrics should be calculated using the attributable health burden when feasible to avoid potentially underestimating inequality. Quantitative health impact and inequality analyses can inform health and environmental justice evaluations, providing important information to decision makers for prioritizing strategies to address exposures at the local level. Full article

(This article belongs to the Special Issue Ambient Air Pollution and Health Vulnerability)

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15 pages, 3874 KiB

Open AccessArticle

The Potential Impact of Satellite-Retrieved Cloud Parameters on Ground-Level PM_2.5 Mass and Composition

by Jessica H. Belle, Howard H. Chang, Yujie Wang, Xuefei Hu, Alexei Lyapustin and Yang Liu

Int. J. Environ. Res. Public Health 2017, 14(10), 1244; https://doi.org/10.3390/ijerph14101244 - 18 Oct 2017

Cited by 21 | Viewed by 6857

Abstract

Satellite-retrieved aerosol optical properties have been extensively used to estimate ground-level fine particulate matter (PM_2.5) concentrations in support of air pollution health effects research and air quality assessment at the urban to global scales. However, a large proportion, ~70%, of satellite [...] Read more.

Satellite-retrieved aerosol optical properties have been extensively used to estimate ground-level fine particulate matter (PM_2.5) concentrations in support of air pollution health effects research and air quality assessment at the urban to global scales. However, a large proportion, ~70%, of satellite observations of aerosols are missing as a result of cloud-cover, surface brightness, and snow-cover. The resulting PM_2.5 estimates could therefore be biased due to this non-random data missingness. Cloud-cover in particular has the potential to impact ground-level PM_2.5 concentrations through complex chemical and physical processes. We developed a series of statistical models using the Multi-Angle Implementation of Atmospheric Correction (MAIAC) aerosol product at 1 km resolution with information from the MODIS cloud product and meteorological information to investigate the extent to which cloud parameters and associated meteorological conditions impact ground-level aerosols at two urban sites in the US: Atlanta and San Francisco. We find that changes in temperature, wind speed, relative humidity, planetary boundary layer height, convective available potential energy, precipitation, cloud effective radius, cloud optical depth, and cloud emissivity are associated with changes in PM_2.5 concentration and composition, and the changes differ by overpass time and cloud phase as well as between the San Francisco and Atlanta sites. A case-study at the San Francisco site confirmed that accounting for cloud-cover and associated meteorological conditions could substantially alter the spatial distribution of monthly ground-level PM_2.5 concentrations. Full article

(This article belongs to the Special Issue Spatial Modelling for Public Health Research)

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14 pages, 322 KiB

Open AccessArticle

Patient Aggression and the Wellbeing of Nurses: A Cross-Sectional Survey Study in Psychiatric and Non-Psychiatric Settings

by Virve Pekurinen, Laura Willman, Marianna Virtanen, Mika Kivimäki, Jussi Vahtera and Maritta Välimäki

Int. J. Environ. Res. Public Health 2017, 14(10), 1245; https://doi.org/10.3390/ijerph14101245 - 18 Oct 2017

Cited by 83 | Viewed by 12796

Abstract

Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing [...] Read more.

Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing of nurses in psychiatric and non-psychiatric specialties (medical and surgical, and emergency medicine). A sample of 5288 nurses (923 psychiatric nurses, 4070 medical and surgical nurses, 295 emergency nurses) participated in the study. Subjective measures were used to assess both the occurrence of patient aggression and the wellbeing of nurses (self-rated health, sleep disturbances, psychological distress and perceived work ability). Binary logistic regression with interaction terms was used to compare the associations between patient aggression and the wellbeing of nurses. Psychiatric nurses reported all types of patient aggression more frequently than medical and surgical nurses, whereas nurses working in emergency settings reported physical violence and verbal aggression more frequently than psychiatric nurses. Psychiatric nurses reported poor self-rated health and reduced work ability more frequently than both of the non-psychiatric nursing groups, whereas medical and surgical nurses reported psychological distress and sleep disturbances more often. Psychiatric nurses who had experienced at least one type of patient aggression or mental abuse in the previous year, were less likely to suffer from psychological distress and sleep disturbances compared to medical and surgical nurses. Psychiatric nurses who had experienced physical assaults and armed threats were less likely to suffer from sleep disturbances compared to nurses working in emergency settings. Compared to medical and surgical nurses, psychiatric nurses face patient aggression more often, but certain types of aggression are more common in emergency settings. Psychiatric nurses have worse subjective health and work ability than both of the non-psychiatric nursing groups, while their psychiatric wellbeing is better and they have less sleep problems compared to medical and surgical nurses. Psychiatric nurses maintain better psychiatric wellbeing and experience fewer sleep problems than non-psychiatric nurses after events of exposure to patient aggression. This suggest that more attention should be given to non-psychiatric settings for maintaining the wellbeing of nurses after exposure to patient aggression. Full article

(This article belongs to the Section Occupational Safety and Health)

10 pages, 1881 KiB

Open AccessArticle

Variations of Escherichia coli O157:H7 Survival in Purple Soils

by Taoxiang Zhang, Suping Hu and Wenhao Yang

Int. J. Environ. Res. Public Health 2017, 14(10), 1246; https://doi.org/10.3390/ijerph14101246 - 18 Oct 2017

Cited by 8 | Viewed by 3636

Abstract

Escherichia coli O157:H7 is a well-recognized cause of human illness. Survival of Escherichia coli O157:H7 in five purple soils from Sichuan Province was investigated. The dynamics of E. coli O157:H7 survival in purple soils were described by the Weibull model. Results showed that [...] Read more.

Escherichia coli O157:H7 is a well-recognized cause of human illness. Survival of Escherichia coli O157:H7 in five purple soils from Sichuan Province was investigated. The dynamics of E. coli O157:H7 survival in purple soils were described by the Weibull model. Results showed that this model is suitable to fit survival curves of E. coli O157:H7 in purple soils, with the calculated t_d value (survival time needed to reach the detection limit of 100 CFU·g⁻¹) ranging from 2.99 days to 26.36 days. The longest survival time of E. coli O157:H7 was observed in neutral purple soils (24.49 days), followed by alkalescent purple soil (18.62 days) and acid purple soil (3.48 days). The redundancy analysis (RDA) revealed that t_d values were significantly enhanced by soil nutrition (total organic carbon (OC), total nitrogen (TN), available potassium (AK) and the ratio of humic acid to fulvic acid (Ha/Fa)), but were significantly suppressed by iron and aluminum oxide. Full article

(This article belongs to the Section Environmental Health)

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10 pages, 1097 KiB

Open AccessArticle

Paid Sick Leave and Risks of All-Cause and Cause-Specific Mortality among Adult Workers in the USA

by Daniel Kim

Int. J. Environ. Res. Public Health 2017, 14(10), 1247; https://doi.org/10.3390/ijerph14101247 - 19 Oct 2017

Cited by 30 | Viewed by 8014

Abstract

Background: The USA is one of only a few advanced economies globally that does not guarantee its workers paid sick leave. While there are plausible reasons why paid sick leave may be linked to mortality, little is known empirically about this association. Methods: [...] Read more.

Background: The USA is one of only a few advanced economies globally that does not guarantee its workers paid sick leave. While there are plausible reasons why paid sick leave may be linked to mortality, little is known empirically about this association. Methods: In a pooled USA nationally-representative longitudinal sample of 57,323 working adults aged 18–85 years from the National Health Interview Surveys 2000–2002, paid sick leave was examined as a predictor of all-cause and cause-specific mortality. Multivariate Cox proportional hazards models were used to estimate the impact of paid sick leave on mortality. Results: Having paid sick leave through one’s job was associated with 10% (hazards ratio, HR = 0.90; 95% CI = 0.81–0.996; p = 0.04), 14% (HR = 0.86; 95% CI = 0.74–0.99; p = 0.04), and 22% (HR = 0.78; 95% CI = 0.65–0.94; p = 0.01) significantly lower hazards of all-cause mortality after mean follow-up times of 11.1, 6.5, and 4.5 years, respectively. This study further identified associations of paid sick leave with 24% (HR = 0.76; 95% CI = 0.59–0.98; p = 0.03), and 35% (HR = 0.65; 95% CI = 0.44–0.95; p = 0.03) lower hazards of dying from heart diseases and unintentional injuries, respectively. Conclusions: To the author’s knowledge, this study provides the first empirical evidence on the linkages between paid sick leave and mortality and supports protective effects, particularly against heart diseases and unintentional injuries. The most salient association corresponded to a lag period of just less than five years. Social policies that mandate paid sick leave may help to reduce health inequities and alleviate the population burden of mortality among working adults in the USA. Full article

(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)

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10 pages, 496 KiB

Open AccessArticle

Living Arrangements and Health-Related Quality of Life in Chinese Adolescents Who Migrate from Rural to Urban Schools: Mediating Effect of Social Support

by Haiyan Wu, Shan Wu, Haibo Wu, Qiming Xia and Ningxiu Li

Int. J. Environ. Res. Public Health 2017, 14(10), 1249; https://doi.org/10.3390/ijerph14101249 - 19 Oct 2017

Cited by 14 | Viewed by 4369

Abstract

Changes in living arrangements (from living with, or not living with family) may affect the health-related quality of life (HRQoL). This study aimed to investigate the impact of living arrangement on HRQoL among adolescents migrating from rural to urban schools, and whether social [...] Read more.

Changes in living arrangements (from living with, or not living with family) may affect the health-related quality of life (HRQoL). This study aimed to investigate the impact of living arrangement on HRQoL among adolescents migrating from rural to urban schools, and whether social support, in addition to living with a family, had an impact. A cross-sectional survey of 459 school adolescents was carried out in two public schools in Guyuan County, Ningxia Hui Autonomous Region, China in 2015. The survey contained the following questionnaires: a self-designed questionnaire, the 12-item Short Form Health Survey (SF-12), and the Social Support Rating Scale (SSRS). Of the 459 adolescents sampled (aged 15.41 ± 1.07 years with range of 13 to 18), 61.7% were living with family, and 38.3% were not living with family. Those students not living with families had lower Mental Component Scale (MCS) scores as well as less social support overall. Those students, who were not living with families, also reported more chronic health problems and more alcohol consumption compared to those students living with families. Social support was a statistically significant mediating factor on the effect of living arrangements on MCS. Our findings demonstrated that those students, who were not living with families, tended to have more health-related quality of life issues, but social support partially mediated the relationship between living arrangements and health. Full article

(This article belongs to the Special Issue Housing and Health)

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10 pages, 326 KiB

Open AccessArticle

Individual and Environmental Correlates to Quality of Life in Park Users in Colombia

by Diana Marina Camargo, Paula Camila Ramírez and Rogério César Fermino

Int. J. Environ. Res. Public Health 2017, 14(10), 1250; https://doi.org/10.3390/ijerph14101250 - 19 Oct 2017

Cited by 24 | Viewed by 4670

Abstract

Purpose: To explore individual and environmental correlates to quality of life (QoL) in park users in Colombia. Methods: A cross-sectional study with face-to-face interviews was conducted with 1392 park users from ten parks in Colombia. The survey included sociodemographic questions, health condition assessed [...] Read more.

Purpose: To explore individual and environmental correlates to quality of life (QoL) in park users in Colombia. Methods: A cross-sectional study with face-to-face interviews was conducted with 1392 park users from ten parks in Colombia. The survey included sociodemographic questions, health condition assessed with EuroQuol-5-Dimensions-5-Levels; in addition, questions about accessibility to the parks and perceptions about quality of infrastructure and green areas were asked. The Spanish version of the questionnaire EUROHIS-QOL-8 items was applied to assess QoL. Log-binomial regression models were applied for analyses. Results: Years of schooling, visits to the park with a companion, active use of the park, a maximum score for quality of trees and walking paths, and the perception of safety on the way to the park were positively associated with a better QoL (p < 0.05). Health conditions related to problems in the ability to perform activities of daily living and anxiety/depression showed negative associations. Conclusions: The present study contributes to the Latin American studies by providing information on how parks in an intermediate city may contribute to increased QoL of park users through safety in neighborhoods, social support, active use, and aesthetics, cleanliness, and care of green areas. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

20 pages, 3257 KiB

Open AccessArticle

Environmental Risk Assessment Strategy for Nanomaterials

by Janeck J. Scott‐Fordsmand, Willie J. G. M. Peijnenburg, Elena Semenzin, Bernd Nowack, Neil Hunt, Danail Hristozov, Antonio Marcomini, Muhammad‐Adeel Irfan, Araceli Sánchez Jiménez, Robert Landsiedel, Lang Tran, Agnes G. Oomen, Peter M. J. Bos and Kerstin Hund‐Rinke

Int. J. Environ. Res. Public Health 2017, 14(10), 1251; https://doi.org/10.3390/ijerph14101251 - 19 Oct 2017

Cited by 40 | Viewed by 8517

Abstract

An Environmental Risk Assessment (ERA) for nanomaterials (NMs) is outlined in this paper. Contrary to other recent papers on the subject, the main data requirements, models and advancement within each of the four risk assessment domains are described, i.e., in the: (i) materials, [...] Read more.

An Environmental Risk Assessment (ERA) for nanomaterials (NMs) is outlined in this paper. Contrary to other recent papers on the subject, the main data requirements, models and advancement within each of the four risk assessment domains are described, i.e., in the: (i) materials, (ii) release, fate and exposure, (iii) hazard and (iv) risk characterisation domains. The material, which is obviously the foundation for any risk assessment, should be described according to the legislatively required characterisation data. Characterisation data will also be used at various levels within the ERA, e.g., exposure modelling. The release, fate and exposure data and models cover the input for environmental distribution models in order to identify the potential (PES) and relevant exposure scenarios (RES) and, subsequently, the possible release routes, both with regard to which compartment(s) NMs are distributed in line with the factors determining the fate within environmental compartment. The initial outcome in the risk characterisation will be a generic Predicted Environmental Concentration (PEC), but a refined PEC can be obtained by applying specific exposure models for relevant media. The hazard information covers a variety of representative, relevant and reliable organisms and/or functions, relevant for the RES and enabling a hazard characterisation. The initial outcome will be hazard characterisation in test systems allowing estimating a Predicted No-Effect concentration (PNEC), either based on uncertainty factors or on a NM adapted version of the Species Sensitivity Distributions approach. The risk characterisation will either be based on a deterministic risk ratio approach (i.e., PEC/PNEC) or an overlay of probability distributions, i.e., exposure and hazard distributions, using the nano relevant models. Full article

(This article belongs to the Collection Environmental Risk Assessment)

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19 pages, 1345 KiB

Open AccessArticle

Correlation Analysis of PM₁₀ and the Incidence of Lung Cancer in Nanchang, China

by Yi Zhou, Lianshui Li and Lei Hu

Int. J. Environ. Res. Public Health 2017, 14(10), 1253; https://doi.org/10.3390/ijerph14101253 - 19 Oct 2017

Cited by 34 | Viewed by 7015

Abstract

Air pollution and lung cancer are closely related. In 2013, the World Health Organization listed outdoor air pollution as carcinogenic and regarded it as the most widespread carcinogen that humans are currently exposed to. Here, grey correlation and data envelopment analysis methods are [...] Read more.

Air pollution and lung cancer are closely related. In 2013, the World Health Organization listed outdoor air pollution as carcinogenic and regarded it as the most widespread carcinogen that humans are currently exposed to. Here, grey correlation and data envelopment analysis methods are used to determine the pollution factors causing lung cancer among residents in Nanchang, China, and identify population segments which are more susceptible to air pollution. This study shows that particulate matter with particle sizes below 10 micron (PM₁₀) is most closely related to the incidence of lung cancer among air pollution factors including annual mean concentrations of SO₂, NO₂, PM₁₀, annual haze days, and annual mean Air Pollution Index/Air Quality Index (API/AQI). Air pollution has a greater impact on urban inhabitants as compared to rural inhabitants. When gender differences are considered, women are more likely to develop lung cancer due to air pollution. Smokers are more likely to suffer from lung cancer. These results provide a reference for the government to formulate policies to reduce air pollutant emissions and strengthen anti-smoking measures. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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14 pages, 1620 KiB

Open AccessArticle

Lung Toxicity of Condensed Aerosol from E-CIG Liquids: Influence of the Flavor and the In Vitro Model Used

by Rossella Bengalli, Emanuele Ferri, Massimo Labra and Paride Mantecca

Int. J. Environ. Res. Public Health 2017, 14(10), 1254; https://doi.org/10.3390/ijerph14101254 - 20 Oct 2017

Cited by 53 | Viewed by 7111

Abstract

The diffusion of e-cigarette (e-CIG) opens a great scientific and regulatory debate about its safety. The huge number of commercialized devices, e-liquids with almost infinite chemical formulations and the growing market demand for a rapid and efficient toxicity screen system that is able [...] Read more.

The diffusion of e-cigarette (e-CIG) opens a great scientific and regulatory debate about its safety. The huge number of commercialized devices, e-liquids with almost infinite chemical formulations and the growing market demand for a rapid and efficient toxicity screen system that is able to test all of these references and related aerosols. A consensus on the best protocols for the e-CIG safety assessment is still far to be achieved, since the huge number of variables characterizing these products (e.g., flavoring type and concentration, nicotine concentration, type of the device, including the battery and the atomizer). This suggests that more experimental evidences are needed to support the regulatory frameworks. The present study aims to contribute in this field by testing the effects of condensed aerosols (CAs) from three main e-liquid categories (tobacco, mint, and cinnamon as food-related flavor), with (18 mg/mL) or without nicotine. Two in vitro models, represented by a monoculture of human epithelial alveolar cells and a three-dimensional (3D) co-culture of alveolar and lung microvascular endothelial cells were used. Cell viability, pro-inflammatory cytokines release and alveolar-blood barrier (ABB) integrity were investigated as inhalation toxicity endpoints. Results showed that nicotine itself had almost no influence on the modulation of the toxicity response, while flavor composition did have. The cell viability was significantly decreased in monoculture and ABB after exposure to the mints and cinnamon CAs. The barrier integrity was significantly affected in the ABB after exposure to cytotoxic CAs. With the exception of the significant IL-8 release in the monoculture after Cinnamon exposure, no increase of inflammatory cytokines (IL-8 and MCP-1) release was observed. These findings point out that multiple assays with different in vitro models are able to discriminate the acute inhalation toxicity of CAs from liquids with different flavors, providing the companies and regulatory bodies with useful tools for the preliminary screening of marketable products. Full article

(This article belongs to the Section Environmental Health)

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12 pages, 418 KiB

Open AccessArticle

Direct Effects of the Home, School, and Consumer Food Environments on the Association between Food Purchasing Patterns and Dietary Intake among Rural Adolescents in Kentucky and North Carolina, 2017

by Alison Gustafson, Stephanie Jilcott Pitts, Jordan McDonald, Hannah Ford, Paige Connelly, Rachel Gillespie, Emily Liu, Heather Bush, Candace Brancato, Toyin Babatande and Janet Mullins

Int. J. Environ. Res. Public Health 2017, 14(10), 1255; https://doi.org/10.3390/ijerph14101255 - 21 Oct 2017

Cited by 24 | Viewed by 6720

Abstract

Background: Obesity rates are higher among rural versus urban adolescents. To examine possible mechanisms for the rural-urban adolescent obesity disparity, we examined the direct and indirect effects of food purchasing patterns, and the home, school, and consumer food environments on dietary intake [...] Read more.

Background: Obesity rates are higher among rural versus urban adolescents. To examine possible mechanisms for the rural-urban adolescent obesity disparity, we examined the direct and indirect effects of food purchasing patterns, and the home, school, and consumer food environments on dietary intake among rural adolescents. Methods: A baseline survey was conducted among adolescents in eight rural high schools (four in Eastern Kentucky, and four in Eastern North Carolina). Participants answered questions about food purchasing patterns, dietary intake, home food availability, and demographics. The school and consumer food environments were assessed using validated measures from the School Meals Cost Study (United States Department of Agriculture-Mathematica) and the Nutrition Environment Measurement Survey for Stores, Restaurants, and Corner Stores. Results: Of 432 adolescents, 55% were normal weight, 24% were overweight, and 21% were obese. There was a direct association between unhealthy food purchasing patterns (shopping frequently at gas stations, fast food, and dollar stores) and consuming more added sugars, when compared to those with a healthy shopping pattern (shopping less frequently at gas stations, fast food, and dollar stores) [Odds Ratio = 2.41 (95% CI (confidence interval) 0.99, 3.82)]. Those who reported always having fruits and vegetables in the home consumed more servings of fruits and vegetables [OR = 0.31 cups (95% CI 0.22, 0.44)] compared to those who reported never having fruits and vegetables in the home. Adolescents attending a school with a low healthy food availability score consumed fewer servings of fruits and vegetables [−0.001 (95% CI −0.001, 0.0001)] compared to those attending a school with a high healthy food availability score. Conclusions: There are direct associations between food purchasing patterns, the home and school food environments, and dietary intake among rural adolescents. These cross-sectional results informed the development of the “Go Big and Bring it Home” program, a text messaging intervention to improve adolescents’ fruit, vegetable, and healthy beverage intake. Full article

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12 pages, 304 KiB

Open AccessArticle

Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

by Hai Fang, Yinzi Jin, Miaomiao Zhao, Huyang Zhang, John A. Rizzo, Donglan Zhang and Zhiyuan Hou

Int. J. Environ. Res. Public Health 2017, 14(10), 1256; https://doi.org/10.3390/ijerph14101256 - 20 Oct 2017

Cited by 16 | Viewed by 4904

Abstract

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on [...] Read more.

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants’ probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management. Full article

(This article belongs to the Section Health Economics)

14 pages, 304 KiB

Open AccessArticle

In Search of Consistent Predictors of Children’s Physical Activity

by Keren Best, Kylie Ball, Dorota Zarnowiecki, Rebecca Stanley and James Dollman

Int. J. Environ. Res. Public Health 2017, 14(10), 1258; https://doi.org/10.3390/ijerph14101258 - 20 Oct 2017

Cited by 44 | Viewed by 5853

Abstract

Physical activity is pivotal for children’s health and well-being, yet participation declines across teenage years. Efforts to increase physical activity need to be strengthened to combat this, however, evidence for the design and planning of physical activity promotion in children is lacking. The [...] Read more.

Physical activity is pivotal for children’s health and well-being, yet participation declines across teenage years. Efforts to increase physical activity need to be strengthened to combat this, however, evidence for the design and planning of physical activity promotion in children is lacking. The aim was to identify predictors of physical activity that were relatively consistent across three different measures of physical activity, in pre- and early adolescent South Australians. This is the first study to compare correlates of physical activity across three measures of physical activity in a single sample, in this age group. Children (n = 324) aged 9–13 years and their parents were surveyed on personal, interpersonal and environmental correlates of physical activity. Child physical activity was objectively measured using pedometers (7 days). Self-reported physical activity was determined from organised sport participation and the Physical Activity Questionnaire for Adolescents. Regression models were used to identify consistent predictors of three physical activity measures. Consistent predictors across multiple physical activity measures were: parent support for physical activity, having appropriate clothing for sport, enjoyment of physical activity and perceived availability of sporting clubs. These predictors identify potential avenues for directing intervention efforts to increase physical activity in early adolescents. Full article

(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)

13 pages, 311 KiB

Open AccessArticle

Toward “Age-Friendly Slums”? Health Challenges of Older Slum Dwellers in Nairobi and the Applicability of the Age-Friendly City Approach

by Isabella Aboderin, Megumi Kano and Hilda Akinyi Owii

Int. J. Environ. Res. Public Health 2017, 14(10), 1259; https://doi.org/10.3390/ijerph14101259 - 20 Oct 2017

Cited by 40 | Viewed by 6182

Abstract

A majority of urban residents in sub-Saharan Africa (SSA) and other developing regions live in informal settlements, or slums. Much of the discourse on slum health centres on younger generations, while an intensifying agenda on healthy ageing as yet lacks a systematic focus [...] Read more.

A majority of urban residents in sub-Saharan Africa (SSA) and other developing regions live in informal settlements, or slums. Much of the discourse on slum health centres on younger generations, while an intensifying agenda on healthy ageing as yet lacks a systematic focus on slums. Similarly, the global age-friendly cities (AFC) movement does not, thus far, extend to slums. This paper examines the particular challenges that a slum-focused age-friendly initiative in SSA may need to address, and the relevance of present AFC indicators and domains for initiatives to advance the health and well-being of older slum dwellers. The analysis builds on the case of two slum communities in Nairobi, Kenya. It analyzes two bodies of relevant evidence from these settlements, namely on the health and social circumstances of older residents, and on the local application and measurement of AFC indicators. The findings point to a set of unsurprising, but also less obvious, core health and social adversities that an age-friendly initiative in such settlements would need to consider. The findings show, further, that the current AFC domains and indicators framework only partly capture these adversities, but that there is potential for adapting the framework to be meaningful for slum settings. The paper concludes by underscoring the need for, and opportunities inherent in, the pursuit of an “age-friendly slums” initiative going forward. Full article

(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)

7 pages, 607 KiB

Open AccessArticle

Symptoms during Adolescents’ First Use of Cigarettes and E-Cigarettes: A Pilot Study

by May S. Chen, Marissa G. Hall, Humberto Parada, Kathryn Peebles, Kaitlyn E. Brodar and Noel T. Brewer

Int. J. Environ. Res. Public Health 2017, 14(10), 1260; https://doi.org/10.3390/ijerph14101260 - 20 Oct 2017

Cited by 10 | Viewed by 4947

Abstract

Symptoms adolescents experience during their first time using a cigarette predict their current use, but little is known regarding the symptoms experienced during first e-cigarette use. We conducted a pilot study to understand the symptoms adolescents experience when they first tried cigarettes and [...] Read more.

Symptoms adolescents experience during their first time using a cigarette predict their current use, but little is known regarding the symptoms experienced during first e-cigarette use. We conducted a pilot study to understand the symptoms adolescents experience when they first tried cigarettes and e-cigarettes and the associations between these symptoms and current use. Participants were 41 adolescents in two U.S. cities who had tried cigarettes or e-cigarettes. We asked adolescents to recall the symptoms they experienced during their first cigarette or e-cigarette and categorized symptoms as negative (felt bad, coughing/chest pain, bad taste, upset stomach, dizzy/lightheaded) or positive (felt relaxed, rush/buzz). Adolescents reported fewer negative symptoms for first e-cigarette than first cigarette use (all p < 0.05). Current cigarette smoking was associated with endorsing fewer negative symptoms (OR = 0.49, 95% CI = [0.25, 0.95]) and more positive symptoms (OR = 7.11, 95% CI = [1.47, 34.33]) at first cigarette use. First e-cigarette use symptoms were not associated with current e-cigarette use. Adolescents reported fewer negative symptoms from first e-cigarette than from first cigarette, and e-cigarette symptoms did not influence use as they do for cigarettes. Additional research is needed to confirm these findings in longitudinal studies. Full article

(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)

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10 pages, 503 KiB

Open AccessArticle

Experience of Japan in Achieving a Total Ban on Asbestos

by Sugio Furuya and Ken Takahashi

Int. J. Environ. Res. Public Health 2017, 14(10), 1261; https://doi.org/10.3390/ijerph14101261 - 20 Oct 2017

Cited by 19 | Viewed by 6595

Abstract

This paper aims to examine the process through which a total ban on asbestos was achieved in Japan. We reconstructed the process, analyzed the roles of involved parties/events, and drew lessons from the Japanese experience of achieving the ban. In Japan, a bill [...] Read more.

This paper aims to examine the process through which a total ban on asbestos was achieved in Japan. We reconstructed the process, analyzed the roles of involved parties/events, and drew lessons from the Japanese experience of achieving the ban. In Japan, a bill to phase out asbestos was proposed in 1992 but rejected without deliberation. Wide support for such a ban subsequently grew, however, largely due to the actions of trade unions and civil societies in establishing a coalition, raising awareness, organizing asbestos victims and their families, and propagating information on international developments. A governmental decision towards a ban was made in 2002 based on several national and international factors. A huge asbestos scandal in 2005 preponed the achievement of a total ban and led to the establishment of comprehensive measures to tackle asbestos issues. However, challenges remain for the elimination of asbestos-related diseases. Full article

(This article belongs to the Special Issue Global Panorama of National Experiences in Public Health Actions to Ban Asbestos)

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10 pages, 1307 KiB

Open AccessArticle

Land Use Regression Modeling of Outdoor Noise Exposure in Informal Settlements in Western Cape, South Africa

by Chloé Sieber, Martina S. Ragettli, Mark Brink, Olaniyan Toyib, Roslyn Baatjies, Apolline Saucy, Nicole Probst-Hensch, Mohamed Aqiel Dalvie and Martin Röösli

Int. J. Environ. Res. Public Health 2017, 14(10), 1262; https://doi.org/10.3390/ijerph14101262 - 20 Oct 2017

Cited by 29 | Viewed by 6092

Abstract

In low- and middle-income countries, noise exposure and its negative health effects have been little explored. The present study aimed to assess the noise exposure situation in adults living in informal settings in the Western Cape Province, South Africa. We conducted continuous one-week [...] Read more.

In low- and middle-income countries, noise exposure and its negative health effects have been little explored. The present study aimed to assess the noise exposure situation in adults living in informal settings in the Western Cape Province, South Africa. We conducted continuous one-week outdoor noise measurements at 134 homes in four different areas. These data were used to develop a land use regression (LUR) model to predict A-weighted day-evening-night equivalent sound levels (L_den) from geographic information system (GIS) variables. Mean noise exposure during day (6:00–18:00) was 60.0 A-weighted decibels (dB(A)) (interquartile range 56.9–62.9 dB(A)), during night (22:00–6:00) 52.9 dB(A) (49.3–55.8 dB(A)) and average L_den was 63.0 dB(A) (60.1–66.5 dB(A)). Main predictors of the LUR model were related to road traffic and household density. Model performance was low (adjusted R²= 0.130) suggesting that other influences than those represented in the geographic predictors are relevant for noise exposure. This is one of the few studies on the noise exposure situation in low- and middle-income countries. It demonstrates that noise exposure levels are high in these settings. Full article

(This article belongs to the Section Environmental Science and Engineering)

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21 pages, 1133 KiB

Open AccessArticle

Petroleum Hydrocarbon Profiles of Water and Sediment of Algoa Bay, Eastern Cape, South Africa

by Abiodun O. Adeniji, Omobola O. Okoh and Anthony I. Okoh

Int. J. Environ. Res. Public Health 2017, 14(10), 1263; https://doi.org/10.3390/ijerph14101263 - 20 Oct 2017

Cited by 51 | Viewed by 7794

Abstract

Petroleum hydrocarbon profiles of water and sediment samples of Algoa Bay in the Eastern Cape Province of South Africa were assessed using standard analytical procedures. Water (from surface and bottom levels) and sediment samples were collected from five locations in the bay from [...] Read more.

Petroleum hydrocarbon profiles of water and sediment samples of Algoa Bay in the Eastern Cape Province of South Africa were assessed using standard analytical procedures. Water (from surface and bottom levels) and sediment samples were collected from five locations in the bay from February to June 2016. Extraction of the petroleum hydrocarbons from the water and sediment samples collected was achieved using liquid-liquid and Soxhlet extraction techniques, respectively, followed by column clean up. Target compounds were analytically determined with gas chromatography–flame ionization detector (GC-FID) and quantified by integrating the areas of both the resolved and unresolved components. Physicochemical properties of the water samples were also determined on site using a SeaBird 19plusV2 CTD SBE 55 device. Estimated limit of detection, limit of quantitation and relative standard deviation for the 35 n-alkane standards ranged from 0.06 to 0.13 μg/L, 0.30 to 0.69 μg/L and 3.61 to 8.32%, respectively. Results showed that total petroleum hydrocarbon (TPH) varied from 45.07 to 307 μg/L in the water and 0.72 to 27.03 mg/kg in the sediments. The mean concentrations of TPH in both the water and sediment samples from Algoa Bay revealed a slight level of pollution. The diagnostic indices used showed that the hydrocarbons in the area were from both biogenic and anthropogenic sources. Hence, there is need for adequate regulation and control of all activities contributing to the levels of petroleum hydrocarbon in the marine environment for the safety of human, aquatic and wild lives in the area. Full article

(This article belongs to the Section Environmental Science and Engineering)

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17 pages, 1095 KiB

Open AccessArticle

Enhancing Resources at the Workplace with Health-Promoting Leadership

by Paul Jiménez, Anita Bregenzer, K. Wolfgang Kallus, Bianca Fruhwirth and Verena Wagner-Hartl

Int. J. Environ. Res. Public Health 2017, 14(10), 1264; https://doi.org/10.3390/ijerph14101264 - 20 Oct 2017

Cited by 40 | Viewed by 9272

Abstract

Leaders engaging in health-promoting leadership can influence their employees’ health directly by showing health awareness or indirectly by changing working conditions. With health-promoting leadership, leaders are able to support a healthy working environment by providing resource-oriented working conditions for their employees to support [...] Read more.

Leaders engaging in health-promoting leadership can influence their employees’ health directly by showing health awareness or indirectly by changing working conditions. With health-promoting leadership, leaders are able to support a healthy working environment by providing resource-oriented working conditions for their employees to support their health. Changing working conditions in a health-supportive way can prevent possible negative consequences from critical working conditions (e.g., burnout risk). The present study examined the relationship between health-promoting leadership and the employees’ resources, stress and burnout. To analyze our proposed model, structural equation modelling was conducted in two samples. The resulting model from the first sample of 228 Austrian workers was cross-validated and could be verified with the second sample (N = 263 Austrian workers). The results supported a model in which health-promoting leadership has a strong direct effect on the employees’ resources and an indirect effect on stress and burnout, which was mediated by resources. The results indicate that health-promoting leadership describes the leaders’ capability and dedication creating the right working conditions for their employees by increasing the employees’ resources at the workplace. This in turn minimizes the risk of experiencing burnout. Full article

(This article belongs to the Section Occupational Safety and Health)

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14 pages, 273 KiB

Open AccessArticle

How Do Communities Use a Participatory Public Health Approach to Build Resilience? The Los Angeles County Community Disaster Resilience Project

by Elizabeth Bromley, David P. Eisenman, Aizita Magana, Malcolm Williams, Biblia Kim, Michael McCreary, Anita Chandra and Kenneth B. Wells

Int. J. Environ. Res. Public Health 2017, 14(10), 1267; https://doi.org/10.3390/ijerph14101267 - 21 Oct 2017

Cited by 23 | Viewed by 8068

Abstract

Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience [...] Read more.

Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience (LACCDR) initiative. LACCDR, an initiative led by the Los Angeles County Department of Public Health with academic partners, randomized 16 community coalitions to implement either an Enhanced Standard Preparedness or Community Resilience approach over 24 months. Facilitated by a public health nurse or community educator, coalitions comprised government agencies, community-focused organizations and community members. We used thematic analysis of data from focus groups (n = 5) and interviews (n = 6 coalition members; n = 16 facilitators) to compare coalitions’ strategies for operationalizing community resilience levers of change (engagement, partnership, self-sufficiency, education). We find that strategies that included bidirectional learning helped coalitions understand and adopt resilience principles. Strategies that operationalized community resilience levers in mutually reinforcing ways (e.g., disseminating information while strengthening partnerships) also secured commitment to resilience principles. We review additional challenges and successes in achieving cross-sector collaboration and engaging at-risk groups in the resilience versus preparedness coalitions. The LACCDR example can inform strategies for uptake and implementation of community resilience and uptake of the resilience concept and methods. Full article

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

11 pages, 323 KiB

Open AccessArticle

Comparison of Summer and Winter Objectively Measured Physical Activity and Sedentary Behavior in Older Adults: Age, Gene/Environment Susceptibility Reykjavik Study

by Nanna Yr Arnardottir, Nina Dora Oskarsdottir, Robert J. Brychta, Annemarie Koster, Dane R. Van Domelen, Paolo Caserotti, Gudny Eiriksdottir, Johanna E. Sverrisdottir, Erlingur Johannsson, Lenore J. Launer, Vilmundur Gudnason, Tamara B. Harris, Kong Y. Chen and Thorarinn Sveinsson

Int. J. Environ. Res. Public Health 2017, 14(10), 1268; https://doi.org/10.3390/ijerph14101268 - 21 Oct 2017

Cited by 37 | Viewed by 8303

Abstract

In Iceland, there is a large variation in daylight between summer and winter. The aim of the study was to identify how this large variation influences physical activity (PA) and sedentary behavior (SB). Free living PA was measured by a waist-worn accelerometer for [...] Read more.

In Iceland, there is a large variation in daylight between summer and winter. The aim of the study was to identify how this large variation influences physical activity (PA) and sedentary behavior (SB). Free living PA was measured by a waist-worn accelerometer for one week during waking hours in 138 community-dwelling older adults (61.1% women, 80.3 ± 4.9 years) during summer and winter months. In general, SB occupied about 75% of the registered wear-time and was highly correlated with age (β = 0.36). Although the differences were small, more time was spent during the summer in all PA categories, except for the moderate-to-vigorous PA (MVPA), and SB was reduced. More lifestyle PA (LSPA) was accumulated in ≥5-min bouts during summer than winter, especially among highly active participants. This information could be important for policy makers and health professionals working with older adults. Accounting for seasonal difference is necessary in analyzing SB and PA data. Full article

(This article belongs to the Collection Aging and Public Health)

9 pages, 266 KiB

Open AccessArticle

Barriers and Facilitators to the Elimination of Asbestos Related Diseases—Stakeholders’ Perspectives

by Joanne Vincenten, Frank George, Marco Martuzzi, Peter Schröder-Bäck and Elizabet Paunovic

Int. J. Environ. Res. Public Health 2017, 14(10), 1269; https://doi.org/10.3390/ijerph14101269 - 22 Oct 2017

Cited by 9 | Viewed by 4144

Abstract

Despite sound scientific knowledge and evidence that any exposure to asbestos fibers in all of its forms, are carcinogenic to humans, its presence, use and trade is still substantial, including in the World Health Organization (WHO) European Region. Banning the production and use [...] Read more.

Despite sound scientific knowledge and evidence that any exposure to asbestos fibers in all of its forms, are carcinogenic to humans, its presence, use and trade is still substantial, including in the World Health Organization (WHO) European Region. Banning the production and use of all forms of asbestos, as recommended by the International Labour Organization (ILO) and WHO, has been proven as the most efficient evidence-based strategy to eliminate Asbestos Related Diseases (ARDs). To effectively move elimination of ARDs forward, attaining a greater understanding of key stakeholders perspectives was identified as an important action. The WHO Regional Office for Europe, the European Centre for Environment and Health, undertook semi-structured interviews, and follow-up discussions with diverse representatives dealing professionally with asbestos. The interview questionnaire was developed based on the current ARDs WHO Report, the Evidence Implementation Model for Public Health and categories of the theory of diffusion. Data were attained on three main questions within the interview questionnaire: (1) Identifying barriers to implementation of WHO evidence-based asbestos recommendations; (2) Describing roles of key stakeholders; and, (3) Proposing possible solutions. The results demonstrated use of sound and convincing scientific evidence along with economic evidence and facilitators can be used to achieve evidence-based policy development, and comprehensive diverse actions. Full article

(This article belongs to the Section Environmental Health)

11 pages, 293 KiB

Open AccessFeature PaperArticle

Factors Influencing Early Feeding of Foods and Drinks Containing Free Sugars—A Birth Cohort Study

by Diep H. Ha, Loc G. Do, Andrew John Spencer, William Murray Thomson, Rebecca K. Golley, Andrew J. Rugg-Gunn, Steven M. Levy and Jane A. Scott

Int. J. Environ. Res. Public Health 2017, 14(10), 1270; https://doi.org/10.3390/ijerph14101270 - 23 Oct 2017

Cited by 34 | Viewed by 6097

Abstract

Early feeding of free sugars to young children can increase the preference for sweetness and the risk of consuming a cariogenic diet high in free sugars later in life. This study aimed to investigate early life factors influencing early introduction of foods/drinks containing [...] Read more.

Early feeding of free sugars to young children can increase the preference for sweetness and the risk of consuming a cariogenic diet high in free sugars later in life. This study aimed to investigate early life factors influencing early introduction of foods/drinks containing free sugars. Data from an ongoing population-based birth cohort study in Australia were used. Mothers of newborn children completed questionnaires at birth and subsequently at ages 3, 6, 12, and 24 months. The outcome was reported feeding (Yes/No) at age 6–9 months of common foods/drinks sources of free sugars (hereafter referred as foods/drinks with free sugars). Household income quartiles, mother’s sugar-sweetened beverage (SSB) consumption, and other maternal factors were exposure variables. Analysis was conducted progressively from bivariate to multivariable log-binomial regression with robust standard error estimation to calculate prevalence ratios (PR) of being fed foods/drinks with free sugars at an early age (by 6–9 months). Models for both complete cases and with multiple imputations (MI) for missing data were generated. Of 1479 mother/child dyads, 21% of children had been fed foods/drinks with free sugars. There was a strong income gradient and a significant positive association with maternal SSB consumption. In the complete-case model, income Q1 and Q2 had PRs of 1.9 (1.2–3.1) and 1.8 (1.2–2.6) against Q4, respectively. The PR for mothers ingesting SSB everyday was 1.6 (1.2–2.3). The PR for children who had been breastfed to at least three months was 0.6 (0.5–0.8). Similar findings were observed in the MI model. Household income at birth and maternal behaviours were significant determinants of early feeding of foods/drinks with free sugars. Full article

(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)

12 pages, 509 KiB

Open AccessArticle

Understanding the Relationship between Socio-Economic Status, Physical Activity and Sedentary Behaviour, and Adiposity in Young Adult South African Women Using Structural Equation Modelling

by Lisa K. Micklesfield, Richard J. Munthali, Alessandra Prioreschi, Rihlat Said-Mohamed, Alastair Van Heerden, Stephen Tollman, Kathleen Kahn, David Dunger and Shane A. Norris

Int. J. Environ. Res. Public Health 2017, 14(10), 1271; https://doi.org/10.3390/ijerph14101271 - 23 Oct 2017

Cited by 34 | Viewed by 6123

Abstract

Socio-economic status (SES) is an important predictor of obesity, but how it is associated with differences in physical activity and sedentary behaviour is less clear. This cross-sectional study examined the association between SES (sum of household assets), physical activity and sedentary time, and [...] Read more.

Socio-economic status (SES) is an important predictor of obesity, but how it is associated with differences in physical activity and sedentary behaviour is less clear. This cross-sectional study examined the association between SES (sum of household assets), physical activity and sedentary time, and how they predict adiposity. Socio-demographic, anthropometric, and physical activity data on rural (n = 509) and urban (n = 510) South African women (18–23 years) were collected. Overweight and obesity prevalence, and sedentary time, were higher; and moderate-vigorous intensity physical activity (MVPA) was lower, in the urban sample. Structural equation models (SEMs) were constructed for BMI and waist circumference. In the urban sample SES had a direct inverse effect on MVPA (ß; 95% CI, −41.69; −73.40 to −9.98), while in the rural sample SES had a direct effect on BMI (ß; 95% CI, 0.306; 0.03 to 0.59). In the pooled sample, SES had a direct inverse effect on MVPA (ß; 95% CI, −144; −170.34 to −119.04), and MVPA was directly associated with BMI (ß; 95% CI, 0.04; 0.01 to 0.08). The influence of SES, and the role of physical activity and sedentary time on adiposity differs between the urban and rural samples, and the importance of other environmental and behavioural factors must be considered in the development of obesity and the design of effective interventions. Full article

(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)

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15 pages, 330 KiB

Open AccessArticle

Parents’ Perceived Barriers to Accessing Sports and Recreation Facilities in Ontario, Canada: Exploring the Relationships between Income, Neighbourhood Deprivation, and Community

by Daniel W. Harrington, Jocelyn W. Jarvis and Heather Manson

Int. J. Environ. Res. Public Health 2017, 14(10), 1272; https://doi.org/10.3390/ijerph14101272 - 23 Oct 2017

Cited by 17 | Viewed by 7482

Abstract

Sports and recreation facilities provide places where children can be physically active. Previous research has shown that availability is often worse in lower-socioeconomic status (SES) areas, yet others have found inverse relationships, no relationships, or mixed findings. Since children’s health behaviours are influenced [...] Read more.

Sports and recreation facilities provide places where children can be physically active. Previous research has shown that availability is often worse in lower-socioeconomic status (SES) areas, yet others have found inverse relationships, no relationships, or mixed findings. Since children’s health behaviours are influenced by their parents, it is important to understand parents’ perceived barriers to accessing sports and recreation facilities. Data from computer assisted telephone interviews with parents living in Ontario, Canada were merged via postal codes with neighbourhood deprivation data. Multivariable logistic regression modeling was used to estimate the likelihood that parents reported barriers to accessing local sports and recreation facilities. Parents with lower household incomes were more likely to report barriers to access. For each unit increase in deprivation score (i.e., more deprived), the likelihood of reporting a barrier increased 16% (95% CI: 1.04, 1.28). For parents, the relationships between household income, neighbourhood-level deprivation, and barriers are complex. Understanding these relationships is important for research, policy and planning, as parental barriers to opportunities for physical activity have implications for child health behaviours, and ultimately childhood overweight and obesity. Full article

(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)

12 pages, 898 KiB

Open AccessArticle

Immobilization of Lead Migrating from Contaminated Soil in Rhizosphere Soil of Barley (Hordeum vulgare L.) and Hairy Vetch (Vicia villosa) Using Hydroxyapatite

by Masahiko Katoh, Elsya Risky and Takeshi Sato

Int. J. Environ. Res. Public Health 2017, 14(10), 1273; https://doi.org/10.3390/ijerph14101273 - 23 Oct 2017

Cited by 14 | Viewed by 4362

Abstract

This study conducted plant growth tests using a rhizobox system to quantitatively determine the distance of immobilization lead migrating from contaminated soil into uncontaminated rhizosphere soil, and to assess the lead phases accumulated in rhizosphere soil by sequential extraction. Without the hydroxyapatite, exchangeable [...] Read more.

This study conducted plant growth tests using a rhizobox system to quantitatively determine the distance of immobilization lead migrating from contaminated soil into uncontaminated rhizosphere soil, and to assess the lead phases accumulated in rhizosphere soil by sequential extraction. Without the hydroxyapatite, exchangeable lead fractions increased as the rhizosphere soil got closer to the contaminated soil. Exchangeable lead fractions were higher even in the rhizosphere soil that shares a boundary with the root surface than in the soil before being planted. Thus, plant growth of hairy vetch was lower in the soil without the hydroxyapatite than in the soil with the hydroxyapatite. The presence of hydroxyapatite may immobilize the majority of lead migrating from contaminated soil into the rhizosphere soil within 1 mm from the contaminated soil. The dominant lead fraction in the rhizosphere soil with the hydroxyapatite was residual. Thus, plant growth was not suppressed and the lead concentration of the plant shoot remained at the background level. These results indicate that the presence of hydroxyapatite in the rhizosphere soil at 5% wt may immobilize most of the lead migrating into the rhizosphere soil within 1 mm from the contaminated soil, resulting in the prevention of lead migration toward the root surface. Full article

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

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13 pages, 799 KiB

Open AccessArticle

Effectiveness of a Video-Versus Text-Based Computer-Tailored Intervention for Obesity Prevention after One Year: A Randomized Controlled Trial

by Kei Long Cheung, Inga Schwabe, Michel J. L. Walthouwer, Anke Oenema, Lilian Lechner and Hein De Vries

Int. J. Environ. Res. Public Health 2017, 14(10), 1275; https://doi.org/10.3390/ijerph14101275 - 23 Oct 2017

Cited by 20 | Viewed by 5874

Abstract

Computer-tailored programs may help to prevent overweight and obesity, which are worldwide public health problems. This study investigated (1) the 12-month effectiveness of a video- and text-based computer-tailored intervention on energy intake, physical activity, and body mass index (BMI), and (2) the role [...] Read more.

Computer-tailored programs may help to prevent overweight and obesity, which are worldwide public health problems. This study investigated (1) the 12-month effectiveness of a video- and text-based computer-tailored intervention on energy intake, physical activity, and body mass index (BMI), and (2) the role of educational level in intervention effects. A randomized controlled trial in The Netherlands was conducted, in which adults were allocated to a video-based condition, text-based condition, or control condition, with baseline, 6 months, and 12 months follow-up. Outcome variables were self-reported BMI, physical activity, and energy intake. Mixed-effects modelling was used to investigate intervention effects and potential interaction effects. Compared to the control group, the video intervention group was effective regarding energy intake after 6 months (least squares means (LSM) difference = −205.40, p = 0.00) and 12 months (LSM difference = −128.14, p = 0.03). Only video intervention resulted in lower average daily energy intake after one year (d = 0.12). Educational role and BMI did not seem to interact with this effect. No intervention effects on BMI and physical activity were found. The video computer-tailored intervention was effective on energy intake after one year. This effect was not dependent on educational levels or BMI categories, suggesting that video tailoring can be effective for a broad range of risk groups and may be preferred over text tailoring. Full article

(This article belongs to the Special Issue The Impacts of Physical Activity on Chronic Disease Prevention and Population Health)

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15 pages, 325 KiB

Open AccessArticle

Psycho-Physiological Associates of Dyspnea in Hospitalized Patients with Interstitial Lung Diseases: A Cross-Sectional Study

by Yan Hua Zhou and Yim Wah Mak

Int. J. Environ. Res. Public Health 2017, 14(10), 1277; https://doi.org/10.3390/ijerph14101277 - 24 Oct 2017

Cited by 4 | Viewed by 4449

Abstract

Dyspnea has been found to be an independent predictor of mortality among patients with respiratory diseases and is often regarded as a difficult symptom to control in patients with interstitial lung diseases (ILDs). Previous studies have found an association of psychological and physiological [...] Read more.

Dyspnea has been found to be an independent predictor of mortality among patients with respiratory diseases and is often regarded as a difficult symptom to control in patients with interstitial lung diseases (ILDs). Previous studies have found an association of psychological and physiological factors with dyspnea among patients with chronic obstructive airway diseases. However, symptom management of hospitalized patients with ILDs has been hampered by difficulty in priority, since they are often admitted with multiple psycho-physiological needs. This study examined the prevalence of dyspnea and the psycho-physiological factors associated with it among hospitalized Chinese patients with ILDs. We studied 165 hospitalized patients with ILDs recruited consecutively over three months in a public hospital in Guangzhou, China. Dyspnea and common psycho-physiological factors, including cough symptoms, activity capacity, lung function, physical and mental health status, and anxiety and depression symptoms, were measured. By ordered logistic regression, level of dyspnea statistically significantly affected performance in a six-minute walk test and physical functioning in work or other regular daily activities in hospitalized patients with ILDs. Respiratory rehabilitation with an appropriate intensity of exercise training or other strategies for enhancing the physical functioning of this population with moderate and severe levels of dyspnea should be prioritized. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

12 pages, 287 KiB

Open AccessArticle

Impact of Psychosocial Environment on Young Children’s Emotional and Behavioral Difficulties

by Regina Grazuleviciene, Sandra Andrusaityte, Inga Petraviciene and Birute Balseviciene

Int. J. Environ. Res. Public Health 2017, 14(10), 1278; https://doi.org/10.3390/ijerph14101278 - 24 Oct 2017

Cited by 11 | Viewed by 6421

Abstract

Objective: The impact of maternal psychosocial stress on young children’s mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and [...] Read more.

Objective: The impact of maternal psychosocial stress on young children’s mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and their 4–6 year-old children pairs, living in Kaunas city, Lithuania. The parent-child relationships were measured using the Parent-Child Dysfunctional Interaction subscale. Children’s mental health difficulties were assessed by the Strengths and Difficulties Questionnaire. We used logistic regression models to indicate the strength of the associations. Results: Lower socioeconomic status women more often than higher ones reported pathological mother-child relations. Low education level was associated with statistically significant increase adjusted odds ratios for emotional symptoms and total behavioral difficulties. With reference to the group of better-educated mothers and normal mother-child relations, low education and pathological mother-child relations statistically significantly increased the risk of total difficulties in 4–6 year-old children; the adjusted odds ratios were 2.45; 95% CI 1.51–3.99. Conclusions: Pathological mother-child relations strengthened the effect of lower education on the increased risk of emotional and behavioral difficulties in preschool-age children. Measures oriented towards health behavior and psychosocial difficulties management may decrease children’s emotional and behavioral difficulties. Full article

(This article belongs to the Section Environmental Health)

12 pages, 1251 KiB

Open AccessArticle

The Assessment of Toxic Metals in Plants Used in Cosmetics and Cosmetology

by Agnieszka Fischer, Barbara Brodziak-Dopierała, Krzysztof Loska and Jerzy Stojko

Int. J. Environ. Res. Public Health 2017, 14(10), 1280; https://doi.org/10.3390/ijerph14101280 - 24 Oct 2017

Cited by 34 | Viewed by 7742

Abstract

Heavy metals polluting the natural environment are absorbed by plants. The use of herbs as components of cosmetics may pose a health risk for humans. The aim of the study was to determine the concentrations of Pb, Cd and Hg in selected species [...] Read more.

Heavy metals polluting the natural environment are absorbed by plants. The use of herbs as components of cosmetics may pose a health risk for humans. The aim of the study was to determine the concentrations of Pb, Cd and Hg in selected species of herbs (horsetail Equisetum arvense, nettle Urtica dioica, St. John’s wort Hypericum perforatum, wormwood Artemisia absinthium, yarrow Achillea millefolium, cottonwood Solidago virgaurea) self-collected from the natural environment in two different locations, and purchased in stores on the territory of Poland. The concentration of the metals studied was: 4.67–23.8 mg/kg Pb, 0.01–1.51 mg/kg Cd, 0.005–0.028 mg/kg Hg. Different concentrations of metals, depending on species and origin of plants, were found. The mean concentration of all studied metals was the lowest in St. John’s wort, and the highest in nettle. In herbs purchased in Polish stores, the concentration of Pb was higher than in plants self-collected in the natural environment. Full article

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15 pages, 797 KiB

Open AccessArticle

The Relationship between Starting to Drink and Psychological Distress, Sleep Disturbance after the Great East Japan Earthquake and Nuclear Disaster: The Fukushima Health Management Survey

by Masatsugu Orui, Yuka Ueda, Yuriko Suzuki, Masaharu Maeda, Tetsuya Ohira, Hirooki Yabe and Seiji Yasumura

Int. J. Environ. Res. Public Health 2017, 14(10), 1281; https://doi.org/10.3390/ijerph14101281 - 24 Oct 2017

Cited by 33 | Viewed by 6306

Abstract

This longitudinal study aimed to investigate the prevalence of newly-started drinkers and their continuing drinking behaviors after the Great East Japan earthquake. Moreover, the relationships between newly-started drinking and psychological factor, disaster-related experience, and perceived radiation risk were examined. We used data from [...] Read more.

This longitudinal study aimed to investigate the prevalence of newly-started drinkers and their continuing drinking behaviors after the Great East Japan earthquake. Moreover, the relationships between newly-started drinking and psychological factor, disaster-related experience, and perceived radiation risk were examined. We used data from 37,687 pre-disaster non-drinkers who participated in the 2012 and 2013 surveys conducted in Fukushima. We defined newly-started drinkers as those who did not drink before the disaster but who began drinking after the disaster, based on information collected retrospectively. In 2012, 9.6% of non-drinkers began drinking, of which the prevalence of heavy drinkers was 18.4%. The prevalence of continued drinking among newly-started drinkers in 2013 was 53.8%. Logistic regression analyses revealed post-disaster newly-started drinking was significantly associated with being male, less than 65 years old, sleep dissatisfaction and psychological distress (Kessler 6 ≤ 13) when this model was adjusted for disaster-related experience and perceived radiation risk. Moreover, psychological distress and heavy drinking were significant risk factors for continued drinking among newly-started drinkers. Newly-started drinkers might use alcohol to cope with disaster-related stress. Thus, they may be targeted for disaster-related health services. Moreover, early intervention should encourage responsible drinking, since post-disaster heavy drinkers were likely to continue heavy drinking. Full article

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

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15 pages, 559 KiB

Open AccessArticle

Doing Good Again? A Multilevel Institutional Perspective on Corporate Environmental Responsibility and Philanthropic Strategy

by Wei Liu, Qiao Wei, Song-Qin Huang and Sang-Bing Tsai

Int. J. Environ. Res. Public Health 2017, 14(10), 1283; https://doi.org/10.3390/ijerph14101283 - 24 Oct 2017

Cited by 53 | Viewed by 6908

Abstract

This study investigates the relationship between corporate environmental responsibility and corporate philanthropy. Using a sample of Chinese listed firms from 2008 to 2013, this paper examines the role of corporate environmental responsibility in corporate philanthropy and the moderating influence of the institutional environment [...] Read more.

This study investigates the relationship between corporate environmental responsibility and corporate philanthropy. Using a sample of Chinese listed firms from 2008 to 2013, this paper examines the role of corporate environmental responsibility in corporate philanthropy and the moderating influence of the institutional environment using multilevel analysis. The results show that corporate eco-friendly events are positively associated with corporate philanthropic strategy to a significant degree. Provincial-level government intervention positively moderate the positive relationship between eco-friendly events and corporate philanthropy and government corruption is negatively moderate the relationship. All these results are robust according to robustness checks. These findings provide a new perspective on corporate philanthropic strategy as a means to obtain critical resources from the government in order to compensate for the loss made on environmental responsibility. Moreover, the institutional environment is proved here to play an important role in corporate philanthropic strategy. Full article

(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)

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12 pages, 8898 KiB

Open AccessArticle

Effects of In Utero Exposure to Di-n-Butyl Phthalate on Testicular Development in Rat

by Tan Ma, Xiaoqin Yin, Ruitong Han, Jie Ding, Huan Zhang, Xiaodong Han and Dongmei Li

Int. J. Environ. Res. Public Health 2017, 14(10), 1284; https://doi.org/10.3390/ijerph14101284 - 24 Oct 2017

Cited by 44 | Viewed by 5717

Abstract

Humans are inevitably exposed to ubiquitous phthalate esters (PAEs). In utero exposure to di-n-butyl phthalate (DBP) induces abnormal development of the testis and reproductive tract in male offspring, which correspond closely with the human condition of testicular dysgenesis syndrome (TDS)-like syndrome. However, the [...] Read more.

Humans are inevitably exposed to ubiquitous phthalate esters (PAEs). In utero exposure to di-n-butyl phthalate (DBP) induces abnormal development of the testis and reproductive tract in male offspring, which correspond closely with the human condition of testicular dysgenesis syndrome (TDS)-like syndrome. However, the underlying mechanisms have not been elucidated in detail. In this study, pregnant rats were orally exposed to either corn oil (controls) or DBP at three different doses by gavage during Gestational Days 12.5–21.5. Pathological examinations were performed for toxicity evaluation. Proliferation and apoptosis related proteins (ras related dexamethasone induced 1 (Rasd1), mitogen-activated protein kinase kinases1/2 (MEK1/2), Bcl-2, and Bax) were measured for mechanisms exploration. The results showed that different doses of DBP caused male developmental and reproductive toxicity in rats, including the decrease of anogenital distance (AGD), the histological damage of testis, and apoptosis of seminiferous tubule cells. Our data suggested that DBP played chronic and continuous toxic roles on male reproductive system by disrupting expression of Rasd1 and MEK1/2 as well as Bcl-2/Bax ratio. Further research is warranted. Full article

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14 pages, 989 KiB

Open AccessArticle

Influence of Afforestation on the Species Diversity of the Soil Seed Bank and Understory Vegetation in the Hill-Gullied Loess Plateau, China

by Ning Wang, Juying Jiao, Yanfeng Jia and Dongli Wang

Int. J. Environ. Res. Public Health 2017, 14(10), 1285; https://doi.org/10.3390/ijerph14101285 - 24 Oct 2017

Cited by 15 | Viewed by 5311

Abstract

The Chinese Loess Plateau region has long been suffering from serious soil erosion. Thus, large-scale afforestation has continued during the past decades in order to control soil erosion. Afforestation can dramatically alter nutrient cycles, affect soil-carbon storage, and change hydrology. However, it is [...] Read more.

The Chinese Loess Plateau region has long been suffering from serious soil erosion. Thus, large-scale afforestation has continued during the past decades in order to control soil erosion. Afforestation can dramatically alter nutrient cycles, affect soil-carbon storage, and change hydrology. However, it is unknown how afforestation influences species diversity of the soil seed bank and understory vegetation compared with spontaneous restoration of abandoned land. Forest land with trees planted 30 years ago, abandoned slope land restored spontaneously for 30 years, and the corresponding slopes with remnant natural vegetation were selected as sampling sites. The species richness both in the soil seed bank and vegetation was significantly higher on the afforested slope compared to the spontaneously restored abandoned land. The species similarity between the afforested slope and the remnant slope land was high both in the soil seed bank and standing vegetation compared to the abandoned land. The soil seed bank density varied from 1778 ± 187 to 3896 ± 221 seeds/m², and more than half of it was constituted by annual and biennial species, with no significant difference among sampling habitats. However, the afforested slope had higher seed density of grass and shrub/subshrubs compared to the abandoned slope. The present study indicates that in the study region, characterized by serious soil erosion, afforestation can better facilitate vegetation succession compared to spontaneously restoration of abandoned slope land. Full article

(This article belongs to the Special Issue Proceedings of 2nd International Symposium on Environment Science and Health)

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34 pages, 1832 KiB

Open AccessReview

Removal of Phenolic Compounds from Water Using Sewage Sludge-Based Activated Carbon Adsorption: A Review

by Nuhu Dalhat Mu’azu, Nabeel Jarrah, Mukarram Zubair and Omar Alagha

Int. J. Environ. Res. Public Health 2017, 14(10), 1094; https://doi.org/10.3390/ijerph14101094 - 21 Sep 2017

Cited by 151 | Viewed by 12317

Abstract

Due to their industrial relevance, phenolic compounds (PC) are amongst the most common organic pollutants found in many industrial wastewater effluents. The potential detrimental health and environmental impacts of PC necessitate their removal from wastewater to meet regulatory discharge standards to ensure meeting [...] Read more.

Due to their industrial relevance, phenolic compounds (PC) are amongst the most common organic pollutants found in many industrial wastewater effluents. The potential detrimental health and environmental impacts of PC necessitate their removal from wastewater to meet regulatory discharge standards to ensure meeting sustainable development goals. In recent decades, one of the promising, cost-effective and environmentally benign techniques for removal of PC from water streams has been adsorption onto sewage sludge (SS)-based activated carbon (SBAC). This is attributed to the excellent adsorptive characteristics of SBAC and also because the approach serves as a strategy for sustainable management of huge quantities of different types of SS that are in continual production globally. This paper reviews conversion of SS into activated carbons and their utilization for the removal of PC from water streams. Wide ranges of topics which include SBAC production processes, physicochemical characteristics of SBAC, factors affecting PC adsorption onto SBAC and their uptake mechanisms as well as the regeneration potential of spent SBAC are covered. Although chemical activation techniques produce better SBAC, yet more research work is needed to harness advances in material science to improve the functional groups and textural properties of SBAC as well as the low performance of physical activation methods. Studies focusing on PC adsorptive performance on SBAC using continuous mode (that are more relevant for industrial applications) in both single and multi-pollutant aqueous systems to cover wide range of PC are needed. Also, the potentials of different techniques for regeneration of spent SBAC used for adsorption of PC need to be assessed in relation to overall economic evaluation within realm of environmental sustainability using life cycle assessment. Full article

(This article belongs to the Section Environmental Science and Engineering)

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13 pages, 290 KiB

Open AccessReview

Refugee Policy Implications of U.S. Immigration Medical Screenings: A New Era of Inadmissibility on Health-Related Grounds

by Mi-Kyung Hong, Reshma E. Varghese, Charulata Jindal and Jimmy T. Efird

Int. J. Environ. Res. Public Health 2017, 14(10), 1107; https://doi.org/10.3390/ijerph14101107 - 24 Sep 2017

Cited by 12 | Viewed by 6638

Abstract

Refugees frequently face extended delays in their efforts to enter the United States (U.S.) and those who are successful, in many cases, encounter overwhelming obstacles, inadequate resources, and a complex system of legal barriers. Travel restrictions based on equivocal health concerns and a [...] Read more.

Refugees frequently face extended delays in their efforts to enter the United States (U.S.) and those who are successful, in many cases, encounter overwhelming obstacles, inadequate resources, and a complex system of legal barriers. Travel restrictions based on equivocal health concerns and a drop in refugee admittance ceilings have complicated the situation. The authors retrieved and analyzed peer-reviewed journal articles, government agency press releases, media postings, epidemiologic factsheets, and relevant lay publications to critically assess U.S. policy regarding refugee resettlement based on health-related grounds. While refugees arguably exhibit an increased incidence of measles and tuberculosis compared with the U.S. population, the legitimacy of the medical examination will be undermined if other diseases that are endemic to refugee populations, yet currently deemed admissible, are used to restrict refugees from entering the U.S. This paper addressees the historic refugee policy of the U.S. and its consequent effect on the health of this vulnerable population. The needs of refugees should be carefully considered in the context of increased disease burden and the associated health care challenges of the country as a whole. Full article

(This article belongs to the Special Issue Refugee Health)

13 pages, 319 KiB

Open AccessReview

Respiratory Morbidity in Children with Repaired Congenital Esophageal Atresia with or without Tracheoesophageal Fistula

by Maria Francesca Patria, Stefano Ghislanzoni, Francesco Macchini, Mara Lelii, Alessandro Mori, Ernesto Leva, Nicola Principi and Susanna Esposito

Int. J. Environ. Res. Public Health 2017, 14(10), 1136; https://doi.org/10.3390/ijerph14101136 - 27 Sep 2017

Cited by 29 | Viewed by 5853

Abstract

Congenital esophageal atresia with or without tracheoesophageal fistula (CEA ± TEF) is a relatively common malformation that occurs in 1 of 2500–4500 live births. Despite the refinement of surgical techniques, a considerable proportion of children experience short- and long-term respiratory complications, which can [...] Read more.

Congenital esophageal atresia with or without tracheoesophageal fistula (CEA ± TEF) is a relatively common malformation that occurs in 1 of 2500–4500 live births. Despite the refinement of surgical techniques, a considerable proportion of children experience short- and long-term respiratory complications, which can significantly affect their health through adulthood. This review focuses on the underlying mechanisms and clinical presentation of respiratory morbidity in children with repaired CEA ± TEF. The reasons for the short-term pulmonary impairments are multifactorial and related to the surgical complications, such as anastomotic leaks, stenosis, and recurrence of fistula. Long-term respiratory morbidity is grouped into four categories according to the body section or function mainly involved: upper respiratory tract, lower respiratory tract, gastrointestinal tract, and aspiration and dysphagia. The reasons for the persistence of respiratory morbidity to adulthood are not univocal. The malformation itself, the acquired damage after the surgical repair, various co-morbidities, and the recurrence of lower respiratory tract infections at an early age can contribute to pulmonary impairment. Nevertheless, other conditions, including smoking habits and, in particular, atopy can play a role in the recurrence of infections. In conclusion, our manuscript shows that most children born with CEA ± TEF survive into adulthood, but many comorbidities, mainly esophageal and respiratory issues, may persist. The pulmonary impairment involves many underlying mechanisms, which begin in the first years of life. Therefore, early detection and management of pulmonary morbidity may be important to prevent impairment in pulmonary function and serious long-term complications. To obtain a successful outcome, it is fundamental to ensure a standardized follow-up that must continue until adulthood. Full article

19 pages, 480 KiB

Open AccessReview

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Permanent Hearing Loss and Tinnitus

by Mariola Śliwińska-Kowalska and Kamil Zaborowski

Int. J. Environ. Res. Public Health 2017, 14(10), 1139; https://doi.org/10.3390/ijerph14101139 - 27 Sep 2017

Cited by 166 | Viewed by 13709

Abstract

Background: Hearing loss is defined as worsening of hearing acuity and is usually expressed as an increase in the hearing threshold. Tinnitus, defined as “ringing in the ear”, is a common and often disturbing accompaniment of hearing loss. Hearing loss and environmental [...] Read more.

Background: Hearing loss is defined as worsening of hearing acuity and is usually expressed as an increase in the hearing threshold. Tinnitus, defined as “ringing in the ear”, is a common and often disturbing accompaniment of hearing loss. Hearing loss and environmental exposures to noise are increasingly recognized health problems. Objectives: The objective was to assess whether the exposure-response relationship can be established between exposures to non-occupational noise and permanent hearing outcomes such as permanent hearing loss and tinnitus. Methods: Information sources: Computer searches of all accessible medical and other databases (PubMed, Web of Science, Scopus) were performed and complemented with manual searches. The search was not limited to a particular time span, except for the effects of personal listening devices (PLDs). The latter was limited to the years 2008–June 2015, since previous knowledge was summarized by SCENIHR descriptive systematic review published in 2008. Study eligibility criteria: The inclusion criteria were as follows: the exposure to noise was measured in sound pressure levels (SPLs) and expressed in individual equivalent decibel values (L_EX,8h), the studies included both exposed and reference groups, the outcome was a permanent health effect, i.e., permanent hearing loss assessed with pure-tone audiometry and/or permanent tinnitus assessed with a questionnaire. The eligibility criteria were evaluated by two independent reviewers. Study appraisal and synthesis methods: The risk of bias was assessed for all of the papers using a template for assessment of quality and the risk of bias. The GRADE (grading of recommendations assessment, development, and evaluation) approach was used to assess the overall quality of evidence. Meta-analysis was not possible due to methodological heterogeneity of included studies and the inadequacy of data. Results: Out of 220 references identified, five studies fulfilled the inclusion criteria. All of them were related to the use of PLDs and comprised in total of 1551 teenagers and young adults. Three studies used hearing loss as the outcome and three tinnitus. There was a positive correlation between noise level and hearing loss either at standard or extended high frequencies in all three of the studies on hearing loss. In one study, there was also a positive correlation between the duration of PLD use and hearing loss. There was no association between prolonged listening to loud music through PLDs and tinnitus or the results were contradictory. All of the evidence was of low quality. Limitations: The studies are cross-sectional. No study provides odds ratios of hearing loss by the level of exposure to noise. Conclusions: While using very strict inclusion criteria, there is low quality GRADE evidence that prolonged listening to loud music through PLDs increases the risk of hearing loss and results in worsening standard frequency audiometric thresholds. However, specific threshold analyses focused on stratifying risk according to clearly defined levels of exposure are missing. Future studies are needed to provide actionable guidance for PLDs users. No studies fulfilling the inclusion criteria related to other isolated or combined exposures to environmental noise were identified. Full article

(This article belongs to the Special Issue WHO Noise and Health Evidence Reviews)

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16 pages, 675 KiB

Open AccessReview

Clinical Effects of Cigarette Smoking: Epidemiologic Impact and Review of Pharmacotherapy Options

by IfeanyiChukwu O. Onor, Daniel L. Stirling, Shandrika R. Williams, Daniel Bediako, Amne Borghol, Martha B. Harris, Tiernisha B. Darensburg, Sharde D. Clay, Samuel C. Okpechi and Daniel F. Sarpong

Int. J. Environ. Res. Public Health 2017, 14(10), 1147; https://doi.org/10.3390/ijerph14101147 - 28 Sep 2017

Cited by 115 | Viewed by 18472

Abstract

Cigarette smoking—a crucial modifiable risk factor for organ system diseases and cancer—remains prevalent in the United States and globally. In this literature review, we aim to summarize the epidemiology of cigarette smoking and tobacco use in the United States, pharmacology of nicotine—the active [...] Read more.

Cigarette smoking—a crucial modifiable risk factor for organ system diseases and cancer—remains prevalent in the United States and globally. In this literature review, we aim to summarize the epidemiology of cigarette smoking and tobacco use in the United States, pharmacology of nicotine—the active constituent of tobacco, and health consequence of cigarette smoking. This article also reviews behavioral and pharmacologic interventions for cigarette smokers and provides cost estimates for approved pharmacologic interventions in the United States. A literature search was conducted on Google Scholar, EBSCOhost, ClinicalKey, and PubMed databases using the following headings in combination or separately: cigarette smoking, tobacco smoking, epidemiology in the United States, health consequences of cigarette smoking, pharmacologic therapy for cigarette smoking, and non-pharmacologic therapy for cigarette smoking. This review found that efficacious non-pharmacologic interventions and pharmacologic therapy are available for cessation of cigarette smoking. Given the availability of efficacious interventions for cigarette smoking cessation, concerted efforts should be made by healthcare providers and public health professionals to promote smoking cessation as a valuable approach for reducing non-smokers’ exposure to environmental tobacco smoke. Full article

(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)

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19 pages, 344 KiB

Open AccessReview

Cadmium and Cadmium/Zinc Ratios and Tobacco-Related Morbidities

by Patricia Richter, Obaid Faroon and R. Steven Pappas

Int. J. Environ. Res. Public Health 2017, 14(10), 1154; https://doi.org/10.3390/ijerph14101154 - 29 Sep 2017

Cited by 150 | Viewed by 10681

Abstract

Metals are one of five major categories of carcinogenic or toxic constituents in tobacco and tobacco smoke. Cadmium is highly volatile and a higher percentage of the total tobacco cadmium content is efficiently transferred to mainstream tobacco smoke than many other toxic metals [...] Read more.

Metals are one of five major categories of carcinogenic or toxic constituents in tobacco and tobacco smoke. Cadmium is highly volatile and a higher percentage of the total tobacco cadmium content is efficiently transferred to mainstream tobacco smoke than many other toxic metals in tobacco. Inhaled cadmium bioaccumulates in the lungs and is distributed beyond the lungs to other tissues, with a total body biological half-life of one to two decades. Chronic cadmium exposure through tobacco use elevates blood and urine cadmium concentrations. Cadmium is a carcinogen, and an inducer of proinflammatory immune responses. Elevated exposure to cadmium is associated with reduced pulmonary function, obstructive lung disease, bronchogenic carcinoma, cardiovascular diseases including myocardial infarction, peripheral arterial disease, prostate cancer, cervical cancer, pancreatic cancer, and various oral pathologies. Cadmium and zinc have a toxicologically inverse relationship. Zinc is an essential element and is reportedly antagonistic to some manifestations of cadmium toxicity. This review summarizes associations between blood, urine, and tissue cadmium concentrations with emphasis on cadmium exposure due to tobacco use and several disease states. Available data about zinc and cadmium/zinc ratios and tobacco-related diseases is summarized from studies reporting smoking status. Collectively, data suggest that blood, urine, and tissue cadmium and cadmium/zinc ratios are often significantly different between smokers and nonsmokers and they are also different in smokers for several diseases and cancers. Additional biomonitoring data such as blood or serum and urine zinc and cadmium levels and cadmium/zinc ratios in smokers may provide further insight into the development and progression of diseases of the lung, cardiovascular system, and possibly other organs. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

27 pages, 437 KiB

Open AccessReview

Vibrio Pathogens: A Public Health Concern in Rural Water Resources in Sub-Saharan Africa

by Charles A. Osunla and Anthony I. Okoh

Int. J. Environ. Res. Public Health 2017, 14(10), 1188; https://doi.org/10.3390/ijerph14101188 - 7 Oct 2017

Cited by 91 | Viewed by 8882

Abstract

Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the [...] Read more.

Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the continuous discovery of novel species. The main route of transmission of Vibrio pathogens to man is through drinking of contaminated water and consumption inadequately cooked aquatic food products. In sub-Saharan Africa and much of the developing world, some rural dwellers use freshwater resources such as rivers for domestic activities, bathing, and cultural and religious purposes. This review describes the impact of inadequately treated sewage effluents on the receiving freshwater resources and the associated risk to the rural dwellers that depends on the water. Vibrio infections remain a threat to public health. In the last decade, Vibrio disease outbreaks have created alertness on the personal, economic, and public health uncertainties associated with the impact of contaminated water in the aquatic environment of sub-Saharan Africa. In this review, we carried out an overview of Vibrio pathogens in rural water resources in Sub-Saharan Africa and the implication of Vibrio pathogens on public health. Continuous monitoring of Vibrio pathogens among environmental freshwater and treated effluents is expected to help reduce the risk associated with the early detection of sources of infection, and also aid our understanding of the natural ecology and evolution of Vibrio pathogens. Full article

(This article belongs to the Special Issue Drinking Water Quality and Human Health)

19 pages, 2898 KiB

Open AccessReview

From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis

by Liliana Leone and Caterina Pesce

Int. J. Environ. Res. Public Health 2017, 14(10), 1193; https://doi.org/10.3390/ijerph14101193 - 8 Oct 2017

Cited by 32 | Viewed by 5906

Abstract

Background: Evidence-based guidelines published by health authorities for the promotion of health-enhancing physical activity (PA), continue to be implemented unsuccessfully and demonstrate a gap between evidence and policies. This review synthesizes evidence on factors influencing delivery, adoption and implementation of PA promotion guidelines [...] Read more.

Background: Evidence-based guidelines published by health authorities for the promotion of health-enhancing physical activity (PA), continue to be implemented unsuccessfully and demonstrate a gap between evidence and policies. This review synthesizes evidence on factors influencing delivery, adoption and implementation of PA promotion guidelines within different policy sectors (e.g., health, transport, urban planning, sport, education). Methods: Published literature was initially searched using PubMed, EBSCO, Google Scholar and continued through an iterative snowball technique. The literature review spanned the period 2002–2017. The realist synthesis approach was adopted to review the content of 39 included studies. An initial programme theory with a four-step chain from evidence emersion to implementation of guidelines was tested. Results: The synthesis furthers our understanding of the link between PA guidelines delivery and the actions of professionals responsible for implementation within health services, school departments and municipalities. The main mechanisms identified for guidance implementation were scientific legitimation, enforcement, feasibility, familiarity with concepts and PA habits. Threats emerged to the successful implementation of PA guidelines at national/local jurisdictional levels. Conclusions: The way PA guidelines are developed may influence their adoption by policy-makers and professionals. Useful lessons emerged that may inform synergies between policymaking and professional practices, promoting win-win multisectoral strategies. Full article

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13 pages, 299 KiB

Open AccessReview

Managing Early Childhood Caries with Atraumatic Restorative Treatment and Topical Silver and Fluoride Agents

by Duangporn Duangthip, Kitty Jieyi Chen, Sherry Shiqian Gao, Edward Chin Man Lo and Chun Hung Chu

Int. J. Environ. Res. Public Health 2017, 14(10), 1204; https://doi.org/10.3390/ijerph14101204 - 10 Oct 2017

Cited by 74 | Viewed by 14707

Abstract

Early childhood caries (ECC) is a significant global health problem affecting millions of preschool children worldwide. In general, preschool children from families with 20% of the lowest family incomes suffered about 80% of the ECC. Most, if not all, surveys indicated that the [...] Read more.

Early childhood caries (ECC) is a significant global health problem affecting millions of preschool children worldwide. In general, preschool children from families with 20% of the lowest family incomes suffered about 80% of the ECC. Most, if not all, surveys indicated that the great majority of ECC was left untreated. Untreated caries progresses into the dental pulp, causing pain and infection. It can spread systemically, affecting a child’s growth, development and general health. Fundamental caries management is based on the conventional restorative approach. Because preschool children are too young to cope with lengthy dental treatment, they often receive dental treatment under general anaesthesia from a specialist dentist. However, treatment under general anaesthesia poses a life-threatening risk to young children. Moreover, there are few dentists in rural areas, where ECC is prevalent. Hence, conventional dental care is unaffordable, inaccessible or unavailable in many communities. However, studies showed that the atraumatic restorative treatment had a very good success rate in treating dentine caries in young children. Silver diamine fluoride is considered safe and effective in arresting dentine caries in primary teeth. The aim of this paper is to review and discuss updated evidence of these alternative approaches in order to manage cavitated ECC. Full article

(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)

19 pages, 784 KiB

Open AccessReview

Multi-Contextual Segregation and Environmental Justice Research: Toward Fine-Scale Spatiotemporal Approaches

by Yoo Min Park and Mei-Po Kwan

Int. J. Environ. Res. Public Health 2017, 14(10), 1205; https://doi.org/10.3390/ijerph14101205 - 10 Oct 2017

Cited by 57 | Viewed by 8425

Abstract

Many environmental justice studies have sought to examine the effect of residential segregation on unequal exposure to environmental factors among different social groups, but little is known about how segregation in non-residential contexts affects such disparity. Based on a review of the relevant [...] Read more.

Many environmental justice studies have sought to examine the effect of residential segregation on unequal exposure to environmental factors among different social groups, but little is known about how segregation in non-residential contexts affects such disparity. Based on a review of the relevant literature, this paper discusses the limitations of traditional residence-based approaches in examining the association between socioeconomic or racial/ethnic segregation and unequal environmental exposure in environmental justice research. It emphasizes that future research needs to go beyond residential segregation by considering the full spectrum of segregation experienced by people in various geographic and temporal contexts of everyday life. Along with this comprehensive understanding of segregation, the paper also highlights the importance of assessing environmental exposure at a high spatiotemporal resolution in environmental justice research. The successful integration of a comprehensive concept of segregation, high-resolution data and fine-grained spatiotemporal approaches to assessing segregation and environmental exposure would provide more nuanced and robust findings on the associations between segregation and disparities in environmental exposure and their health impacts. Moreover, it would also contribute to significantly expanding the scope of environmental justice research. Full article

(This article belongs to the Special Issue Environmental Justice Research: Contemporary Issues and Emerging Topics)

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15 pages, 1159 KiB

Open AccessReview

Systematic Review: Land Cover, Meteorological, and Socioeconomic Determinants of Aedes Mosquito Habitat for Risk Mapping

by Mohamed F. Sallam, Chelsea Fizer, Andrew N. Pilant and Pai-Yei Whung

Int. J. Environ. Res. Public Health 2017, 14(10), 1230; https://doi.org/10.3390/ijerph14101230 - 16 Oct 2017

Cited by 69 | Viewed by 9073

Abstract

Asian tiger and yellow fever mosquitoes (Aedes albopictus and Ae. aegypti) are global nuisances and are competent vectors for viruses such as Chikungunya (CHIKV), Dengue (DV), and Zika (ZIKV). This review aims to analyze available spatiotemporal distribution models of Aedes mosquitoes [...] Read more.

Asian tiger and yellow fever mosquitoes (Aedes albopictus and Ae. aegypti) are global nuisances and are competent vectors for viruses such as Chikungunya (CHIKV), Dengue (DV), and Zika (ZIKV). This review aims to analyze available spatiotemporal distribution models of Aedes mosquitoes and their influential factors. A combination of five sets of 3–5 keywords were used to retrieve all relevant published models. Five electronic search databases were used: PubMed, MEDLINE, EMBASE, Scopus, and Google Scholar through 17 May 2017. We generated a hierarchical decision tree for article selection. We identified 21 relevant published studies that highlight different combinations of methodologies, models and influential factors. Only a few studies adopted a comprehensive approach highlighting the interaction between environmental, socioeconomic, meteorological and topographic systems. The selected articles showed inconsistent findings in terms of number and type of influential factors affecting the distribution of Aedes vectors, which is most likely attributed to: (i) limited availability of high-resolution data for physical variables, (ii) variation in sampling methods; Aedes feeding and oviposition behavior; (iii) data collinearity and statistical distribution of observed data. This review highlights the need and sets the stage for a rigorous multi-system modeling approach to improve our knowledge about Aedes presence/abundance within their flight range in response to the interaction between environmental, socioeconomic, and meteorological systems. Full article

(This article belongs to the Special Issue Environmental Determinants of Infectious Disease Transmission)

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11 pages, 323 KiB

Open AccessReview

Non-Traditional Risk Factors of Albuminuria in the Pediatric Population: A Scoping Review

by Erick Sierra-Diaz, Alfredo De Jesus Celis-de la Rosa, Felipe Lozano-Kasten, Alejandro Bravo-Cuellar, Mariana Garcia-Gutierrez and Hernandez-Flores Georgina

Int. J. Environ. Res. Public Health 2017, 14(10), 1231; https://doi.org/10.3390/ijerph14101231 - 16 Oct 2017

Cited by 4 | Viewed by 4569

Abstract

The presence of albumin in urine has been used for more than four decades as a marker of renal and cardiovascular damage. Most of the information on this marker is related to adults. The prevalence of albuminuria in the pediatric population has been [...] Read more.

The presence of albumin in urine has been used for more than four decades as a marker of renal and cardiovascular damage. Most of the information on this marker is related to adults. The prevalence of albuminuria in the pediatric population has been reported as being 2.2–12.8% in some countries. Most research in this field is related to albuminuria and diseases, such as diabetes and hypertension. Using the methodology described by Arksey and O’Malley in 2005, a scoping review was carried out to show that the presence of albumin in urine in the pediatric population might be associated with environmental, demographic, congenital, infectious, and non-infectious factors. The information collected is supported by 74 references present in PubMed. The results reveal the multiple causes associated with albuminuria in the pediatric population. This information can be very useful for clinical practice by adding knowledge about albuminuria behavior in children. Full article

(This article belongs to the Special Issue Maternal and Child Health 2018)

16 pages, 856 KiB

Open AccessReview

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Adverse Birth Outcomes

by Mark J. Nieuwenhuijsen, Gordana Ristovska and Payam Dadvand

Int. J. Environ. Res. Public Health 2017, 14(10), 1252; https://doi.org/10.3390/ijerph14101252 - 19 Oct 2017

Cited by 112 | Viewed by 11276

Abstract

Introduction: Three recent systematic reviews suggested a relationship between noise exposure and adverse birth outcomes. The aim of this review was to evaluate the evidence for the World Health Organization (WHO) noise guidelines and conduct an updated systematic review of environmental noise, specifically [...] Read more.

Introduction: Three recent systematic reviews suggested a relationship between noise exposure and adverse birth outcomes. The aim of this review was to evaluate the evidence for the World Health Organization (WHO) noise guidelines and conduct an updated systematic review of environmental noise, specifically aircraft and road traffic noise and birth outcomes, such as preterm birth, low birth weight, being small for gestational age and congenital malformations. Materials and methods: We reviewed again all the papers on environmental noise and birth outcomes included in the previous three systematic reviews and conducted a systematic search on noise and birth outcomes to update previous reviews. Web of Science, PubMed and Embase electronic databases were searched for papers published between June 2014 (end date of previous systematic review) and December 2016 using a list of specific search terms. Studies were also screened in the reference list of relevant reviews/articles. Further inclusion and exclusion criteria for the studies provided by the WHO expert group were applied. Risk of bias was assessed according to criteria from the Newcastle-Ottawa quality assessment scale for case-control and cohort studies. Finally, we applied the GRADE principles to our systematic review in a reproducible and appropriate way for judgment about quality of evidence. Results: In total, 14 studies are included in this review, six studies on aircraft noise and birth outcomes, five studies (two with more or less the same population) on road traffic noise and birth outcomes and three related studies on total ambient noise that is likely to be mostly traffic noise that met the criteria. The number of studies on environmental noise and birth outcomes is small and the quality of evidence generally ranges from very low to low, particularly in case of the older studies. The quality is better for the more recent traffic noise and birth outcomes studies. As there were too few studies, we did not conduct meta-analyses. Discussion: This systematic review is supported by previous systematic reviews and meta-analyses that suggested that there may be some suggestive evidence for an association between environmental noise exposure and birth outcomes, although they pointed more generally to a stronger role of occupational noise exposure, which tends to be higher and last longer. Very strict criteria for inclusion and exclusion of studies, performance of quality assessment for risk of bias, and finally applying GRADE principles for judgment of quality of evidence are the strengths of this review. Conclusions: We found evidence of very low quality for associations between aircraft noise and preterm birth, low birth weight and congenital anomalies, and low quality evidence for an association between road traffic noise and low birth weight, preterm birth and small for gestational age. Further high quality studies are required to establish such associations. Future studies are recommended to apply robust exposure assessment methods (e.g., modeled or measured noise levels at bedroom façade), disentangle associations for different sources of noise as well as daytime and nighttime noise, evaluate the impacts of noise evens (that stand out of the noise background), and control the analyses for confounding factors, such as socioeconomic status, lifestyle factors and other environmental factors, especially air pollution. Full article

(This article belongs to the Special Issue WHO Noise and Health Evidence Reviews)

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31 pages, 1273 KiB

Open AccessReview

Wear and Tear of Tyres: A Stealthy Source of Microplastics in the Environment

by Pieter Jan Kole, Ansje J. Löhr, Frank G. A. J. Van Belleghem and Ad M. J. Ragas

Int. J. Environ. Res. Public Health 2017, 14(10), 1265; https://doi.org/10.3390/ijerph14101265 - 20 Oct 2017

Cited by 1078 | Viewed by 69246

Abstract

Wear and tear from tyres significantly contributes to the flow of (micro-)plastics into the environment. This paper compiles the fragmented knowledge on tyre wear and tear characteristics, amounts of particles emitted, pathways in the environment, and the possible effects on humans. The estimated [...] Read more.

Wear and tear from tyres significantly contributes to the flow of (micro-)plastics into the environment. This paper compiles the fragmented knowledge on tyre wear and tear characteristics, amounts of particles emitted, pathways in the environment, and the possible effects on humans. The estimated per capita emission ranges from 0.23 to 4.7 kg/year, with a global average of 0.81 kg/year. The emissions from car tyres (100%) are substantially higher than those of other sources of microplastics, e.g., airplane tyres (2%), artificial turf (12–50%), brake wear (8%) and road markings (5%). Emissions and pathways depend on local factors like road type or sewage systems. The relative contribution of tyre wear and tear to the total global amount of plastics ending up in our oceans is estimated to be 5–10%. In air, 3–7% of the particulate matter (PM_2.5) is estimated to consist of tyre wear and tear, indicating that it may contribute to the global health burden of air pollution which has been projected by the World Health Organization (WHO) at 3 million deaths in 2012. The wear and tear also enters our food chain, but further research is needed to assess human health risks. It is concluded here that tyre wear and tear is a stealthy source of microplastics in our environment, which can only be addressed effectively if awareness increases, knowledge gaps on quantities and effects are being closed, and creative technical solutions are being sought. This requires a global effort from all stakeholders; consumers, regulators, industry and researchers alike. Full article

(This article belongs to the Special Issue Microplastics: Hazards to Environmental and Human Health)

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13 pages, 1067 KiB

Open AccessReview

Association between Obesity and Puberty Timing: A Systematic Review and Meta-Analysis

by Wenyan Li, Qin Liu, Xu Deng, Yiwen Chen, Shudan Liu and Mary Story

Int. J. Environ. Res. Public Health 2017, 14(10), 1266; https://doi.org/10.3390/ijerph14101266 - 24 Oct 2017

Cited by 205 | Viewed by 14890

Abstract

This systematic review and meta-analysis examined the associations between obesity and puberty timing based on scientific evidence. Eight electronic databases were searched up to February 2017 for eligible studies, and two reviewers screened the articles and extracted the data independently. A total of [...] Read more.

This systematic review and meta-analysis examined the associations between obesity and puberty timing based on scientific evidence. Eight electronic databases were searched up to February 2017 for eligible studies, and two reviewers screened the articles and extracted the data independently. A total of 11 cohort studies with 4841 subjects met the inclusion criteria. Compared with the group of normal-weight girls, the obese group had more girls with menarche (RR: 1.87, 95% CI: 1.59–2.19, 2 studies). The number of girls with early puberty was significantly higher in the obese group than the normal weight group (RR: 2.44, 95% CI: 1.32–4.52, 5 studies). However, no differences were detected between girls who were obese or normal weight at age of menarche (WMD: −0.53 years, 95% CI: −1.24–0.19, 2 studies). There is no consistent result in the relationship between obesity and timing of pubertal onset in boys. Obesity may contribute to early onset of puberty in girls, while in boys, there is insufficient data. Given the limited number of cohort studies included in this meta-analysis, high-quality studies with strong markers of puberty onset, as well as standardized criteria for defining obesity are needed. Full article

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18 pages, 1020 KiB

Open AccessReview

Endocrine Disruptors Leading to Obesity and Related Diseases

by Demetrios Petrakis, Loukia Vassilopoulou, Charalampos Mamoulakis, Christos Psycharakis, Aliki Anifantaki, Stavros Sifakis, Anca Oana Docea, John Tsiaoussis, Antonios Makrigiannakis and Aristides M. Tsatsakis

Int. J. Environ. Res. Public Health 2017, 14(10), 1282; https://doi.org/10.3390/ijerph14101282 - 24 Oct 2017

Cited by 164 | Viewed by 13564

Abstract

The review aims to comprehensively present the impact of exposure to endocrine disruptors (EDs) in relation to the clinical manifestation of obesity and related diseases, including diabetes mellitus, metabolic syndrome, cardiovascular diseases, carcinogenesis and infertility. EDs are strong participants in the obesity epidemic [...] Read more.

The review aims to comprehensively present the impact of exposure to endocrine disruptors (EDs) in relation to the clinical manifestation of obesity and related diseases, including diabetes mellitus, metabolic syndrome, cardiovascular diseases, carcinogenesis and infertility. EDs are strong participants in the obesity epidemic scenery by interfering with cellular morphological and biochemical processes; by inducing inflammatory responses; and by presenting transcriptional and oncogenic activity. Obesity and lipotoxicity enhancement occur through reprogramming and/or remodeling of germline epigenome by exposure to EDs. Specific population groups are vulnerable to ED exposure due to current dietary and environmental conditions. Obesity, morbidity and carcinogenicity induced by ED exposure are an evolving reality. Therefore, a new collective strategic approach is deemed essential, for the reappraisal of current global conditions pertaining to energy management. Full article

(This article belongs to the Special Issue Endocrine Disruptors Leading to Obesity and Related Diseases)

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7 pages, 1582 KiB

Open AccessCase Report

Role of High-Resolution Chest Computed Tomography in a Child with Persistent Tachypnoea and Intercostal Retractions: A Case Report of Neuroendocrine Cell Hyperplasia

by Mara Lelii, Maria Francesca Patria, Raffaella Pinzani, Rossana Tenconi, Alessandro Mori, Nicola Bonelli, Nicola Principi and Susanna Esposito

Int. J. Environ. Res. Public Health 2017, 14(10), 1113; https://doi.org/10.3390/ijerph14101113 - 25 Sep 2017

Cited by 3 | Viewed by 5356

Abstract

Background: Chronic interstitial lung diseases in children (chILD) are a heterogeneous group of disorders that can represent a clinical challenge for pediatric pneumologists. Among them, neuroendocrine cell hyperplasia of infancy (NEHI) is a diffuse lung disease prevalent in the first years of [...] Read more.

Background: Chronic interstitial lung diseases in children (chILD) are a heterogeneous group of disorders that can represent a clinical challenge for pediatric pneumologists. Among them, neuroendocrine cell hyperplasia of infancy (NEHI) is a diffuse lung disease prevalent in the first years of life that spontaneously improves over time. The clinical presentation of NEHI is indistinguishable from other interstitial lung diseases, so a correct and non-invasive diagnosis by chest computed tomography (CT) without lung biopsy might not be simple. Case presentation: An 8-month-old male infant presented with a history of chronic tachypnoea and dyspnoea since 6 months of age. The patient was born at term, with APGAR scores of 9 and 10 at 1 and 5 min, respectively. Since his second month of life, the patient suffered from abnormal breathing, which was characterized by mild tachypnoea and costal retractions that worsened during breastfeeding, crying, and respiratory infections. Bilateral inspiratory crackles, preferential to the lung bases, without oxygen desaturation were detected. A chest X-ray showed a diffuse over-inflation of the lungs, but laboratory tests did not reveal any abnormalities. High-resolution chest CT documented patchy areas of ground-glass opacity involving the right upper lobe, middle lobe, and lingula, and showed mosaic areas of air-trapping, suggesting a diagnosis of NEHI. The infant was discharged without therapy and gradually improved over time. At 1 year of age, the patient was eupnoeic and chest auscultation had normalized. Conclusions: NEHI is an interstitial disease of infancy characterized by tachypnoea from the first months of life, with a good prognosis and for which a rational diagnostic approach is crucial for making a specific, early diagnosis. Initially, clinical suspicions can be confirmed with reasonable accuracy by a CT scan of the chest. Other more invasive and more expensive investigations should be reserved for selected cases that do not show a spontaneous, favourable clinical evolution. Full article

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8 pages, 289 KiB

Open AccessCommentary

Breaking Up Sitting with Light-Intensity Physical Activity: Implications for Shift-Workers

by Grace E. Vincent, Sarah M. Jay, Corneel Vandelanotte and Sally A. Ferguson

Int. J. Environ. Res. Public Health 2017, 14(10), 1233; https://doi.org/10.3390/ijerph14101233 - 16 Oct 2017

Cited by 10 | Viewed by 5221

Abstract

Prolonged sitting, restricted sleep, and circadian disruption are all independent risk factors for non-communicable diseases. Previous research has demonstrated that breaking up sitting with light-intensity physical activity has clear benefits for the health of day workers, but these findings may not apply in [...] Read more.

Prolonged sitting, restricted sleep, and circadian disruption are all independent risk factors for non-communicable diseases. Previous research has demonstrated that breaking up sitting with light-intensity physical activity has clear benefits for the health of day workers, but these findings may not apply in the presence of sleep restriction and/or circadian disruption—both of which are commonly experienced by shift-workers. Specifically, sleep restriction, and circadian disruption result in acute physiological changes that may offset the benefits of breaking up sitting. This commentary will explore the potential benefits of breaking up sitting for health, work performance, and subsequent sleep in shift-workers. Future areas of research designed to understand the mechanisms by which prolonged sitting and shift work impact worker health and safety and to support the design of effective occupational health and safety interventions are proposed. Full article

(This article belongs to the Special Issue The Impacts of Physical Activity on Chronic Disease Prevention and Population Health)

12 pages, 2704 KiB

Open AccessData Descriptor

Trends and Weekly Cycles in a Large Swiss Emergency Centre: A 10 Year Period at the University Hospital of Bern

by Christian T. Braun, Cornelia R. Gnägi, Jolanta Klukowska-Rötzler, Sufian S. Ahmad, Meret E. Ricklin and Aristomenis K. Exadaktylos

Int. J. Environ. Res. Public Health 2017, 14(10), 1239; https://doi.org/10.3390/ijerph14101239 - 17 Oct 2017

Cited by 3 | Viewed by 3214

Abstract

Popular demand for high quality care has increased in recent years. This is also the case for medical services and support at all times of the day and night is nowadays required. During the last ten years, there has been a marked increase [...] Read more.

Popular demand for high quality care has increased in recent years. This is also the case for medical services and support at all times of the day and night is nowadays required. During the last ten years, there has been a marked increase in the demands on hospital emergency hospitals, particularly in the Western industrialized countries. The present retrospective study investigates how the demands on a large Swiss university centre have changed over a period of 10 years. Patient numbers are differentiated by age, gender, nationality, weekday and mode of referral. A retrospective analysis was performed of the data of the patients admitted to the Emergency Centre of Bern University Medical Hospital (Inselspital) during the ten-year period from 2004 up to and including 2013 and who were treated as emergencies. A total of 264,272 patients were included in the study. It was shown that there was an uninterrupted annual increase from 23,555 patients in 2004 to 34,918 patients in 2013 (+48%). Most patients came to the Emergency Centre on Mondays, followed by Fridays. Because of the marked increase in life expectancy and the resulting demographic changes, there has been a marked increase in the number of older patients coming to the Emergency Centre for acute medical care. It was found that there were disproportionately high numbers of patients aged 20 to 49 years who were not Swiss citizens. In contrast, most patients over 60 were Swiss. In the coming years, emergency centres will have to adapt to the continued increase in patient numbers. This trend will continue, so that it is essential to consider the sociodemographic structure of a region when planning the availability of emergency medical care. Full article

(This article belongs to the Section Environmental Science and Engineering)

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8 pages, 276 KiB

Open AccessCommentary

Leveraging the Domain of Work to Improve Migrant Health

by Michael A. Flynn and Kolitha Wickramage

Int. J. Environ. Res. Public Health 2017, 14(10), 1248; https://doi.org/10.3390/ijerph14101248 - 19 Oct 2017

Cited by 24 | Viewed by 5852

Abstract

Work is a principal driver of current international migration, a primary social determinant of health, and a fundamental point of articulation between migrants and their host society. Efforts by international organizations to promote migrant health have traditionally focused on infectious diseases and access [...] Read more.

Work is a principal driver of current international migration, a primary social determinant of health, and a fundamental point of articulation between migrants and their host society. Efforts by international organizations to promote migrant health have traditionally focused on infectious diseases and access to healthcare, while international labor organizations have largely focused on issues of occupational health. The underutilization of the domain of work in addressing the health of migrants is truly a missed opportunity for influencing worker well-being and reducing societal economic burden. Understanding of the relationships among migration, work, and health would facilitate further integration of migrant health concerns into the policy agenda of governments and international agencies that work at the nexus of labor, health and development. The domain of work offers an opportunity to capitalize on the existing health and development infrastructure and leverage technical resources, programs and research to promote migrant health. It also provides the opportunity to advance migrant health through new and innovative approaches and partnerships. Full article

(This article belongs to the Special Issue Refugee Health)

19 pages, 1698 KiB

Open AccessProtocol

Socio-Ecological Intervention to Promote Active Commuting to Work: Protocol and Baseline Findings of a Cluster Randomized Controlled Trial in Finland

by Minna Aittasalo, Johanna Tiilikainen, Kari Tokola, Timo Seimelä, Satu-Maaria Sarjala, Pasi Metsäpuro, Ari Hynynen, Jaana Suni, Harri Sievänen, Henri Vähä-Ypyä, Kalle Vaismaa, Olli Vakkala, Charlie Foster, Sylvia Titze and Tommi Vasankari

Int. J. Environ. Res. Public Health 2017, 14(10), 1257; https://doi.org/10.3390/ijerph14101257 - 20 Oct 2017

Cited by 11 | Viewed by 6553

Abstract

Active commuting to work (ACW) is beneficial to traffic, environment and population health. More evidence is needed on effective ways to promote ACW. This paper describes the protocol and baseline findings of a cluster-randomized controlled study, which aims to promote ACW with multilevel [...] Read more.

Active commuting to work (ACW) is beneficial to traffic, environment and population health. More evidence is needed on effective ways to promote ACW. This paper describes the protocol and baseline findings of a cluster-randomized controlled study, which aims to promote ACW with multilevel strategies in two large workplace areas in Tampere, Finland. In Phase 1, the impacts of environmental strategies (trail improvements) were evaluated in 11 workplaces within Area 1. In Phase 2, five more workplaces were recruited from Area 2 to evaluate the impacts of social and behavioral strategies customized for each workplace. For this purpose, the workplaces in both areas were randomly assigned into experimental group (EXP, n = 6 + 2), which promoted ACW with social and behavioral strategies or into comparison group (COM, n = 5 + 3), which participated in the data collection only. The primary indicator in both phases is the change in employees’ ACW. Secondary indicators are e.g., changes in employees’ self-rated health, wellbeing at work, restrictions to and motivation for ACW, adverse effects due to ACW and the use and quality of the main walking and cycling trails. Also process, efficiency and environmental evaluation is included. The study is the first one in Finland to combine interdisciplinary collaboration between practitioners and researchers working in the fields of transportation, urban design, physical activity and sustainable development to promote ACW. The findings benefit all stakeholders interested in promoting ACW in urban context. Full article

(This article belongs to the Special Issue Sustainable Transportation and Health)

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4 pages, 243 KiB

Open AccessBrief Report

Generally Recognized as Safe: Uncertainty Surrounding E-Cigarette Flavoring Safety

by Clara G. Sears, Joy L. Hart, Kandi L. Walker and Rose Marie Robertson

Int. J. Environ. Res. Public Health 2017, 14(10), 1274; https://doi.org/10.3390/ijerph14101274 - 23 Oct 2017

Cited by 20 | Viewed by 6162

Abstract

Despite scientific uncertainty regarding the relative safety of inhaling e-cigarette aerosol and flavorings, some consumers regard the U.S. Food and Drug Administration’s “generally recognized as safe” (GRAS) designation as evidence of flavoring safety. In this study, we assessed how college students’ perceptions of [...] Read more.

Despite scientific uncertainty regarding the relative safety of inhaling e-cigarette aerosol and flavorings, some consumers regard the U.S. Food and Drug Administration’s “generally recognized as safe” (GRAS) designation as evidence of flavoring safety. In this study, we assessed how college students’ perceptions of e-cigarette flavoring safety are related to understanding of the GRAS designation. During spring 2017, an online questionnaire was administered to college students. Chi-square p-values and multivariable logistic regression were employed to compare perceptions among participants considering e-cigarette flavorings as safe and those considering e-cigarette flavorings to be unsafe. The total sample size was 567 participants. Only 22% knew that GRAS designation meant that a product is safe to ingest, not inhale, inject, or use topically. Of participants who considered flavorings to be GRAS, the majority recognized that the designation meant a product is safe to ingest but also considered it safe to inhale. Although scientific uncertainty on the overall safety of flavorings in e-cigarettes remains, health messaging can educate the public about the GRAS designation and its irrelevance to e-cigarette safety. Full article

(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)

9 pages, 289 KiB

Open AccessBrief Report

Nature Elements and Fundamental Motor Skill Development Opportunities at Five Elementary School Districts in British Columbia

by Christopher Lim, Andrew M. Donovan, Nevin J. Harper and Patti-Jean Naylor

Int. J. Environ. Res. Public Health 2017, 14(10), 1279; https://doi.org/10.3390/ijerph14101279 - 24 Oct 2017

Cited by 11 | Viewed by 5644

Abstract

The majority of Canadian children are not physically active enough for healthy development. School playgrounds are a primary location to promote physical activity and motor skill practice. The benefits of children’s play in nature have also been highlighted, but few studies have evaluated [...] Read more.

The majority of Canadian children are not physically active enough for healthy development. School playgrounds are a primary location to promote physical activity and motor skill practice. The benefits of children’s play in nature have also been highlighted, but few studies have evaluated children’s access and exposure to nature for play on school grounds. This study examined children’s access to nature on school grounds and the opportunities afforded by those natural elements for motor skill practice. Results: Extensive naturescapes (multiple nature elements in one setting) were not common, and natural elements were limited, ranging from 1.97 to 5.71 elements/school. The most common element was a forested area (26.5% of all natural elements identified). In comparison to built structures, the number of natural elements was low. Some elements differed between school districts and appeared to be related to local geography and terrain (hilly, rocky terrain, tidal flats, etc.). Our assessment showed that naturescape elements afforded opportunities for the development of some key fundamental motor skills (FMS), specifically, locomotor and stability skills, but opportunities to develop manipulative skills were limited. To maximize potential FMS development, physical literacy, and psycho-social benefits, additional elements or more comprehensive multi-element naturescapes and facilitation (social or environmental) are recommended. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Int. J. Environ. Res. Public Health, Volume 14, Issue 10 (October 2017) – 193 articles

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