Next Issue
Previous Issue

E-Mail Alert

Add your e-mail address to receive forthcoming issues of this journal:

Journal Browser

Journal Browser

Table of Contents

Int. J. Environ. Res. Public Health, Volume 14, Issue 4 (April 2017)

  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Readerexternal link to open them.
Cover Story (view full-size image) Six years ago, a massive earthquake and resultant tsunami struck the northeast area of Japan, [...] Read more.
View options order results:
result details:
Displaying articles 1-116
Export citation of selected articles as:
Open AccessArticle
Fat Mass Is Positively Associated with Estimated Hip Bone Strength among Chinese Men Aged 50 Years and above with Low Levels of Lean Mass
Int. J. Environ. Res. Public Health 2017, 14(4), 453; https://doi.org/10.3390/ijerph14040453
Received: 1 February 2017 / Revised: 30 March 2017 / Accepted: 19 April 2017 / Published: 24 April 2017
Cited by 2 | Viewed by 1043 | PDF Full-text (2026 KB) | HTML Full-text | XML Full-text
Abstract
This study investigated the relationships of fat mass (FM) and lean mass (LM) with estimated hip bone strength in Chinese men aged 50–80 years (median value: 62.0 years). A cross-sectional study including 889 men was conducted in Guangzhou, China. Body composition and hip [...] Read more.
This study investigated the relationships of fat mass (FM) and lean mass (LM) with estimated hip bone strength in Chinese men aged 50–80 years (median value: 62.0 years). A cross-sectional study including 889 men was conducted in Guangzhou, China. Body composition and hip bone parameters were generated by dual-energy X-ray absorptiometry (DXA). The relationships of the LM index (LMI) and the FM index (FMI) with bone phenotypes were detected by generalised additive models and multiple linear regression. The associations between the FMI and the bone variables in LMI tertiles were further analysed. The FMI possessed a linear relationship with greater estimated hip bone strength after adjustment for the potential confounders (p < 0.05). Linear relationships were also observed for the LMI with most bone phenotypes, except for the cross-sectional area (p < 0.05). The contribution of the LMI (4.0%–12.8%) was greater than that of the FMI (2.0%–5.7%). The associations between the FMI and bone phenotypes became weaker after controlling for LMI. Further analyses showed that estimated bone strength ascended with FMI in the lowest LMI tertile (p < 0.05), but not in the subgroups with a higher LMI. This study suggested that LM played a critical role in bone health in middle-aged and elderly Chinese men, and that the maintenance of adequate FM could help to promote bone acquisition in relatively thin men. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle
Breast Cancer Screening Programmes across the WHO European Region: Differences among Countries Based on National Income Level
Int. J. Environ. Res. Public Health 2017, 14(4), 452; https://doi.org/10.3390/ijerph14040452
Received: 6 February 2017 / Revised: 3 April 2017 / Accepted: 17 April 2017 / Published: 23 April 2017
Cited by 11 | Viewed by 1867 | PDF Full-text (1479 KB) | HTML Full-text | XML Full-text
Abstract
Breast cancer (BC) is the most frequent tumour affecting women all over the world. In low- and middle-income countries, where its incidence is expected to rise further, BC seems set to become a public health emergency. The aim of the present study is [...] Read more.
Breast cancer (BC) is the most frequent tumour affecting women all over the world. In low- and middle-income countries, where its incidence is expected to rise further, BC seems set to become a public health emergency. The aim of the present study is to provide a systematic review of current BC screening programmes in WHO European Region to identify possible patterns. Multiple correspondence analysis was performed to evaluate the association among: measures of occurrence; GNI level; type of BC screening programme; organization of public information and awareness campaigns regarding primary prevention of modifiable risk factors; type of BC screening services; year of screening institution; screening coverage and data quality. A key difference between High Income (HI) and Low and Middle Income (LMI) States, emerging from the present data, is that in the former screening programmes are well organized, with approved screening centres, the presence of mobile units to increase coverage, the offer of screening tests free of charge; the fairly high quality of occurrence data based on high-quality sources, and the adoption of accurate methods to estimate incidence and mortality. In conclusion, the governments of LMI countries should allocate sufficient resources to increase screening participation and they should improve the accuracy of incidence and mortality rates. Full article
(This article belongs to the Special Issue Geographical Variation in Breast Cancer Outcomes)
Figures

Figure 1

Open AccessArticle
Job Strain and Casual Blood Pressure Distribution: Looking beyond the Adjusted Mean and Taking Gender, Age, and Use of Antihypertensives into Account. Results from ELSA-Brasil
Int. J. Environ. Res. Public Health 2017, 14(4), 451; https://doi.org/10.3390/ijerph14040451
Received: 23 November 2016 / Revised: 24 March 2017 / Accepted: 3 April 2017 / Published: 22 April 2017
Cited by 2 | Viewed by 1573 | PDF Full-text (1937 KB) | HTML Full-text | XML Full-text
Abstract
Methodological issues are pointed to as the main sources of inconsistencies in studies about the association between job strain and blood pressure (BP)/hypertension. Our aim was to analyze the relationship between job strain and the whole BP distribution, as well as potential differences [...] Read more.
Methodological issues are pointed to as the main sources of inconsistencies in studies about the association between job strain and blood pressure (BP)/hypertension. Our aim was to analyze the relationship between job strain and the whole BP distribution, as well as potential differences by gender, age, and use of antihypertensives. Additionally, we addressed issues relating to the operationalization of the exposure and outcome variables that influence the study of their inter-relations. We evaluated the baseline date of 12,038 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) (2008–2010), a multicenter cohort study of 35–74-year-old civil servants. Job strain was assessed by the Demand-Control-Support Questionnaire. The distribution of casual BP by categories of job strain was compared by a combination of exploratory techniques. Participants were classified into three subgroups (normotensives, medicated hypertensives, and unmedicated hypertensives), and analyses were stratified by gender and age. The relationship between job strain and casual BP varied along the whole outcome distribution. Hypertensive participants had greater differences in casual BP by job strain category, especially medicated hypertensives. Differences in casual BP were also greater for systolic than for diastolic BP and for older participants. No differences were encountered by gender. The exclusion of participants susceptible to misclassification for the exposure and outcome variables increased the differences observed between the categories of low and high job strain. In conclusion, the relationship between job strain and casual BP varied along the whole outcome distribution and by use of antihypertensive drugs, age, and BP parameter evaluated. Misclassification for exposure and outcome variables should be considered in analyses of this topic. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle
A National Study of Social Media, Television, Radio, and Internet Usage of Adults by Sexual Orientation and Smoking Status: Implications for Campaign Design
Int. J. Environ. Res. Public Health 2017, 14(4), 450; https://doi.org/10.3390/ijerph14040450
Received: 16 December 2016 / Revised: 5 April 2017 / Accepted: 18 April 2017 / Published: 21 April 2017
Cited by 12 | Viewed by 2477 | PDF Full-text (296 KB) | HTML Full-text | XML Full-text
Abstract
Background: Smoking rates among lesbian, gay, and bisexual (LGB) people significantly exceed that of heterosexuals. Media interventions are an important part of tobacco control efforts, but limited information is available on LGB people’s media use. Methods: A nationally representative sample of [...] Read more.
Background: Smoking rates among lesbian, gay, and bisexual (LGB) people significantly exceed that of heterosexuals. Media interventions are an important part of tobacco control efforts, but limited information is available on LGB people’s media use. Methods: A nationally representative sample of 12,900 U.S. adults completed an online questionnaire assessing media use, smoking status, and demographic information. Multivariable logistic regression was used to assess relationships between media use with sexual orientation and smoking status. Results: A total of 590 (4.6%) respondents identified as LGB, of which 29% were smokers. Regardless of sexual orientation and smoking status, the Internet was the most popular media channel used, followed by television and radio. LGB respondents had significantly greater odds of having accounts on social media websites, accessing Facebook daily, and being a frequent Internet user, compared to heterosexual respondents. Similar media use was found between smokers and non-smokers, but smokers had greater odds of being frequent television viewers and frequent Internet users, compared to non-smokers. Conclusions: Compared to heterosexuals, LGB respondents reported greater use of the Internet, especially social media. Media campaigns targeting LGB populations can maximize reach by utilizing social media alongside traditional media channels. Full article
(This article belongs to the collection Health Behavior and Public Health)
Open AccessArticle
Associations between Temperature and Hospital Admissions for Subarachnoid Hemorrhage in Korea
Int. J. Environ. Res. Public Health 2017, 14(4), 449; https://doi.org/10.3390/ijerph14040449
Received: 10 March 2017 / Revised: 17 April 2017 / Accepted: 19 April 2017 / Published: 21 April 2017
Viewed by 1381 | PDF Full-text (865 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The relationship between temperature and subarachnoid hemorrhage (SAH) is less studied than that between temperature and myocardial infarction or other cardiovascular diseases. This study investigated the association between daily temperature and risk of SAH by analyzing the hospital admission records of 111,316 SAH [...] Read more.
The relationship between temperature and subarachnoid hemorrhage (SAH) is less studied than that between temperature and myocardial infarction or other cardiovascular diseases. This study investigated the association between daily temperature and risk of SAH by analyzing the hospital admission records of 111,316 SAH patients from 2004 to 2012 in Korea. A Poisson regression model was used to examine the association between temperature and daily SAH hospital admissions. To analyze data and identify vulnerable groups, we used the following subgroups: sex, age, insurance type, area (rural or urban), and different climate zones. We confirmed a markedly higher SAH risk only for people of low socioeconomic status in both hot and cold temperatures; the relative risk (RR) in the Medicaid group was significantly increased and ranged from 1.04 to 1.11 for cold temperatures and 1.10 to 1.11 for hot temperatures. For the National Health Insurance group, the RR was increased to 1.02 for the maximum temperature only. The increased risk for SAH was highest in the temperate zone. An increase above the heat threshold temperature and a decrease below the cold threshold temperature were correlated with an increased risk of SAH in susceptible populations and were associated with different lag effects and RRs. Full article
(This article belongs to the Special Issue Climate Change and Human Health)
Figures

Figure 1

Open AccessArticle
Who Is Using Outdoor Fitness Equipment and How? The Case of Xihu Park
Int. J. Environ. Res. Public Health 2017, 14(4), 448; https://doi.org/10.3390/ijerph14040448
Received: 15 February 2017 / Revised: 31 March 2017 / Accepted: 18 April 2017 / Published: 21 April 2017
Cited by 6 | Viewed by 1664 | PDF Full-text (442 KB) | HTML Full-text | XML Full-text
Abstract
Outdoor fitness equipment (OFE) placed in public parks has the potential to encourage physical activity. However, little is known about OFE users and use patterns. This study employed onsite and video observations of OFE usage to describe user characteristics and patterns in Xihu [...] Read more.
Outdoor fitness equipment (OFE) placed in public parks has the potential to encourage physical activity. However, little is known about OFE users and use patterns. This study employed onsite and video observations of OFE usage to describe user characteristics and patterns in Xihu Park. Results indicate that OFE in this park attracted considerable use, particularly in the early morning and late afternoon. During these peak-hour observations, approximately 12 users per hour used the OFE, with the majority being females and seniors. The triple arm stretch and air walker were the most popular stations. However, most OFE users interacted with less than three of the available six OFE stations. Furthermore, users spent an average of less than nine minutes on all OFE stations combined. While OFE equipment was well-used in this urban park, it appears users did not interact with OFE at rates to produce a sufficient bout or level of physical activity during their park visit. Further investigations of OFE are encouraged to determine their health impact. Full article
(This article belongs to the collection Health Behavior and Public Health)
Figures

Figure 1

Open AccessArticle
Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland
Int. J. Environ. Res. Public Health 2017, 14(4), 447; https://doi.org/10.3390/ijerph14040447
Received: 21 February 2017 / Revised: 5 April 2017 / Accepted: 19 April 2017 / Published: 21 April 2017
Cited by 3 | Viewed by 1215 | PDF Full-text (327 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed [...] Read more.
This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the “Reducing Social Inequalities in Health” program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence (p < 0.0001). Complete smoke-free rules were adopted by 22.1% of the study participants. Two factors, smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes—a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS. Full article
(This article belongs to the collection Health Behavior and Public Health)
Open AccessArticle
Association between Serum Selenium Concentrations and Levels of Proinflammatory and Profibrotic Cytokines—Interleukin-6 and Growth Differentiation Factor-15, in Patients with Alcoholic Liver Cirrhosis
Int. J. Environ. Res. Public Health 2017, 14(4), 437; https://doi.org/10.3390/ijerph14040437
Received: 22 March 2017 / Revised: 14 April 2017 / Accepted: 16 April 2017 / Published: 21 April 2017
Cited by 8 | Viewed by 1563 | PDF Full-text (428 KB) | HTML Full-text | XML Full-text
Abstract
According to some authors, serum selenium levels are strongly associated with the severity of liver diseases, including liver cirrhosis. The aim of this study was to determine the relationship between the concentration of selenium and pro-inflammatory and profibrotic cytokines—interleukin-6 (IL-6) and growth differentiation [...] Read more.
According to some authors, serum selenium levels are strongly associated with the severity of liver diseases, including liver cirrhosis. The aim of this study was to determine the relationship between the concentration of selenium and pro-inflammatory and profibrotic cytokines—interleukin-6 (IL-6) and growth differentiation factor 15 (GDF-15) in patients with alcoholic liver cirrhosis. The parameters studied were determined in the serum of 99 patients with alcoholic liver cirrhosis divided based on the severity of disease according to the Child-Turcotte-Pugh criteria. In patients with liver cirrhosis, the serum selenium concentration was statistically lower, whereas serum IL-6 and GDF-15 concentrations were higher than those in the control group. Moreover, the concentration of selenium negatively correlated with the levels of GDF-15 and IL-6. The above results may indicate a role of selenium deficiency in the pathogenesis and progression of alcoholic liver disease. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessArticle
Prospective Analysis of the Influence of Sport and Educational Factors on the Prevalence and Initiation of Smoking in Older Adolescents from Croatia
Int. J. Environ. Res. Public Health 2017, 14(4), 446; https://doi.org/10.3390/ijerph14040446
Received: 22 March 2017 / Revised: 15 April 2017 / Accepted: 18 April 2017 / Published: 20 April 2017
Cited by 2 | Viewed by 1503 | PDF Full-text (2969 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The prevalence of smoking among Croatian adolescents is alarmingly high, but no previous study has prospectively examined the sport- and academic-factors associated with smoking and smoking initiation. This study aimed to prospectively examine the associations between scholastic (educational) achievement and sport factors and [...] Read more.
The prevalence of smoking among Croatian adolescents is alarmingly high, but no previous study has prospectively examined the sport- and academic-factors associated with smoking and smoking initiation. This study aimed to prospectively examine the associations between scholastic (educational) achievement and sport factors and smoking in 16- to 18-year-old adolescents. This two-year prospective cohort study included 644 adolescents who were 16 years of age at baseline (46% females). Baseline testing was implemented at the beginning of the 3rd year of high school (September 2014) when participants were 16 years old. Follow-up testing was completed at the end of the fourth year of high school, which occurred 20 months later. The evaluated predictor variables were educational-achievement- and sport-related-factors. The outcome variables were (i) smoking at baseline; (ii) smoking at follow-up; and (iii) smoking initiation over the course of the study. We assessed the associations between predictors and outcomes using logistic regression models adjusted for age, gender, socioeconomic status, and conflict with parents. The educational variables were consistently associated with smoking, with lower grade-point-average (Baseline: odd ratio (OR): 2.01, 95% confidence interval (CI): 1.61–2.55; Follow-up: 1.59, 1.31–1.94), more frequent absence from school (Baseline: OR: 1.40, 95% CI: 1.19–1.69; Follow-up: 1.30, 1.08–1.58), and lower behavioral grades (Baseline: OR: 1.80, 95% CI: 1.10–2.89; Follow-up: 1.57, 1.03–2.41) in children who smoke. Adolescents who reported quitting sports were at greater odds of being smokers (Baseline: 2.07, 1.31–3.32; Follow-up: 1.66, 1.09–2.56). Sport competitive achievement at baseline was protective against smoking initiation during following two-year period (0.45, 0.21–0.91). While the influence of the educational variables on smoking initiation has been found to be established earlier; sport achievement was identified as a significant protective factor against initiating smoking in older adolescents. Results should be used in development of an anti-smoking preventive campaign in older adolescents. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle
The Impact of Hyposalivation on Quality of Life (QoL) and Oral Health in the Aging Population of Al Madinah Al Munawarrah
Int. J. Environ. Res. Public Health 2017, 14(4), 445; https://doi.org/10.3390/ijerph14040445
Received: 8 March 2017 / Revised: 17 April 2017 / Accepted: 18 April 2017 / Published: 20 April 2017
Cited by 5 | Viewed by 1349 | PDF Full-text (317 KB) | HTML Full-text | XML Full-text
Abstract
Hyposalivation (HS) affects aging individuals by causing pain and discomfort in the oral cavity. The aim here was to determine the impact of hyposalivation and the saliva pH on the quality of life and caries status of geriatrics population. A total of 138 [...] Read more.
Hyposalivation (HS) affects aging individuals by causing pain and discomfort in the oral cavity. The aim here was to determine the impact of hyposalivation and the saliva pH on the quality of life and caries status of geriatrics population. A total of 138 male outpatients attending the Taibah University College of Dentistry (TUCoD) dental clinic were included in the study. The saliva flow, pH, Quality of Life (QoL), and caries status were recorded. The QoL was measured using the Arabic version of the Oral Health Impact Profile-14 (OHIP-14), and the caries status was recorded using the Decayed, Missed, Filled Teeth (DMFT) index. The mean age was 67.5 years and 64% were classified as having hyposalivation. The older respondents tended to have a lower saliva flow and pH compared to their younger counterparts. There was a significant inverse association (p = 0.02) between the caries status and mean saliva flow rate. There was also a significant (p < 0.001) positive correlation between caries and the OHIP-14 scores (Spearman’s ρ = 0.293). The prevalence of hyposalivation was relatively high and there was an inverse relationship between the age, the saliva flow, and pH. Those with more caries reported significantly poor QoL. Full article
(This article belongs to the Section Health Economics)
Open AccessArticle
The Cost of Arbovirus Disease Prevention in Europe: Area-Wide Integrated Control of Tiger Mosquito, Aedes albopictus, in Emilia-Romagna, Northern Italy
Int. J. Environ. Res. Public Health 2017, 14(4), 444; https://doi.org/10.3390/ijerph14040444
Received: 30 January 2017 / Revised: 17 April 2017 / Accepted: 18 April 2017 / Published: 20 April 2017
Cited by 3 | Viewed by 2656 | PDF Full-text (3545 KB) | HTML Full-text | XML Full-text
Abstract
Aedes albopictus (tiger mosquito) has become the most invasive mosquito species worldwide, in addition to being a well-known vector of diseases, with a proven capacity for the transmission of chikungunya and dengue viruses in Europe as well as the Zika virus in Africa [...] Read more.
Aedes albopictus (tiger mosquito) has become the most invasive mosquito species worldwide, in addition to being a well-known vector of diseases, with a proven capacity for the transmission of chikungunya and dengue viruses in Europe as well as the Zika virus in Africa and in laboratory settings. This research quantifies the cost that needs to be provided by public-health systems for area-wide prevention of arboviruses in Europe. This cost has been calculated by evaluating the expenditure of the plan for Aedes albopictus control set up in the Emilia-Romagna region (Northern Italy) after a chikungunya outbreak occurred in 2007. This plan involves more than 280 municipalities with a total of 4.2 million inhabitants. Public expenditure for plan implementation in 2008–2011 was examined through simple descriptive statistics. Annual expenditure was calculated to be approximately €1.3 per inhabitant, with a declining trend (from a total of €7.6 million to €5.3 million) and a significant variability at the municipality level. The preventative measures in the plan included antilarval treatments (about 75% of total expenditure), education for citizens and in schools, entomological surveillance, and emergency actions for suspected viremias. Ecological factors and the relevance of tourism showed a correlation with the territorial variability in expenditure. The median cost of one antilarval treatment in public areas was approximately €0.12 per inhabitant. Organizational aspects were also analyzed to identify possible improvements in resource use. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle
Acceptable Risk Analysis for Abrupt Environmental Pollution Accidents in Zhangjiakou City, China
Int. J. Environ. Res. Public Health 2017, 14(4), 443; https://doi.org/10.3390/ijerph14040443
Received: 11 February 2017 / Revised: 17 April 2017 / Accepted: 17 April 2017 / Published: 20 April 2017
Cited by 1 | Viewed by 1413 | PDF Full-text (881 KB) | HTML Full-text | XML Full-text
Abstract
Abrupt environmental pollution accidents cause considerable damage worldwide to the ecological environment, human health, and property. The concept of acceptable risk aims to answer whether or not a given environmental pollution risk exceeds a societally determined criterion. This paper presents a case study [...] Read more.
Abrupt environmental pollution accidents cause considerable damage worldwide to the ecological environment, human health, and property. The concept of acceptable risk aims to answer whether or not a given environmental pollution risk exceeds a societally determined criterion. This paper presents a case study on acceptable environmental pollution risk conducted through a questionnaire survey carried out between August and October 2014 in five representative districts and two counties of Zhangjiakou City, Hebei Province, China. Here, environmental risk primarily arises from accidental water pollution, accidental air pollution, and tailings dam failure. Based on 870 valid questionnaires, demographic and regional differences in public attitudes towards abrupt environmental pollution risks were analyzed, and risk acceptance impact factors determined. The results showed females, people between 21–40 years of age, people with higher levels of education, public servants, and people with higher income had lower risk tolerance. People with lower perceived risk, low-level risk knowledge, high-level familiarity and satisfaction with environmental management, and without experience of environmental accidents had higher risk tolerance. Multiple logistic regression analysis indicated that public satisfaction with environmental management was the most significant factor in risk acceptance, followed by perceived risk of abrupt air pollution, occupation, perceived risk of tailings dam failure, and sex. These findings should be helpful to local decision-makers concerned with environmental risk management (e.g., selecting target groups for effective risk communication) in the context of abrupt environmental accidents. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessReview
A Systematic Review: Costing and Financing of Water, Sanitation, and Hygiene (WASH) in Schools
Int. J. Environ. Res. Public Health 2017, 14(4), 442; https://doi.org/10.3390/ijerph14040442
Received: 15 March 2017 / Revised: 30 March 2017 / Accepted: 10 April 2017 / Published: 20 April 2017
Cited by 2 | Viewed by 2014 | PDF Full-text (1240 KB) | HTML Full-text | XML Full-text
Abstract
Despite the success of recent efforts to increase access to improved water, sanitation, and hygiene (WASH) globally, approximately one-third of schools around the world still lack adequate WASH services. A lack of WASH in schools can lead to the spread of preventable disease [...] Read more.
Despite the success of recent efforts to increase access to improved water, sanitation, and hygiene (WASH) globally, approximately one-third of schools around the world still lack adequate WASH services. A lack of WASH in schools can lead to the spread of preventable disease and increase school absences, especially among women. Inadequate financing and budgeting has been named as a key barrier for integrating successful and sustainable WASH programs into school settings. For this reason, the purpose of this review is to describe the current knowledge around the costs of WASH components as well as financing models that could be applied to WASH in schools. Results show a lack of information around WASH costing, particularly around software elements as well as a lack of data overall for WASH in school settings as compared to community WASH. This review also identifies several key considerations when designing WASH budgets or selecting financing mechanisms. Findings may be used to advise future WASH in school programs. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle
Water Access, Sanitation, and Hygiene Conditions and Health Outcomes among Two Settlement Types in Rural Far North Cameroon
Int. J. Environ. Res. Public Health 2017, 14(4), 441; https://doi.org/10.3390/ijerph14040441
Received: 24 February 2017 / Revised: 8 April 2017 / Accepted: 13 April 2017 / Published: 20 April 2017
Cited by 3 | Viewed by 1951 | PDF Full-text (2836 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The Far North region in Cameroon has been more heavily impacted by cholera than any other region over the past decade, but very little has been done to study the drivers of waterborne diseases in the region. We investigated the relationship between water, [...] Read more.
The Far North region in Cameroon has been more heavily impacted by cholera than any other region over the past decade, but very little has been done to study the drivers of waterborne diseases in the region. We investigated the relationship between water, sanitation, and hygiene (WASH) parameters, microbial and antibiotic resistance (AR) contamination levels in drinking water, and health outcomes using health survey and molecular analysis during June and July of 2014 in two settlement types (agro-pastoralist villages and transhumant pastoralist camps). Quantitative polymerase chain reaction was used to determine fecal contamination sources, enteric pathogens, and antibiotic resistance genes. Ruminant-associated fecal contamination was widespread in both settlement types (81.2%), with human-associated contamination detected in 21.7% of the samples. Salmonella spp. (59.4%) and Shiga toxin-producing E. coli (stx1 44.9% and stx2 31.9%) were detected across all samples. Tetracycline resistance was found only in village samples. A significant difference in diarrheal incidence within the past 28 days among young children was found between camps (31.3%) and villages (0.0%). Our findings suggest that water contamination may play an important role in contributing to gastrointestinal illness, supporting the need for future research and public health intervention to reduce gastrointestinal illness in the area. Full article
Figures

Figure 1

Open AccessArticle
Evaluation of the Effects of Airborne Particulate Matter on Bone Marrow-Mesenchymal Stem Cells (BM-MSCs): Cellular, Molecular and Systems Biological Approaches
Int. J. Environ. Res. Public Health 2017, 14(4), 440; https://doi.org/10.3390/ijerph14040440
Received: 4 March 2017 / Revised: 7 April 2017 / Accepted: 14 April 2017 / Published: 20 April 2017
Cited by 3 | Viewed by 1627 | PDF Full-text (2565 KB) | HTML Full-text | XML Full-text
Abstract
Particulate matter (PM) contains heavy metals that affect various cellular functions and gene expression associated with a range of acute and chronic diseases in humans. However, the specific effects they exert on the stem cells remain unclear. Here, we report the effects of [...] Read more.
Particulate matter (PM) contains heavy metals that affect various cellular functions and gene expression associated with a range of acute and chronic diseases in humans. However, the specific effects they exert on the stem cells remain unclear. Here, we report the effects of PM collected from the city of Jeddah on proliferation, cell death, related gene expression and systems of biological analysis in bone marrow mesenchymal stem cells (BM-MSCs), with the aim of understanding the underlying mechanisms. PM2.5 and PM10 were tested in vitro at various concentrations (15 to 300 µg/mL) and durations (24 to 72 h). PMs induced cellular stress including membrane damage, shrinkage and death. Lower concentrations of PM2.5 increased proliferation of BM-MSCs, while higher concentrations served to decrease it. PM10 decreased BM-MSCs proliferation in a concentration-dependent manner. The X-ray fluorescence spectrometric analysis showed that PM contains high levels of heavy metals. Ingenuity Pathway Analysis (IPA) and hierarchical clustering analyses demonstrated that heavy metals were associated with signaling pathways involving cell stress/death, cancer and chronic diseases. qRT-PCR results showed differential expression of the apoptosis genes (BCL2, BAX); inflammation associated genes (TNF-α and IL-6) and the cell cycle regulation gene (p53). We conclude that PM causes inflammation and cell death, and thereby predisposes to chronic debilitating diseases. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessReview
A Little Bug with a Big Bite: Impact of Hemlock Woolly Adelgid Infestations on Forest Ecosystems in the Eastern USA and Potential Control Strategies
Int. J. Environ. Res. Public Health 2017, 14(4), 438; https://doi.org/10.3390/ijerph14040438
Received: 26 February 2017 / Revised: 15 April 2017 / Accepted: 15 April 2017 / Published: 19 April 2017
Cited by 1 | Viewed by 1260 | PDF Full-text (322 KB) | HTML Full-text | XML Full-text
Abstract
Hemlock woolly adelgid (Adelges tsugae Annand, HWA) remains the single greatest threat to the health and sustainability of hemlock in the eastern USA. The loss of hemlock trees leads to further negative impacts on the diversity and stability of ecosystems in the [...] Read more.
Hemlock woolly adelgid (Adelges tsugae Annand, HWA) remains the single greatest threat to the health and sustainability of hemlock in the eastern USA. The loss of hemlock trees leads to further negative impacts on the diversity and stability of ecosystems in the eastern part of North America. It is, therefore, urgent to develop effective control measures to reduce HWA populations and promote overall hemlock health. Currently available individual and integrated approaches should continue to be evaluated in the laboratory and in the field along with the development of other new and innovative methods. Full article
(This article belongs to the Section Environmental Health)
Open AccessReview
Non-Responsive Feeding Practices, Unhealthy Eating Behaviors, and Risk of Child Overweight and Obesity in Southeast Asia: A Systematic Review
Int. J. Environ. Res. Public Health 2017, 14(4), 436; https://doi.org/10.3390/ijerph14040436
Received: 25 February 2017 / Revised: 28 March 2017 / Accepted: 12 April 2017 / Published: 19 April 2017
Cited by 1 | Viewed by 1731 | PDF Full-text (428 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Childhood obesity is increasing dramatically in many Southeast Asian countries, and becoming a significant public health concern. This review summarizes the evidence on associations between parental feeding practices, child eating behaviors, and the risk of overweight and obesity in Southeast Asian children 2–12 [...] Read more.
Childhood obesity is increasing dramatically in many Southeast Asian countries, and becoming a significant public health concern. This review summarizes the evidence on associations between parental feeding practices, child eating behaviors, and the risk of overweight and obesity in Southeast Asian children 2–12 years old. We systematically searched five electronic academic/research (PubMed, PsycINFO, ProQuest Nursing, Medline, and CINAHL) databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for peer-reviewed studies published in English between January 2000 and December 2016. Fourteen observational studies met the inclusion criteria and were reviewed. Reviewed studies were examined separately for preschool- and school-aged children and revealed that non-responsive parental feeding practices and unhealthy child eating behaviors were associated with a risk of child overweight and obesity in several Southeast Asian countries. Nonetheless, due to the small number of identified studies (n = 14) and because only about half of the Southeast Asian countries (Thailand, Vietnam, Singapore, the Philippines, and Malaysia) were represented (5/11) in the examined studies, additional research is needed to further understand the factors associated with childhood obesity among children in Southeast Asia to develop interventions that are tailored to the specific needs of Southeast Asian countries and designed to address practices and behaviors that may promote childhood obesity. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessReview
Economic Burden of Obesity: A Systematic Literature Review
Int. J. Environ. Res. Public Health 2017, 14(4), 435; https://doi.org/10.3390/ijerph14040435
Received: 5 March 2017 / Revised: 13 April 2017 / Accepted: 16 April 2017 / Published: 19 April 2017
Cited by 74 | Viewed by 4722 | PDF Full-text (781 KB) | HTML Full-text | XML Full-text
Abstract
Background: The rising prevalence of obesity represents an important public health issue. An assessment of its costs may be useful in providing recommendations for policy and decision makers. This systematic review aimed to assess the economic burden of obesity and to identify, [...] Read more.
Background: The rising prevalence of obesity represents an important public health issue. An assessment of its costs may be useful in providing recommendations for policy and decision makers. This systematic review aimed to assess the economic burden of obesity and to identify, measure and describe the different obesity-related diseases included in the selected studies. Methods: A systematic literature search of studies in the English language was carried out in Medline (PubMed) and Web of Science databases to select cost-of-illness studies calculating the cost of obesity in a study population aged ≥18 years with obesity, as defined by a body mass index of ≥30 kg/m², for the whole selected country. The time frame for the analysis was January 2011 to September 2016. Results: The included twenty three studies reported a substantial economic burden of obesity in both developed and developing countries. There was considerable heterogeneity in methodological approaches, target populations, study time frames, and perspectives. This prevents an informative comparison between most of the studies. Specifically, there was great variety in the included obesity-related diseases and complications among the studies. Conclusions: There is an urgent need for public health measures to prevent obesity in order to save societal resources. Moreover, international consensus is required on standardized methods to calculate the cost of obesity to improve homogeneity and comparability. This aspect should also be considered when including obesity-related diseases. Full article
(This article belongs to the Section Health Economics)
Figures

Figure 1

Open AccessErratum
Erratum: Wong, L.P., et al. The Self-Regulation Model of Illness: Comparison between Zika and Dengue and Its Application to Predict Mosquito Prevention Behaviours in Malaysia, a Dengue-Endemic Country Int. J. Environ. Res. Public Health 2016, 13, 1210
Int. J. Environ. Res. Public Health 2017, 14(4), 433; https://doi.org/10.3390/ijerph14040433
Received: 15 March 2017 / Revised: 20 March 2017 / Accepted: 20 March 2017 / Published: 19 April 2017
Viewed by 1024 | PDF Full-text (222 KB) | HTML Full-text | XML Full-text
(This article belongs to the Section Global Health)
Open AccessReview
How Sensors Might Help Define the External Exposome
Int. J. Environ. Res. Public Health 2017, 14(4), 434; https://doi.org/10.3390/ijerph14040434
Received: 11 January 2017 / Revised: 14 March 2017 / Accepted: 23 March 2017 / Published: 18 April 2017
Cited by 18 | Viewed by 2034 | PDF Full-text (462 KB) | HTML Full-text | XML Full-text
Abstract
The advent of the exposome concept, the advancement of mobile technology, sensors, and the “internet of things” bring exciting opportunities to exposure science. Smartphone apps, wireless devices, the downsizing of monitoring technologies, along with lower costs for such equipment makes it possible for [...] Read more.
The advent of the exposome concept, the advancement of mobile technology, sensors, and the “internet of things” bring exciting opportunities to exposure science. Smartphone apps, wireless devices, the downsizing of monitoring technologies, along with lower costs for such equipment makes it possible for various aspects of exposure to be measured more easily and frequently. We discuss possibilities and lay out several criteria for using smart technologies for external exposome studies. Smart technologies are evolving quickly, and while they provide great promise for advancing exposure science, many are still in developmental stages and their use in epidemiology and risk studies must be carefully considered. The most useable technologies for exposure studies at this time relate to gathering exposure-factor data, such as location and activities. Development of some environmental sensors (e.g., for some air pollutants, noise, UV) is moving towards making the use of these more reliable and accessible to research studies. The possibility of accessing such an unprecedented amount of personal data also comes with various limitations and challenges, which are discussed. The advantage of improving the collection of long term exposure factor data is that this can be combined with more “traditional” measurement data to model exposures to numerous environmental factors. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessArticle
Association between Blood Lead Levels and Delta-Aminolevulinic Acid Dehydratase in Pregnant Women
Int. J. Environ. Res. Public Health 2017, 14(4), 432; https://doi.org/10.3390/ijerph14040432
Received: 1 March 2017 / Revised: 6 April 2017 / Accepted: 12 April 2017 / Published: 18 April 2017
Cited by 1 | Viewed by 1305 | PDF Full-text (528 KB) | HTML Full-text | XML Full-text
Abstract
Blood lead levels (BLLs) and delta-aminolevulinic acid dehydratase (ALAD) activity are considered biomarkers of lead exposure and lead toxicity, respectively. The present study was designed to investigate the association between BLLs and ALAD activity in pregnant women from Durango, Mexico. A total of [...] Read more.
Blood lead levels (BLLs) and delta-aminolevulinic acid dehydratase (ALAD) activity are considered biomarkers of lead exposure and lead toxicity, respectively. The present study was designed to investigate the association between BLLs and ALAD activity in pregnant women from Durango, Mexico. A total of 633 pregnant women aged 13–43 years participated in this study. Blood lead was measured by a graphite furnace atomic absorption spectrometer. ALAD activity was measured spectrophotometrically. Mean blood lead was 2.09 ± 2.34 µg/dL; and 26 women (4.1%) crossed the Centers for Disease Control (CDC) recommended level of 5 µg/dL. ALAD activity was significantly lower in women with levels of lead ≥5 µg/dL compared to those with BLLs < 5 µg/dL (p = 0.002). To reduce the influence of extreme values on the statistical analysis, BLLs were analyzed by quartiles. A significant negative correlation between blood lead and ALAD activity was observed in the fourth quartile of BLLs (r = −0.113; p < 0.01). Among women with blood lead concentrations ≥2.2 µg/dL ALAD activity was negatively correlated with BLLs (r = −0.413; p < 0.01). Multiple linear regression demonstrated that inhibition of ALAD in pregnant women may occur at levels of lead in blood above 2.2 µg/dL. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessArticle
Demographic and Environmental Factors Associated with Mental Health: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2017, 14(4), 431; https://doi.org/10.3390/ijerph14040431
Received: 14 February 2017 / Revised: 10 April 2017 / Accepted: 14 April 2017 / Published: 17 April 2017
Cited by 7 | Viewed by 2041 | PDF Full-text (1283 KB) | HTML Full-text | XML Full-text
Abstract
Relevant demographic and environmental conditions need to be understood before tailoring policies to improve mental health. Using community health survey data from 25 communities in Seoul, 2013, cross-sectional associations between mental health and community level environments were assessed. Mental health outcomes (self-rated stress [...] Read more.
Relevant demographic and environmental conditions need to be understood before tailoring policies to improve mental health. Using community health survey data from 25 communities in Seoul, 2013, cross-sectional associations between mental health and community level environments were assessed. Mental health outcomes (self-rated stress levels (SRS) and depressive symptoms (DS)) were analyzed. Community environmental factors included green space, green facilities, and annual PM10 level (AnnPM10); socio-demographic factors included sex, age, education, labor market participation, comorbidity, sleep hours, physical activity, smoking, and drinking. A total of 23,139 people with the following characteristics participated: men (44.2%); age groups 19−39 (36.0%), 40−59 (39.4%), 60−74 (19.2%), and 75+ (5.4%). Women had higher odds ratios (OR) for SRS [OR 1.22, 95% Confidence interval (CI) 1.17–1.27] and DS [OR 1.55, 95% CI 1.42–1.71]. Regular physical activity predicted SRS [OR 0.90, 95% CI 0.84–0.95] and DS [OR 0.98, 95% CI 0.88–1.10]; current smoking and drinking were adversely associated with both SRS and DS. Higher accessibility to green space (Q4) was inversely associated with DS [OR 0.89, 95% CI 0.81−0.97] compared to lower accessibility (Q1). AnnPM10, annual levels for particles of aerodynamic diameter <10 µm (PM10), among communities was associated with poorer SRS [OR 1.02, 95% CI 1.00–1.04] by 10 μg/m3 increases. Therefore, both demographic and environmental factors should be considered to understand mental health conditions among the general population. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessArticle
Using Moss to Assess Airborne Heavy Metal Pollution in Taizhou, China
Int. J. Environ. Res. Public Health 2017, 14(4), 430; https://doi.org/10.3390/ijerph14040430
Received: 18 January 2017 / Revised: 17 March 2017 / Accepted: 12 April 2017 / Published: 17 April 2017
Cited by 6 | Viewed by 1604 | PDF Full-text (2956 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Bryophytes act as bioindicators and bioaccumulators of metal deposition in the environment. To understand the atmospheric deposition of heavy metals (cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), nickel (Ni), lead (Pb), and zinc (Zn)) in Taizhou, East China, samples of moss ( [...] Read more.
Bryophytes act as bioindicators and bioaccumulators of metal deposition in the environment. To understand the atmospheric deposition of heavy metals (cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), nickel (Ni), lead (Pb), and zinc (Zn)) in Taizhou, East China, samples of moss (Haplocladium microphyllum) were collected from 60 sites selected by a systematic sampling method during the summer of 2012, and the concentrations of these heavy metals were determined by inductively coupled plasma atomic emission spectroscopy (ICP-AES). The results suggested that the concentrations of these metals varied moderately among different sites, indicating a similar contamination level for each element throughout the monitoring region. The mean values under investigation were higher than those from neighboring cities, such as Wuxi, Xuzhou, and Nanjing, and much higher than those in Europe based on a 2010 survey. Significant (p < 0.01) correlations were identified among some of the heavy metals, suggesting that these originated from identical sources. There was no statistically significant correlation between Hg and all the other elements. Spatial distribution maps of the elements over the sampled territory were created using Arc-GIS 9.0. The potential ecological risk index indicated that the air was heavily polluted by Cd and Hg, and that there was a considerable potential ecological risk from all the heavy metals studied. Full article
(This article belongs to the Special Issue Heavy Metals: Environmental and Human Health)
Figures

Figure 1

Open AccessArticle
Health Risk Assessment of Indoor Air Quality, Socioeconomic and House Characteristics on Respiratory Health among Women and Children of Tirupur, South India
Int. J. Environ. Res. Public Health 2017, 14(4), 429; https://doi.org/10.3390/ijerph14040429
Received: 15 March 2017 / Revised: 12 April 2017 / Accepted: 13 April 2017 / Published: 17 April 2017
Cited by 3 | Viewed by 1644 | PDF Full-text (516 KB) | HTML Full-text | XML Full-text
Abstract
Background: Indoor air pollution is still considered as one of the leading causes of morbidity and mortality worldwide and especially in developing countries, including India. This study aims to assess social, housing, and indoor environmental factors associated with respiratory health among mothers and [...] Read more.
Background: Indoor air pollution is still considered as one of the leading causes of morbidity and mortality worldwide and especially in developing countries, including India. This study aims to assess social, housing, and indoor environmental factors associated with respiratory health among mothers and children. Methods: The study was conducted in the city of Tirupur, South India. We quantitatively assessed the indoor exposure to fine particulate matter (PM2.5) and carbon monoxide in relation to respiratory health among women and children. Information on health status, household characteristics and socioeconomic factors was collected using a modified standardised questionnaire. Results: This study demonstrates the significant health impact of housing and socioeconomic characteristics on the burden of respiratory illness among women and children in urban South India. Increased respiratory symptoms were recorded among women and children from low income households, and those who allowed smoking inside. The mean PM2.5 concentration measured in this study was 3.8 mg/m3 which exceeded the World Health Organization (WHO) 24 h guideline value of 0.025 mg/m3. Conclusions: This study is the first to our knowledge carried out in urban South India and the findings can be used for future intervention studies. Full article
(This article belongs to the Special Issue Health Impact Assessment)
Open AccessArticle
The Effects of PM2.5 from Asian Dust Storms on Emergency Room Visits for Cardiovascular and Respiratory Diseases
Int. J. Environ. Res. Public Health 2017, 14(4), 428; https://doi.org/10.3390/ijerph14040428
Received: 23 January 2017 / Revised: 27 March 2017 / Accepted: 13 April 2017 / Published: 16 April 2017
Cited by 7 | Viewed by 1426 | PDF Full-text (286 KB) | HTML Full-text | XML Full-text
Abstract
A case-crossover study examined how PM2.5 from Asian Dust Storms (ADS) affects the number of emergency room (ER) admissions for cardiovascular diseases (CVDs) and respiratory diseases (RDs). Our data indicated that PM2.5 concentration from ADS was highly correlated with ER visits [...] Read more.
A case-crossover study examined how PM2.5 from Asian Dust Storms (ADS) affects the number of emergency room (ER) admissions for cardiovascular diseases (CVDs) and respiratory diseases (RDs). Our data indicated that PM2.5 concentration from ADS was highly correlated with ER visits for CVDs and RDs. The odds ratios (OR) increased by 2.92 (95% CI: 1.22–5.08) and 1.86 (95% CI: 1.30–2.91) per 10 µg/m3 increase in PM2.5 levels, for CVDs and RDs, respectively. A 10 µg/m3 increase in PM2.5 from ADSs was significantly associated with an increase in ER visits for CVDs among those 65 years of age and older (an increase of 2.77 in OR) and for females (an increase of 3.09 in OR). In contrast, PM2.5 levels had a significant impact on RD ER visits among those under 65 years of age (OR = 1.77). The risk of ER visits for CVDs increased on the day when the ADS occurred in Taiwan and the day after (lag 0 and lag 1); the corresponding risk increase for RDs only increased on the fifth day after the ADS (lag 5). In Taiwan’s late winter and spring, the severity of ER visits for CVDs and RDs increases. Environmental protection agencies should employ an early warning system for ADS to reduce high-risk groups’ exposure to PM2.5. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle
Advanced Stage at Presentation Remains a Major Factor Contributing to Breast Cancer Survival Disparity between Public and Private Hospitals in a Middle-Income Country
Int. J. Environ. Res. Public Health 2017, 14(4), 427; https://doi.org/10.3390/ijerph14040427
Received: 22 February 2017 / Revised: 12 April 2017 / Accepted: 13 April 2017 / Published: 16 April 2017
Cited by 6 | Viewed by 1291 | PDF Full-text (276 KB) | HTML Full-text | XML Full-text
Abstract
Background: Survival disparities in cancer are known to occur between public and private hospitals. We compared breast cancer presentation, treatment and survival between a public academic hospital and a private hospital in a middle-income country. Methods: The demographics, clinical characteristics, treatment and overall [...] Read more.
Background: Survival disparities in cancer are known to occur between public and private hospitals. We compared breast cancer presentation, treatment and survival between a public academic hospital and a private hospital in a middle-income country. Methods: The demographics, clinical characteristics, treatment and overall survival (OS) of 2767 patients with invasive breast carcinoma diagnosed between 2001 and 2011 in the public hospital were compared with 1199 patients from the private hospital. Results: Compared to patients in the private hospital, patients from the public hospital were older at presentation, and had more advanced cancer stages. They were also more likely to receive mastectomy and chemotherapy but less radiotherapy. The five-year OS in public patients was significantly lower than in private patients (71.6% vs. 86.8%). This difference was largely attributed to discrepancies in stage at diagnosis and, although to a much smaller extent, to demographic differences and treatment disparities. Even following adjustment for these factors, patients in the public hospital remained at increased risk of mortality compared to their counterparts in the private hospital (Hazard Ratio: 1.59; 95% Confidence Interval: 1.36–1.85). Conclusion: Late stage at diagnosis appears to be a major contributing factor explaining the breast cancer survival disparity between public and private patients in this middle-income setting. Full article
(This article belongs to the Special Issue Geographical Variation in Breast Cancer Outcomes)
Open AccessArticle
Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L
Int. J. Environ. Res. Public Health 2017, 14(4), 426; https://doi.org/10.3390/ijerph14040426
Received: 16 February 2017 / Revised: 16 March 2017 / Accepted: 13 April 2017 / Published: 16 April 2017
Cited by 7 | Viewed by 1790 | PDF Full-text (2198 KB) | HTML Full-text | XML Full-text
Abstract
The EQ-5D-5L is a widely used generic instrument to measure health-related quality of life. This study evaluates health perception in a representative sample of the general German population from 2015. To compare results over time, a component analysis technique was used that separates [...] Read more.
The EQ-5D-5L is a widely used generic instrument to measure health-related quality of life. This study evaluates health perception in a representative sample of the general German population from 2015. To compare results over time, a component analysis technique was used that separates changes in the description and valuation of health states. The whole sample and also subgroups, stratified by sociodemographic parameters as well as disease affliction, were analyzed. In total, 2040 questionnaires (48.4% male, mean age 47.3 year) were included. The dimension with the lowest number of reported problems was self-care (93.0% without problems), and the dimension with the highest proportion of impairment was pain/discomfort (71.2% without problems). Some 64.3% of the study population were identified as problem-free. The visual analog scale (VAS) mean for all participants was 85.1. Low education was connected with significantly lower VAS scores, but the effect was small. Depression, heart disease, and diabetes had a strong significant negative effect on reported VAS means. Results were slightly better than those in a similar 2012 survey; the most important driver was the increase in the share of the study population that reported to be problem-free. In international comparisons, health perception of the general German population is relatively high and, compared with previous German studies, fairly stable over recent years. Elderly and sick people continue to report significant reductions in perceived health states. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle
Gaseous Elemental Mercury and Total and Leached Mercury in Building Materials from the Former Hg-Mining Area of Abbadia San Salvatore (Central Italy)
Int. J. Environ. Res. Public Health 2017, 14(4), 425; https://doi.org/10.3390/ijerph14040425
Received: 3 January 2017 / Revised: 14 March 2017 / Accepted: 7 April 2017 / Published: 15 April 2017
Cited by 1 | Viewed by 1693 | PDF Full-text (6299 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Mercury has a strong environmental impact since both its organic and inorganic forms are toxic, and it represents a pollutant of global concern. Liquid Hg is highly volatile and can be released during natural and anthropogenic processes in the hydrosphere, biosphere and atmosphere. [...] Read more.
Mercury has a strong environmental impact since both its organic and inorganic forms are toxic, and it represents a pollutant of global concern. Liquid Hg is highly volatile and can be released during natural and anthropogenic processes in the hydrosphere, biosphere and atmosphere. In this study, the distribution of Gaseous Elemental Mercury (GEM) and the total and leached mercury concentrations on paint, plaster, roof tiles, concrete, metals, dust and wood structures were determined in the main buildings and structures of the former Hg-mining area of Abbadia San Salvatore (Siena, Central Italy). The mining complex (divided into seven units) covers a surface of about 65 ha and contains mining structures and managers’ and workers’ buildings. Nine surveys of GEM measurements were carried out from July 2011 to August 2015 for the buildings and structures located in Units 2, 3 and 6, the latter being the area where liquid mercury was produced. Measurements were also performed in February, April, July, September and December 2016 in the edifices and mining structures of Unit 6. GEM concentrations showed a strong variability in time and space mostly depending on ambient temperature and the operational activities that were carried out in each building. The Unit 2 surveys carried out in the hotter period (from June to September) showed GEM concentrations up to 27,500 ng·m−3, while in Unit 6, they were on average much higher, and occasionally, they saturated the GEM measurement device (>50,000 ng·m−3). Concentrations of total (in mg·kg−1) and leached (in μg·L−1) mercury measured in different building materials (up to 46,580 mg·kg−1 and 4470 mg·L−1, respectively) were highly variable, being related to the edifice or mining structure from which they were collected. The results obtained in this study are of relevant interest for operational cleanings to be carried out during reclamation activities. Full article
(This article belongs to the Special Issue Mercury and Health: Current Perspectives and Future Directions)
Figures

Figure 1

Open AccessArticle
Work Characteristics Associated with Physical Functioning in Women
Int. J. Environ. Res. Public Health 2017, 14(4), 424; https://doi.org/10.3390/ijerph14040424
Received: 31 January 2017 / Revised: 30 March 2017 / Accepted: 11 April 2017 / Published: 15 April 2017
Cited by 2 | Viewed by 1499 | PDF Full-text (850 KB) | HTML Full-text | XML Full-text
Abstract
Women make up almost half of the labor force with older women becoming a growing segment of the population. Work characteristics influence physical functioning and women are at particular risk for physical limitations. However, little research has explored the effects of work characteristics [...] Read more.
Women make up almost half of the labor force with older women becoming a growing segment of the population. Work characteristics influence physical functioning and women are at particular risk for physical limitations. However, little research has explored the effects of work characteristics on women’s physical functioning. U.S. women between the ages of 50 and 79 were enrolled in the Women’s Health Initiative Observational Study between 1993 and 1998. Women provided job titles and years worked at their three longest-held jobs (n = 79,147). Jobs were linked to characteristics in the Occupational Information Network. Three categories of job characteristics related to substantive complexity, physical demand, and social collaboration emerged. The association between job characteristics and physical limitations in later life, measured using a SF-36 Physical Functioning score <25th percentile, was examined using modified Poisson regression. After controlling for confounding variables, high physical demand was positively associated with physical limitations (RR = 1.09 CI: 1.06–1.12) and substantively complex work was negatively associated (RR = 0.94, CI: 0.91–0.96). Jobs requiring complex problem solving, active learning, and critical thinking were associated with better physical functioning. Employers should explore opportunities to reduce strain from physically demanding jobs and incorporate substantively complex tasks into women’s work to improve long-term health. Full article
(This article belongs to the Special Issue Women’s Health and the Work Environment)
Figures

Figure 1

Open AccessArticle
Ambient Air Pollution and Out-of-Hospital Cardiac Arrest in Beijing, China
Int. J. Environ. Res. Public Health 2017, 14(4), 423; https://doi.org/10.3390/ijerph14040423
Received: 12 February 2017 / Revised: 7 April 2017 / Accepted: 11 April 2017 / Published: 14 April 2017
Cited by 6 | Viewed by 1723 | PDF Full-text (1348 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Air pollutants are associated with cardiovascular death; however, there is limited evidence of the effects of different pollutants on out-of-hospital cardiac arrests (OHCAs) in Beijing, China. We aimed to investigate the associations of OHCAs with the air pollutants PM2.5–10 (coarse particulate matter), [...] Read more.
Air pollutants are associated with cardiovascular death; however, there is limited evidence of the effects of different pollutants on out-of-hospital cardiac arrests (OHCAs) in Beijing, China. We aimed to investigate the associations of OHCAs with the air pollutants PM2.5–10 (coarse particulate matter), PM2.5 (particles ≤2.5 μm in aerodynamic diameter), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) between 2013 and 2015 using a time-stratified case-crossover study design. We obtained health data from the nationwide emergency medical service database; 4720 OHCA cases of cardiac origin were identified. After adjusting for relative humidity and temperature, the highest odds ratios of OHCA for a 10 μg/m3 increase in PM2.5 were observed at Lag Day 1 (1.07; 95% confidence interval (CI): 1.04–1.10), with strong associations with advanced age (aged ≥70 years) (1.09; 95% CI: 1.05–1.13) and stroke history (1.11; 95% CI: 1.06–1.16). PM2.5–10 and NO2 also showed significant associations with OHCAs, whereas SO2, CO, and O3 had no effects. After simultaneously adjusting for NO2 and SO2 in a multi-pollutant model, PM2.5 remained significant. The effects of PM2.5 in the single-pollutant models for cases with hypertension, respiratory disorders, diabetes mellitus, and heart disease were higher than those for cases without these complications; however, the differences were not statistically significant. The results support that elevated PM2.5 exposure contributes to triggering OHCA, especially in those who are advanced in age and have a history of stroke. Full article
Figures

Figure 1

Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top