International Journal of Environmental Research and Public Health

26 pages, 29292 KiB

Open AccessArticle

Assessing Risks from Cyclones for Human Lives and Livelihoods in the Coastal Region of Bangladesh

by Mohammad Abdul Quader, Amanat Ullah Khan and Matthieu Kervyn

Int. J. Environ. Res. Public Health 2017, 14(8), 831; https://doi.org/10.3390/ijerph14080831 - 25 Jul 2017

Cited by 68 | Viewed by 13082

As a disaster prone country, Bangladesh is regularly hit by natural hazards, including devastating cyclones, such as in 1970, 1991 and 2007. Although the number of cyclones’ fatalities reduced from 0.3 million in 1970 to a few thousand or fewer in recent events, [...] Read more.

As a disaster prone country, Bangladesh is regularly hit by natural hazards, including devastating cyclones, such as in 1970, 1991 and 2007. Although the number of cyclones’ fatalities reduced from 0.3 million in 1970 to a few thousand or fewer in recent events, loss of lives and impact on livelihoods remains a concern. It depends on the meteorological characteristics of cyclone and the general vulnerability and capacity of the exposed population. In that perspective, a spatially explicit risk assessment is an essential step towards targeted disaster risk reduction. This study aims at analyzing the spatial variation of the different factors contributing to the risk for coastal communities at regional scale, including the distribution of the hazards, exposure, vulnerability and capacity. An exploratory factor analysis method is used to map vulnerability contrasts between local administrative units. Indexing and ranking using geospatial techniques are used to produce maps of exposure, hazard, vulnerability, capacities and risk. Results show that vulnerable populations and exposed areas are distributed along the land sea boundary, islands and major inland rivers. The hazard, assessed from the density of historical cyclone paths, is highest in the southwestern part of the coast. Whereas cyclones shelters are shown to properly serve the most vulnerable populations as priority evacuation centers, the overall pattern of capacity accounting for building quality and road network shows a more complex pattern. Resultant risk maps also provide a reasonable basis from which to take further structural measures to minimize loss of lives in the upcoming cyclones. Full article

(This article belongs to the Special Issue Human Health, Risk Analysis and Environmental Hazards)

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8 pages, 560 KiB

Open AccessArticle

Evaluating the Effectiveness of Implementing a More Severe Drunk-Driving Law in China: Findings from Two Open Access Data Sources

by Wangxin Xiao, Peishan Ning, David C. Schwebel and Guoqing Hu

Int. J. Environ. Res. Public Health 2017, 14(8), 832; https://doi.org/10.3390/ijerph14080832 - 25 Jul 2017

Cited by 10 | Viewed by 5661

Abstract

In 2011, China implemented a more severe drunk-driving law. This study evaluated the effectiveness of the law on road traffic morbidity and mortality attributed to alcohol use. Data were from two open-access data sources, the Global Burden of Disease (GBD) 2015 update and [...] Read more.

In 2011, China implemented a more severe drunk-driving law. This study evaluated the effectiveness of the law on road traffic morbidity and mortality attributed to alcohol use. Data were from two open-access data sources, the Global Burden of Disease (GBD) 2015 update and police data. Poisson regression examined the significance of changes in morbidity and mortality. Large gaps in crude death estimates from road traffic crashes attributed to alcohol use emerged between the two data sources. For the GBD 2015 update, crude and age-standardized mortality displayed consistent trends between 1990 and 2015; age-standardized mortality per 100,000 persons increased from 5.71 in 1990 to 7.48 in 2005 and then continuously decreased down to 5.94 in 2015. Police data showed a decrease for crude mortality per 100,000 persons from 0.29 in 2006 to 0.15 in 2010 and then an increase to 0.19 in 2015. We conclude available data are inadequate to determine the effectiveness of the implementation of the more severe drunk-driving law in China since the two data sources present highly inconsistent results. Further effort is needed to tackle data inconsistencies and obtain reliable and accurate data on road traffic injury attributable to alcohol use in China. Full article

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

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12 pages, 608 KiB

Open AccessArticle

Monitoring of Pesticide Residues in Commonly Used Fruits and Vegetables in Kuwait

by Mustapha F. A. Jallow, Dawood G. Awadh, Mohammed S. Albaho, Vimala Y. Devi and Nisar Ahmad

Int. J. Environ. Res. Public Health 2017, 14(8), 833; https://doi.org/10.3390/ijerph14080833 - 25 Jul 2017

Cited by 215 | Viewed by 12798

Abstract

The presence of pesticide residues in primary and derived agricultural products raises serious health concerns for consumers. The aim of this study was to assess the level of pesticide residues in commonly consumed fruits and vegetables in Kuwait. A total of 150 samples [...] Read more.

The presence of pesticide residues in primary and derived agricultural products raises serious health concerns for consumers. The aim of this study was to assess the level of pesticide residues in commonly consumed fruits and vegetables in Kuwait. A total of 150 samples of different fresh vegetables and fruits were analyzed for the presence of 34 pesticides using the quick easy cheap effective rugged and safe (QuEChERS) multi-residue extraction, followed by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-tandem mass spectrometry (LC-MS/MS). Pesticide residues above the maximum residue limits (MRL) were detected in 21% of the samples and 79% of the samples had no residues of the pesticides surveyed or contained residues below the MRL. Multiple residues were present in 40% of the samples with two to four pesticides, and four samples were contaminated with more than four pesticide residues. Of the pesticides investigated, 16 were detected, of which imidacloprid, deltamethrin, cypermethrin, malathion, acetamiprid, monocrotophos, chlorpyrifos-methyl, and diazinon exceeded their MRLs. Aldrin, an organochlorine pesticide, was detected in one apple sample, with residues below the MRL. The results indicate the occurrence of pesticide residues in commonly consumed fruits and vegetables in Kuwait, and pointed to an urgent need to develop comprehensive intervention measures to reduce the potential health risk to consumers. The need for the regular monitoring of pesticide residues and the sensitization of farmers to better pesticide safety practices, especially the need to adhere to recommended pre-harvest intervals is recommended. Full article

(This article belongs to the Section Environmental Health)

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16 pages, 7476 KiB

Open AccessArticle

Schools, Air Pollution, and Active Transportation: An Exploratory Spatial Analysis of Calgary, Canada

by Stefania Bertazzon and Rizwan Shahid

Int. J. Environ. Res. Public Health 2017, 14(8), 834; https://doi.org/10.3390/ijerph14080834 - 25 Jul 2017

Cited by 12 | Viewed by 10689

Abstract

An exploratory spatial analysis investigates the location of schools in Calgary (Canada) in relation to air pollution and active transportation options. Air pollution exhibits marked spatial variation throughout the city, along with distinct spatial patterns in summer and winter; however, all school locations [...] Read more.

An exploratory spatial analysis investigates the location of schools in Calgary (Canada) in relation to air pollution and active transportation options. Air pollution exhibits marked spatial variation throughout the city, along with distinct spatial patterns in summer and winter; however, all school locations lie within low to moderate pollution levels. Conversely, the study shows that almost half of the schools lie in low walkability locations; likewise, transitability is low for 60% of schools, and only bikability is widespread, with 93% of schools in very bikable locations. School locations are subsequently categorized by pollution exposure and active transportation options. This analysis identifies and maps schools according to two levels of concern: schools in car-dependent locations and relatively high pollution; and schools in locations conducive of active transportation, yet exposed to relatively high pollution. The findings can be mapped and effectively communicated to the public, health practitioners, and school boards. The study contributes with an explicitly spatial approach to the intra-urban public health literature. Developed for a moderately polluted city, the methods can be extended to more severely polluted environments, to assist in developing spatial public health policies to improve respiratory outcomes, neurodevelopment, and metabolic and attention disorders in school-aged children. Full article

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

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10 pages, 289 KiB

Open AccessArticle

Health Inequities among Lesbian, Gay, and Bisexual Adults in North Carolina, 2011–2014

by Melissa M. Barnhill, Joseph G. L. Lee and Ann P. Rafferty

Int. J. Environ. Res. Public Health 2017, 14(8), 835; https://doi.org/10.3390/ijerph14080835 - 25 Jul 2017

Cited by 12 | Viewed by 5744

Abstract

Inequalities in health have been identified for lesbian, gay, and bisexual (LGB) populations nationally. Policies in the U.S. South offer fewer protections for LGB people than in other regions, yet, limited data exist for this region. North Carolina (NC) BRFSS data from 2011 [...] Read more.

Inequalities in health have been identified for lesbian, gay, and bisexual (LGB) populations nationally. Policies in the U.S. South offer fewer protections for LGB people than in other regions, yet, limited data exist for this region. North Carolina (NC) BRFSS data from 2011 to 2014 were combined (LGB n = 604; heterosexual n = 33,170) and analyzed using SAS survey procedures to estimate health characteristics by sexual orientation within gender. Many examined indicators were not different by sexual orientation, however, other results were significant and consistent with findings from state population surveys in other regions of the country. Both genders showed inequities in mental health, having over twice the odds of five or more poor mental health days in the past month and of having ever been diagnosed with a depressive disorder. Sexual minority women had higher odds compared with heterosexual women for ever having smoked cigarettes, current smoking, exposure to secondhand smoke both in the workplace and at home, and both alcohol risk factors, binge and heavy drinking. Being part of the LGB population in NC is associated with worse health. The implementation of anti-LGB policies in the NC warrants ongoing monitoring of LGB health inequities in NC and in other southeastern states for potential effects on the health and well-being of sexual minorities. Full article

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

16 pages, 557 KiB

Open AccessArticle

Early Marriage and Barriers to Contraception among Syrian Refugee Women in Lebanon: A Qualitative Study

by Zeinab Cherri, Julita Gil Cuesta, Jose M. Rodriguez-Llanes and Debarati Guha-Sapir

Int. J. Environ. Res. Public Health 2017, 14(8), 836; https://doi.org/10.3390/ijerph14080836 - 25 Jul 2017

Cited by 64 | Viewed by 21630

Abstract

The Syrian conflict has displaced five million individuals outside their country with Lebanon hosting the largest numbers per capita. Around 24% of Syrian refugees fleeing to Lebanon are women of reproductive age (15–49). Yet, a better understanding of the sexual and reproductive health [...] Read more.

The Syrian conflict has displaced five million individuals outside their country with Lebanon hosting the largest numbers per capita. Around 24% of Syrian refugees fleeing to Lebanon are women of reproductive age (15–49). Yet, a better understanding of the sexual and reproductive health needs of Syrian refugee women in Lebanon is required to improve provided services. Eleven focus group discussions were conducted in four regions of Lebanon with 108 Syrian refugee women of reproductive age. Thematic analysis was used to examine the data. Interviewed women were mainly adults. They believed that, in Lebanon, they were subjected to early marriage compared to the norm in Syria due to their financial situation and uncertainty. Cost was reported as the main barrier to use contraception in Lebanon but some Syrian refugee women were not aware of free services covering sexual and reproductive health. In general, marriage, pregnancy, and family planning behavior of Syrian refugee women in Lebanon slightly differed from those in Syria pre-conflict in terms of age of marriage, conception subsequent to marriage, and contraception method. Hence, interventions to increase awareness of subsidized sexual and reproductive health services, including free contraceptives at primary health care centers, and those targeting protection from early marriage of Syrian refugee women in Lebanon are strongly recommended. Full article

(This article belongs to the Special Issue Refugee Health)

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13 pages, 298 KiB

Open AccessArticle

European Policies to Promote Children’s Rights and Combat Child Poverty

by Mona Sandbæk

Int. J. Environ. Res. Public Health 2017, 14(8), 837; https://doi.org/10.3390/ijerph14080837 - 26 Jul 2017

Cited by 5 | Viewed by 5943

Abstract

The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at [...] Read more.

The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at supporting parents to care and provide for their children in accordance with the UN Convention on the Rights of the Child. By means of a document analysis this article examines what kind of parental practices and provision to parents the recommendations suggest to safeguard children’s rights in the family. Three findings are highlighted: first, both recommendations reflect a commitment to respecting children’s rights while at the same time acknowledging parents as children’s primary caregivers. Second, both recognize parents’ rights to work, while also recognizing the necessity of adequate income support if work is not available or income too low. Third, adequate resources are defined as a combination of universal policies and services, which guarantee a minimum level for all, and targeted measures reaching out to the most disadvantaged. The recommendations’ emphasis on children and parents as partners and on the families’ economic situations are valuable for future development of family and child policy and support programs. Full article

(This article belongs to the Special Issue Poverty and Child Well-Being)

14 pages, 926 KiB

Open AccessArticle

Thermographic Evaluation of the Hands of Pig Slaughterhouse Workers Exposed to Cold Temperatures

by Adriana Seára Tirloni, Diogo Cunha dos Reis, Eliane Ramos and Antônio Renato Pereira Moro

Int. J. Environ. Res. Public Health 2017, 14(8), 838; https://doi.org/10.3390/ijerph14080838 - 26 Jul 2017

Cited by 20 | Viewed by 5785

Abstract

Brazil was rated the fourth leading producer and exporter of pork meat in the world. The aim of this study was to evaluate the temperature of the hands of pig slaughterhouse workers and its relation to the thermal sensation of the hands and [...] Read more.

Brazil was rated the fourth leading producer and exporter of pork meat in the world. The aim of this study was to evaluate the temperature of the hands of pig slaughterhouse workers and its relation to the thermal sensation of the hands and the use of a cutting tool. The study included 106 workers in a pig slaughterhouse. An infrared camera FlirThermaCAM E320 (Flir Systems, Wilsonville, OR, USA) was used to collect the images of the dorsal and palmar surfaces of both hands. A numerical scale was used to obtain the thermal sensation. Chi-square test, Pearson correlation and Student’s t test or Wilcoxon were used (p ≤ 0.05). The majority of workers felt cold in the hands (66%) and workers who used the knife felt the coldest. There was an association between the thermal sensation and the use of knife (p = 0.001). Workers who used the tool showed correlation between the thermal sensation and the temperatures of the left fingers, with a difference between the temperatures of the right and left hands of those who used the knife (p ≤ 0.05). The hands (left) that manipulated the products presented the lowest temperatures. Findings indicate that employers of pig slaughterhouses should provide gloves with adequate thermal insulation to preserve the health of workers’ hands. Full article

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

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13 pages, 489 KiB

Open AccessArticle

Facilitators of Physical Activity: Voices of Adolescents in a Disadvantaged Community

by Linus Jonsson, Christina Berg, Christel Larsson, Peter Korp and Eva-Carin Lindgren

Int. J. Environ. Res. Public Health 2017, 14(8), 839; https://doi.org/10.3390/ijerph14080839 - 26 Jul 2017

Cited by 19 | Viewed by 7626

Abstract

Despite increasing socioeconomic inequalities in the health and well-being of adolescents, the voices of adolescents in disadvantaged communities regarding facilitators of physical activity (PA) have received relatively little attention. In response, the purpose of this study was to illuminate what adolescents in a [...] Read more.

Despite increasing socioeconomic inequalities in the health and well-being of adolescents, the voices of adolescents in disadvantaged communities regarding facilitators of physical activity (PA) have received relatively little attention. In response, the purpose of this study was to illuminate what adolescents in a multicultural community of low socioeconomic status (SES) in Sweden convey concerning facilitators of PA. Adolescents (n = 53, aged 12–13 years) were recruited from a school in a multicultural community of low SES in Sweden. Following an interpretive approach, 10 focus group interviews were conducted to produce data for a qualitative content analysis. When the adolescents mentioned PA, they mostly referred to spontaneous PA rather than organized PA, and expressed that they enjoyed their PA engagement, which they stated was promoted by the variation of PA, available options for PA, their physical skills, and the presence of peers. They reported that social support from family and friends facilitated their PA, and they offered several suggestions regarding how the school environment could better support their PA. From the perspective of self-determination theory (SDT), the results stress the importance of facilitating intrinsic motivation with a supportive PA environment in which adolescents can satisfy their needs for autonomy, competence, and relatedness. Full article

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

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25 pages, 16690 KiB

Open AccessArticle

Effects of Land Use/Cover Changes and Urban Forest Configuration on Urban Heat Islands in a Loess Hilly Region: Case Study Based on Yan’an City, China

by Xinping Zhang, Dexiang Wang, Hongke Hao, Fangfang Zhang and Youning Hu

Int. J. Environ. Res. Public Health 2017, 14(8), 840; https://doi.org/10.3390/ijerph14080840 - 26 Jul 2017

Cited by 46 | Viewed by 6909

Abstract

In this study Yan’an City, a typical hilly valley city, was considered as the study area in order to explain the relationships between the surface urban heat island (SUHI) and land use/land cover (LULC) types, the landscape pattern metrics of LULC types and [...] Read more.

In this study Yan’an City, a typical hilly valley city, was considered as the study area in order to explain the relationships between the surface urban heat island (SUHI) and land use/land cover (LULC) types, the landscape pattern metrics of LULC types and land surface temperature (LST) and remote sensing indexes were retrieved from Landsat data during 1990–2015, and to find factors contributed to the green space cool island intensity (GSCI) through field measurements of 34 green spaces. The results showed that during 1990–2015, because of local anthropogenic activities, SUHI was mainly located in lower vegetation cover areas. There was a significant suburban-urban gradient in the average LST, as well as its heterogeneity and fluctuations. Six landscape metrics comprising the fractal dimension index, percentage of landscape, aggregation index, division index, Shannon’s diversity index, and expansion intensity of the classified LST spatiotemporal changes were paralleled to LULC changes, especially for construction land, during the past 25 years. In the urban area, an index-based built-up index was the key positive factor for explaining LST increases, whereas the normalized difference vegetation index and modified normalized difference water index were crucial factors for explaining LST decreases during the study periods. In terms of the heat mitigation performance of green spaces, mixed forest was better than pure forest, and the urban forest configuration had positive effects on GSCI. The results of this study provide insights into the importance of species choice and the spatial design of green spaces for cooling the environment. Full article

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

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12 pages, 1301 KiB

Open AccessArticle

Chronic Respiratory Diseases in the Regions of Northern Russia: Epidemiological Distinctions in the Results of a National Population Study

by Marine H. Gambaryan, Svetlana A. Shalnova, Alexander D. Deev and Oxana M. Drapkina

Int. J. Environ. Res. Public Health 2017, 14(8), 841; https://doi.org/10.3390/ijerph14080841 - 26 Jul 2017

Cited by 7 | Viewed by 4689

Abstract

The aim of the study is to investigate the epidemiological situation regarding chronic respiratory diseases in populations that inhabit different climatic–geographical regions of Russia, and to develop targeted programs for prevention of these diseases. Methods: (1) a comparative analysis of the standardized mortality [...] Read more.

The aim of the study is to investigate the epidemiological situation regarding chronic respiratory diseases in populations that inhabit different climatic–geographical regions of Russia, and to develop targeted programs for prevention of these diseases. Methods: (1) a comparative analysis of the standardized mortality data in Russia and other selected regions of the Russian North using the European standard for respiratory diseases, in a population aged 25–64; and (2) data from a randomized cross-sectional epidemiological study, with subjects from three different climatic-geographical regions of Russia. Results: (1) the respiratory disease-related mortality rates in the majority of Russian Northern regions were much higher compared to the national average. Although death rates from chronic lower respiratory diseases were higher among the Northern regions and in the whole of Russia relative to the countries of European Union (EU), the cause of death in the populations of the Northern regions tend to be lower respiratory infections and pneumonia; and (2) despite the absence of any significant differences in the prevalence of smoking, the prevalence of chronic respiratory diseases (COPD) is significantly higher in Far North Yakutsk compared to the other two regions in this study—Chelyabinsk and Vologda. The status of hyperborean had the highest chance of a significant contribution to COPD and cardiorespiratory pathology among all other risk factors. The results revealed a need for effective targeted strategies for primary and secondary prevention of chronic respiratory diseases for the populations of the Northern regions of Russia. Conclusions: The revealed regional distinctions regarding the prevalence of, and mortality from, chronic respiratory diseases should be taken into consideration when designing integrated programs for chronic non-communicable disease prevention in these regions. Full article

(This article belongs to the Section Global Health)

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13 pages, 691 KiB

Open AccessArticle

Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China

by Chaofan Li, Lei Dou, Haipeng Wang, Shanshan Jing and Aitian Yin

Int. J. Environ. Res. Public Health 2017, 14(8), 842; https://doi.org/10.3390/ijerph14080842 - 26 Jul 2017

Cited by 47 | Viewed by 6105

Abstract

Background: Equitable utilization of health care is a primary goal of the Chinese health system. This study aimed to examine horizontal inequity in health care utilization and identify the factors resulting in inequity among the middle-aged and elderly in China. Methods: The data [...] Read more.

Background: Equitable utilization of health care is a primary goal of the Chinese health system. This study aimed to examine horizontal inequity in health care utilization and identify the factors resulting in inequity among the middle-aged and elderly in China. Methods: The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We employed the concentration index (CI) and horizontal inequity (HI) to measure inequity in health care utilization. Non-linear regression models were used to decompose the CI into the contribution of each factor. Results: The CIs for the probability of and total number of outpatient visits were 0.0642 and 0.0780, respectively, and those for inpatient visits were 0.1418 and 0.1471, respectively. The HIs were also significantly positive. Living standard was the most important contributor. The contribution of health insurance varied between plans. Conclusions: This study supported the presence of pro-rich inequity in health care utilization for both probability and frequency among the middle-aged and elderly in China. Narrowing the living standard gap and improving the health insurance benefit package for the elderly should help to resolve these inequities. Full article

(This article belongs to the Section Health Economics)

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9 pages, 313 KiB

Open AccessArticle

Awareness of the Risk of Exposure to Infectious Material and the Behaviors of Polish Paramedics with Respect to the Hazards from Blood-Borne Pathogens—A Nationwide Study

by Anna Garus-Pakowska, Mariusz Górajski and Franciszek Szatko

Int. J. Environ. Res. Public Health 2017, 14(8), 843; https://doi.org/10.3390/ijerph14080843 - 27 Jul 2017

Cited by 18 | Viewed by 4576

Abstract

(1) Background: To determine paramedics’ frequency of contact with blood and other body fluids, as well as the analysis of knowledge of paramedics about blood-borne infections, their attitudes to patients infected with blood-borne viruses, and the post-exposure procedures implemented by paramedics; (2) Methods: [...] Read more.

(1) Background: To determine paramedics’ frequency of contact with blood and other body fluids, as well as the analysis of knowledge of paramedics about blood-borne infections, their attitudes to patients infected with blood-borne viruses, and the post-exposure procedures implemented by paramedics; (2) Methods: An anonymous questionnaire among 190 paramedics working in various health care facilities in Poland (adjusted response rate, 76.3%); (3) Results: 78% of paramedics had contact with potentially infectious material at least several times a week. Paramedics’ knowledge on transferring infection was insufficient. Paramedics with longer employment time and better professional experience suffered fewer injuries with used needles/medical tools (p = 0.079). Most frequently reported factors that prevented the use of personal protective equipment were emergency situations (19.5%), skin irritations and contact allergies (19%) and, in the case of protective gloves, reduced manual dexterity (16%). In total, 82% of paramedics were concerned about the risk of being infected with HIV, HBV or HCV as a result of performing their job. In total, 97% of paramedics behaved more carefully while caring for infected patients. In total, 90% of the paramedics never refrained from performing the specific procedures necessary to help the patient whom they knew to be infected; (4) Conclusions: Despite the paramedics’ insufficient theoretical knowledge about the risk of blood-borne infections, the emphasis in the training of future paramedics should be on classes perfecting practical skills, because growing experience significantly reduces the risk of injury. Full article

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

10 pages, 951 KiB

Open AccessArticle

Modeling the Effect of Physical Activity on Obesity in China: Evidence from the Longitudinal China Health and Nutrition Study 1989–2011

by Tao Zhang

Int. J. Environ. Res. Public Health 2017, 14(8), 844; https://doi.org/10.3390/ijerph14080844 - 27 Jul 2017

Cited by 5 | Viewed by 5861

Abstract

Although physical activity has been widely recognized as an important influential factor in determining the risk of obesity, the results in the existing literature empirically examining such issue are mixed. Especially for China, relevant studies are rarely found. One aim of this study [...] Read more.

Although physical activity has been widely recognized as an important influential factor in determining the risk of obesity, the results in the existing literature empirically examining such issue are mixed. Especially for China, relevant studies are rarely found. One aim of this study is to test the direction of effects between obesity and physical activity. It uses longitudinal data to investigate the relationship and causality between physical activity and obesity for both children and adults in China. The longitudinal data and dynamic panel model used here can yield more solid results than the other studies employing cross-sectional data, particularly considering strict endogeneity and self-selection. It is discovered that obesity does not affect children’s physical activity but that obese children are more sedentary. For adults in China, physical activity can significantly reduce the weight, but not in the opposite direction. 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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14 pages, 2188 KiB

Open AccessArticle

Combined Effects of High-Speed Railway Noise and Ground Vibrations on Annoyance

by Shigenori Yokoshima, Takashi Morihara, Tetsumi Sato and Takashi Yano

Int. J. Environ. Res. Public Health 2017, 14(8), 845; https://doi.org/10.3390/ijerph14080845 - 27 Jul 2017

Cited by 25 | Viewed by 5463

Abstract

The Shinkansen super-express railway system in Japan has greatly increased its capacity and has expanded nationwide. However, many inhabitants in areas along the railways have been disturbed by noise and ground vibration from the trains. Additionally, the Shinkansen railway emits a higher level [...] Read more.

The Shinkansen super-express railway system in Japan has greatly increased its capacity and has expanded nationwide. However, many inhabitants in areas along the railways have been disturbed by noise and ground vibration from the trains. Additionally, the Shinkansen railway emits a higher level of ground vibration than conventional railways at the same noise level. These findings imply that building vibrations affect living environments as significantly as the associated noise. Therefore, it is imperative to quantify the effects of noise and vibration exposures on each annoyance under simultaneous exposure. We performed a secondary analysis using individual datasets of exposure and community response associated with Shinkansen railway noise and vibration. The data consisted of six socio-acoustic surveys, which were conducted separately over the last 20 years in Japan. Applying a logistic regression analysis to the datasets, we confirmed the combined effects of vibration/noise exposure on noise/vibration annoyance. Moreover, we proposed a representative relationship between noise and vibration exposures, and the prevalence of each annoyance associated with the Shinkansen railway. Full article

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

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22 pages, 1062 KiB

Open AccessArticle

Human Health Risk Assessment Applied to Rural Populations Dependent on Unregulated Drinking Water Sources: A Scoping Review

by Lorelei Ford, Lalita Bharadwaj, Lianne McLeod and Cheryl Waldner

Int. J. Environ. Res. Public Health 2017, 14(8), 846; https://doi.org/10.3390/ijerph14080846 - 28 Jul 2017

Cited by 14 | Viewed by 9253

Abstract

Safe drinking water is a global challenge for rural populations dependent on unregulated water. A scoping review of research on human health risk assessments (HHRA) applied to this vulnerable population may be used to improve assessments applied by government and researchers. This review [...] Read more.

Safe drinking water is a global challenge for rural populations dependent on unregulated water. A scoping review of research on human health risk assessments (HHRA) applied to this vulnerable population may be used to improve assessments applied by government and researchers. This review aims to summarize and describe the characteristics of HHRA methods, publications, and current literature gaps of HHRA studies on rural populations dependent on unregulated or unspecified drinking water. Peer-reviewed literature was systematically searched (January 2000 to May 2014) and identified at least one drinking water source as unregulated (21%) or unspecified (79%) in 100 studies. Only 7% of reviewed studies identified a rural community dependent on unregulated drinking water. Source water and hazards most frequently cited included groundwater (67%) and chemical water hazards (82%). Most HHRAs (86%) applied deterministic methods with 14% reporting probabilistic and stochastic methods. Publications increased over time with 57% set in Asia, and 47% of studies identified at least one literature gap in the areas of research, risk management, and community exposure. HHRAs applied to rural populations dependent on unregulated water are poorly represented in the literature even though almost half of the global population is rural. Full article

(This article belongs to the Special Issue Health Impact Assessment (HIA))

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12 pages, 618 KiB

Open AccessArticle

Smoke-Free Recovery from Trauma Surgery: A Pilot Trial of an Online Smoking Cessation Program for Orthopaedic Trauma Patients

by Sam McCrabb, Amanda L. Baker, John Attia, Zsolt J. Balogh, Natalie Lott, Justine Naylor, Ian A. Harris, Christopher M. Doran, Johnson George, Luke Wolfenden, Eliza Skelton and Billie Bonevski

Int. J. Environ. Res. Public Health 2017, 14(8), 847; https://doi.org/10.3390/ijerph14080847 - 28 Jul 2017

Cited by 9 | Viewed by 6232

Abstract

Smoking increases the risk of complications associated with orthopaedic trauma surgery, however delivery of care is low. Online interventions may provide needed smoking cessation care and promote abstinence. This study aims to examine the engagement, acceptability, and retention of an online smoking cessation [...] Read more.

Smoking increases the risk of complications associated with orthopaedic trauma surgery, however delivery of care is low. Online interventions may provide needed smoking cessation care and promote abstinence. This study aims to examine the engagement, acceptability, and retention of an online smoking cessation program (Smoke-Free Recovery; SFR) among a sample of orthopaedic trauma patients, as well as themes around the smoking cessation process. A pilot study of SFR with 31 orthopaedic trauma patients admitted to a public hospital in New South Wales, Australia took place. Semi-structured telephone interviews were conducted following hospital discharge. Thematic analysis and descriptive statistics were used. Engagement was high with 28 participants accessing SFR during admission. Twenty individuals completed follow-up phone calls. Program acceptability was rated favourably. After discharge, changes in smoking habits were noted, with program retention low. Themes on program use included: lack of time or need for additional support; computer illiteracy or technology issues; feeling unready or too stressed to quit; or feeling they had reached the boundary of what could be learnt from the program. This study highlights the difficulties faced by patients following hospital admission, the lack of follow-up support received, and the need for consumer testing prior to roll out. Continuing to develop interventions to promote hospital-initiated cessation attempts that continue post-discharge should be a priority. Full article

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

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17 pages, 719 KiB

Open AccessArticle

Uranium and Associated Heavy Metals in Ovis aries in a Mining Impacted Area in Northwestern New Mexico

by Christine Samuel-Nakamura, Wendie A. Robbins and Felicia S. Hodge

Int. J. Environ. Res. Public Health 2017, 14(8), 848; https://doi.org/10.3390/ijerph14080848 - 28 Jul 2017

Cited by 15 | Viewed by 5463

Abstract

The objective of this study was to determine uranium (U) and other heavy metal (HM) concentrations (As, Cd, Pb, Mo, and Se) in tissue samples collected from sheep (Ovis aries), the primary meat staple on the Navajo reservation in northwestern New [...] Read more.

The objective of this study was to determine uranium (U) and other heavy metal (HM) concentrations (As, Cd, Pb, Mo, and Se) in tissue samples collected from sheep (Ovis aries), the primary meat staple on the Navajo reservation in northwestern New Mexico. The study setting was a prime target of U mining, where more than 1100 unreclaimed abandoned U mines and structures remain. The forage and water sources for the sheep in this study were located within 3.2 km of abandoned U mines and structures. Tissue samples from sheep (n = 3), their local forage grasses (n = 24), soil (n = 24), and drinking water (n = 14) sources were collected. The samples were analyzed using Inductively Coupled Plasma-Mass Spectrometry. Results: In general, HMs concentrated more in the roots of forage compared to the above ground parts. The sheep forage samples fell below the National Research Council maximum tolerable concentration (5 mg/kg). The bioaccumulation factor ratio was >1 in several forage samples, ranging from 1.12 to 16.86 for Mo, Cd, and Se. The study findings showed that the concentrations of HMs were greatest in the liver and kidneys. Of the calculated human intake, Se Reference Dietary Intake and Mo Recommended Dietary Allowance were exceeded, but the tolerable upper limits for both were not exceeded. Food intake recommendations informed by research are needed for individuals especially those that may be more sensitive to HMs. Further study with larger sample sizes is needed to explore other impacted communities across the reservation. Full article

(This article belongs to the Section Environmental Health)

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14 pages, 890 KiB

Open AccessArticle

A Multiyear Model of Influenza Vaccination in the United States

by Arnold Kamis, Yuji Zhang and Tamara Kamis

Int. J. Environ. Res. Public Health 2017, 14(8), 849; https://doi.org/10.3390/ijerph14080849 - 28 Jul 2017

Cited by 3 | Viewed by 5373

Abstract

Vaccinating adults against influenza remains a challenge in the United States. Using data from the Centers for Disease Control and Prevention, we present a model for predicting who receives influenza vaccination in the United States between 2012 and 2014, inclusive. The logistic regression [...] Read more.

Vaccinating adults against influenza remains a challenge in the United States. Using data from the Centers for Disease Control and Prevention, we present a model for predicting who receives influenza vaccination in the United States between 2012 and 2014, inclusive. The logistic regression model contains nine predictors: age, pneumococcal vaccination, time since last checkup, highest education level attained, employment, health care coverage, number of personal doctors, smoker status, and annual household income. The model, which classifies correctly 67 percent of the data in 2013, is consistent with models tested on the 2012 and 2014 datasets. Thus, we have a multiyear model to explain and predict influenza vaccination in the United States. The results indicate room for improvement in vaccination rates. We discuss how cognitive biases may underlie reluctance to obtain vaccination. We argue that targeted communications addressing cognitive biases could be useful for effective framing of vaccination messages, thus increasing the vaccination rate. Finally, we discuss limitations of the current study and questions for future research. Full article

(This article belongs to the Section Global Health)

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10 pages, 4138 KiB

Open AccessArticle

Quantifying Grain-Size Variability of Metal Pollutants in Road-Deposited Sediments Using the Coefficient of Variation

by Hongtao Zhao, Xiaoxue Wang and Xuyong Li

Int. J. Environ. Res. Public Health 2017, 14(8), 850; https://doi.org/10.3390/ijerph14080850 - 28 Jul 2017

Cited by 22 | Viewed by 4097

Abstract

Particle grain size is an important indicator for the variability in physical characteristics and pollutants composition of road-deposited sediments (RDS). Quantitative assessment of the grain-size variability in RDS amount, metal concentration, metal load and GSF_Load is essential to elimination of the uncertainty [...] Read more.

Particle grain size is an important indicator for the variability in physical characteristics and pollutants composition of road-deposited sediments (RDS). Quantitative assessment of the grain-size variability in RDS amount, metal concentration, metal load and GSF_Load is essential to elimination of the uncertainty it causes in estimation of RDS emission load and formulation of control strategies. In this study, grain-size variability was explored and quantified using the coefficient of variation (Cv) of the particle size compositions, metal concentrations, metal loads, and GSF_Load values in RDS. Several trends in grain-size variability of RDS were identified: (i) the medium class (105–450 µm) variability in terms of particle size composition, metal loads, and GSF_Load values in RDS was smaller than the fine (<105 µm) and coarse (450–2000 µm) class; (ii) The grain-size variability in terms of metal concentrations increased as the particle size increased, while the metal concentrations decreased; (iii) When compared to the Lorenz coefficient (Lc), the Cv was similarly effective at describing the grain-size variability, whereas it is simpler to calculate because it did not require the data to be pre-processed. The results of this study will facilitate identification of the uncertainty in modelling RDS caused by grain-size class variability. Full article

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

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48 pages, 1278 KiB

Open AccessReview

Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review

by Margaret M. Hansen, Reo Jones and Kirsten Tocchini

Int. J. Environ. Res. Public Health 2017, 14(8), 851; https://doi.org/10.3390/ijerph14080851 - 28 Jul 2017

Cited by 470 | Viewed by 72812

Abstract

Background: Current literature supports the comprehensive health benefits of exposure to nature and green environments on human systems. The aim of this state-of-the-art review is to elucidate empirical research conducted on the physiological and psychological effects of Shinrin-Yoku (or Forest Bathing) in transcontinental [...] Read more.

Background: Current literature supports the comprehensive health benefits of exposure to nature and green environments on human systems. The aim of this state-of-the-art review is to elucidate empirical research conducted on the physiological and psychological effects of Shinrin-Yoku (or Forest Bathing) in transcontinental Japan and China. Furthermore, we aim to encourage healthcare professionals to conduct longitudinal research in Western cultures regarding the clinically therapeutic effects of Shinrin-Yoku and, for healthcare providers/students to consider practicing Shinrin-Yoku to decrease undue stress and potential burnout. Methods: A thorough review was conducted to identify research published with an initial open date range and then narrowing the collection to include papers published from 2007 to 2017. Electronic databases (PubMed, PubMed Central, CINAHL, PsycINFO and Scopus) and snowball references were used to cull papers that evaluated the use of Shinrin-Yoku for various populations in diverse settings. Results: From the 127 papers initially culled using the Boolean phrases: “Shinrin-yoku” AND/OR “forest bathing” AND/OR “nature therapy”, 64 studies met the inclusion criteria and were included in this summary review and then divided into “physiological,” “psychological,” “sensory metrics” and “frameworks” sub-groups. Conclusions: Human health benefits associated with the immersion in nature continue to be currently researched. Longitudinal research, conducted worldwide, is needed to produce new evidence of the relationships associated with Shinrin-Yoku and clinical therapeutic effects. Nature therapy as a health-promotion method and potential universal health model is implicated for the reduction of reported modern-day “stress-state” and “technostress.”. Full article

(This article belongs to the Special Issue Evidence-Based Nature Therapy: Advances in Physiological Evaluation)

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12 pages, 1037 KiB

Open AccessArticle

Exogenous GR24 Alleviates Cadmium Toxicity by Reducing Cadmium Uptake in Switchgrass (Panicum virgatum) Seedlings

by Zhenglan Tai, Xinqiang Yin, Zhigang Fang, Gaoling Shi, Laiqing Lou and Qingsheng Cai

Int. J. Environ. Res. Public Health 2017, 14(8), 852; https://doi.org/10.3390/ijerph14080852 - 29 Jul 2017

Cited by 64 | Viewed by 5871

Abstract

Strigolactones (SLs) are classified into plant hormones, playing a key role as a mediator of plant growth in response to several abiotic stresses, including drought and salinity. However, the role of SLs in cadmium (Cd)-induced stress to plants is still unknown. The physiological [...] Read more.

Strigolactones (SLs) are classified into plant hormones, playing a key role as a mediator of plant growth in response to several abiotic stresses, including drought and salinity. However, the role of SLs in cadmium (Cd)-induced stress to plants is still unknown. The physiological responses of switchgrass (Panicum virgatum) stressed in 10 μmol L^-1 Cd to exogenous synthetic SLs analog, GR24 were studied in hydroponics. The Cd stress significantly caused the adverse effects on plant growth and root morphology, inhibited photosynthesis, but boosted lipid peroxidation of Switchgrass seedlings. After treatment of 1 μmol L^-1 GR24, the above adverse effects caused by Cd stress were significantly alleviated, mainly reflects in improvement of shoot biomass, relative water content, root development, chlorophyll contents, activities of typical antioxidant enzymes, nutrient uptake. The reason for exogenous GR24 alleviating cadmium toxicity might be owing to that exogenous GR24 promoted the content of endogenous SLs, increased some essential element Fe (iron), Zn (zinc), Mn (manganese) and Cu (copper) uptake and reduced cadmium uptake, accumulation and partition in shoot of switchgrass seedlings. Full article

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

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13 pages, 435 KiB

Open AccessReview

Heat Exposure and Maternal Health in the Face of Climate Change

by Leeann Kuehn and Sabrina McCormick

Int. J. Environ. Res. Public Health 2017, 14(8), 853; https://doi.org/10.3390/ijerph14080853 - 29 Jul 2017

Cited by 165 | Viewed by 32489

Abstract

Climate change will increasingly affect the health of vulnerable populations, including maternal and fetal health. This systematic review aims to identify recent literature that investigates increasing heat and extreme temperatures on pregnancy outcomes globally. We identify common research findings in order to create [...] Read more.

Climate change will increasingly affect the health of vulnerable populations, including maternal and fetal health. This systematic review aims to identify recent literature that investigates increasing heat and extreme temperatures on pregnancy outcomes globally. We identify common research findings in order to create a comprehensive understanding of how immediate effects will be sustained in the next generation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide, we systematically reviewed articles from PubMed and Cochrane Reviews. We included articles that identify climate change-related exposures and adverse health effects for pregnant women. There is evidence that temperature extremes adversely impact birth outcomes, including, but not limited to: changes in length of gestation, birth weight, stillbirth, and neonatal stress in unusually hot temperature exposures. The studies included in this review indicate that not only is there a need for further research on the ways that climate change, and heat in particular, may affect maternal health and neonatal outcomes, but that uniform standards for assessing the effects of heat on maternal fetal health also need to be established. Full article

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

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16 pages, 1951 KiB

Open AccessArticle

Treatment of Human Placental Choriocarcinoma Cells with Formaldehyde and Benzene Induced Growth and Epithelial Mesenchymal Transition via Induction of an Antioxidant Effect

by Hae-Miru Lee, Soo-Min Kim and Kyung-Chul Choi

Int. J. Environ. Res. Public Health 2017, 14(8), 854; https://doi.org/10.3390/ijerph14080854 - 29 Jul 2017

Cited by 6 | Viewed by 5650

Abstract

Cigarette smoke (CS) causes about 480,000 deaths each year worldwide, and it is well-known to have harmful effects on the human body, leading to heart disease, stroke, lung cancer, and cardiovascular problems. In this study, the effects of formaldehyde (FA) and benzene (Bz), [...] Read more.

Cigarette smoke (CS) causes about 480,000 deaths each year worldwide, and it is well-known to have harmful effects on the human body, leading to heart disease, stroke, lung cancer, and cardiovascular problems. In this study, the effects of formaldehyde (FA) and benzene (Bz), the main components of CS, on cell proliferation and epithelial mesenchymal transition (EMT) of JEG-3 human choriocarcinoma cells were examined to confirm the relationship between CS components and placenta carcinoma. Upon MTT assay, FA (10⁻⁸ M to 10⁻⁵ M) and Bz (10⁻¹¹ M to 10⁻⁸ M) increased JEG-3 cell proliferation. Western blot assay revealed that the protein expression of cyclin D1 and E1 increased, while the levels of p21 and p27 were reduced following treatment. In Scratch assay, FA (10⁻⁸ M and 10⁻⁵ M) and Bz (10⁻¹¹ M and 10⁻⁸ M) increased migration of JEG-3 cells at 24 h and 48 h compared with that at 0 h. In addition, the expression of the epithelial marker, E-cadherin, was significantly decreased, while the expression of the mesenchymal marker, N-cadherin, was significantly increased by FA (10⁻⁸ M and 10⁻⁵ M) and Bz (10⁻¹¹ M and 10⁻⁸ M). snail and slug transcriptional factors were associated with EMT, which were also up-regulated by FA and Bz, indicating that FA and Bz lead to an increase in the EMT process in JEG-3 choriocarcinoma cells. We further evaluated reactive oxygen species (ROS) and activation of antioxidant effect using dichlorofluorescin diacetate (DCFH-DA) and Western blot assay. FA and Bz increased the ROS production and an antioxidant related marker, Nrf2, in JEG-3 cells. However, eIF2α levels were reduced by FA and Bz via activation of the antioxidant reaction. Taken together, these results indicated that FA and Bz induce the growth and migration of human choriocarcinoma cells via regulation of the cell cycle and EMT and activation of ROS and antioxidant related markers. Full article

(This article belongs to the Section Environmental Health)

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6 pages, 392 KiB

Open AccessCase Report

Unusual Onset of Celiac Disease and Addison’s Disease in a 12-Year-Old Boy

by Francesco Miconi, Emanuela Savarese, Giovanni Miconi, Gabriele Cabiati, Valentina Rapaccini, Nicola Principi and Susanna Esposito

Int. J. Environ. Res. Public Health 2017, 14(8), 855; https://doi.org/10.3390/ijerph14080855 - 29 Jul 2017

Cited by 6 | Viewed by 5235

Abstract

Background: Celiac disease (CD) is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison’s disease (AD) and CD [...] Read more.

Background: Celiac disease (CD) is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison’s disease (AD) and CD may co-exist, although this association is relatively uncommon in children. In addition, it is not precisely defined whether a gluten-free diet influences the course of AD. Case presentation: A case of CD in a 12-year-old boy presenting as acute adrenal insufficiency is described here. A gluten-free diet had a significant therapeutic role in this case, wherein most of the clinical signs and symptoms of AD disappeared in a few days. In addition, the dosage of cortisol acetate, initially administered to treat the AD, was able to be rapidly reduced. Conclusion: This case highlights that CD can be associated with AD in children, and a gluten-free diet seems to positively influence the course of AD. Full article

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

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10 pages, 295 KiB

Open AccessArticle

Child Supervision and Burn Outcome among Admitted Patients at Major Trauma Hospitals in the Gambia

by Edrisa Sanyang, Corinne Peek-Asa, Tracy Young and Laurence Fuortes

Int. J. Environ. Res. Public Health 2017, 14(8), 856; https://doi.org/10.3390/ijerph14080856 - 30 Jul 2017

Cited by 14 | Viewed by 4893

Abstract

Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs), where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper [...] Read more.

Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs), where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper was to examine the general characteristics of burns and identify burn injury outcomes among adult-supervised children compared to those who were not supervised. The study examined burn injury and clinical characteristics among all burn patients admitted to two trauma hospitals in The Gambia, West Africa. At intake in the emergency room, the treating physician or nurse determined the need for admission based on body surface area burned (BSAB), depth of burn, and other clinical considerations such as co-occurring injuries and co-morbidities. During the study period of 1 April 2014 through 31 October 2016, 105 burn patients were admitted and data were collected by the treating physician for all of them. Information about supervision was only asked for children aged five years or less. More than half (51%) of the burn patients were children under 18 years, and 22% were under 5 years. Among children under five, most (86.4%) were supervised by an adult at the time of burn event. Of the 19 supervised children, 16 (84.2%) had body area surface burned (BSAB) of less than 20%. Two of the three children without adult supervision at the time of burn event had BSAB ≥ 20%. Overall, 59% of the patients had 20% + BSAB. Females (aOR = 1.25; 95% CI = 0.43–3.62), those burned in rural towns and villages (aOR = 2.29; 95% CI = 0.69–7.57), or burned by fire or flames (aOR = 1.47; 95% CI = 0.51–4.23) had increased odds of having a BSAB ≥ 20%, although these differences were not statistically significant. Children 0–5 years or 5–18 years (aOR = 0.04, 95% CI = 0.01–0.17; aOR = 0.07, 95% CI = 0.02–0.23, respectively) were less likely to have BSAB ≥ 20% than adults. Those burned in a rural location (aOR = 9.23, 95% CI = 2.30–37.12) or by fire or flames (aOR = 6.09, 95% CI = 1.55–23.97) were more likely to die. Children 0–5 years or 5–18 years (aOR = 0.2, 95% CI = 0.03–1.18; aOR = 0.38; 95% CI = 0.11–1.570, respectively) were less likely to die. Children constitute a significant proportion of admitted burn patients, and most of them were supervised at the time of the burn event. Supervised children (compared to unsupervised children) had less severe burns. Programs that focus on burn prevention at all levels including child supervision could increase awareness and reduce burns or their severity. Programs need to be designed and evaluated with focus on the child development stage and the leading causes of burns by age group. Full article

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

9 pages, 1674 KiB

Open AccessCommunication

Quick Estimation Model for the Concentration of Indoor Airborne Culturable Bacteria: An Application of Machine Learning

by Zhijian Liu, Hao Li and Guoqing Cao

Int. J. Environ. Res. Public Health 2017, 14(8), 857; https://doi.org/10.3390/ijerph14080857 - 30 Jul 2017

Cited by 40 | Viewed by 6493

Abstract

Indoor airborne culturable bacteria are sometimes harmful to human health. Therefore, a quick estimation of their concentration is particularly necessary. However, measuring the indoor microorganism concentration (e.g., bacteria) usually requires a large amount of time, economic cost, and manpower. In this paper, we [...] Read more.

Indoor airborne culturable bacteria are sometimes harmful to human health. Therefore, a quick estimation of their concentration is particularly necessary. However, measuring the indoor microorganism concentration (e.g., bacteria) usually requires a large amount of time, economic cost, and manpower. In this paper, we aim to provide a quick solution: using knowledge-based machine learning to provide quick estimation of the concentration of indoor airborne culturable bacteria only with the inputs of several measurable indoor environmental indicators, including: indoor particulate matter (PM_2.5 and PM₁₀), temperature, relative humidity, and CO₂ concentration. Our results show that a general regression neural network (GRNN) model can sufficiently provide a quick and decent estimation based on the model training and testing using an experimental database with 249 data groups. Full article

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

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8 pages, 282 KiB

Open AccessArticle

Awareness of Standardised Tobacco Packaging among Adults and Young People during the Final Phase of Policy Implementation in Great Britain

by Ilze Bogdanovica, Magdalena Opazo Breton, Tessa Langley and John Britton

Int. J. Environ. Res. Public Health 2017, 14(8), 858; https://doi.org/10.3390/ijerph14080858 - 31 Jul 2017

Cited by 10 | Viewed by 5322

Abstract

Background: In May 2016, along with the latest European Tobacco Products Directive (TPD), standardised packaging legislation was implemented in the UK. During the following 12-month transition period, both new and old types of packaging were allowed on the market. This study aimed [...] Read more.

Background: In May 2016, along with the latest European Tobacco Products Directive (TPD), standardised packaging legislation was implemented in the UK. During the following 12-month transition period, both new and old types of packaging were allowed on the market. This study aimed to assess awareness of standardised packaging and other TPD changes in the UK population in March 2017, when both forms of packaging were in widespread use. Methods: We conducted two surveys—one in adults and one in young people—investigating awareness of plain packaging legislation. In young people, we also measured susceptibility to smoking using previously validated questions. We asked smokers whether they had recently changed the product they used and also whether they used any of the products that are banned by the new legislation. Results: In the adult survey, 73.5% (95% CI: 71.5–75.5%) of the participants were aware of the new legislation and 32.4% (95% CI: 30.3–34.5%) had noticed changes in tobacco packaging, this proportion being considerably higher among smokers (83.7%; 95% CI: 78.9–87.5%) than never smokers (20.7%; 95% CI: 18.2–23.4%). More than half (52.4%; 95% CI: 46.5–58.4%) were using pack sizes or shapes (typically less than 20 cigarettes or 30 g loose tobacco), that would become illegal after full TPD implementation, and 31.4% (95% CI: 26.2–37.1%) reported switching to a different product since October 2016, in most cases to a cheaper brand. Among young people, 20.2% (95% CI: 17.8–22.7%) reported that they had noticed standardised packaging, comprising 16.2% (95% CI: 13.7–19.0%) of non-susceptible never smokers, 25.6% (95% CI: 18.0–35%) of susceptible never smokers, and 49% (95% CI: 37.8–60.2%) of ever smokers. Conclusions: In the final stages of implementation, awareness of the introduction of standardised packs was highest among smokers. The TPD will cause nearly half of adult smokers to purchase larger packs, and may cause many smokers to switch to cheaper brands. Full article

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

22 pages, 3605 KiB

Open AccessArticle

Geochemical Background and Baseline Values Determination and Spatial Distribution of Heavy Metal Pollution in Soils of the Andes Mountain Range (Cajamarca-Huancavelica, Peru)

by Fernando Santos-Francés, Antonio Martinez-Graña, Pilar Alonso Rojo and Antonio García Sánchez

Int. J. Environ. Res. Public Health 2017, 14(8), 859; https://doi.org/10.3390/ijerph14080859 - 31 Jul 2017

Cited by 105 | Viewed by 9989

Abstract

Concentrations of seven heavy metals (Cd, Cr, Cu, Hg, Ni, Pb, and Zn) and one metalloid (As) as well as various parameters (pH, organic carbon, granulometric analysis and cation exchange capacity) were analyzed in 77 soil samples collected in the mining areas of [...] Read more.

Concentrations of seven heavy metals (Cd, Cr, Cu, Hg, Ni, Pb, and Zn) and one metalloid (As) as well as various parameters (pH, organic carbon, granulometric analysis and cation exchange capacity) were analyzed in 77 soil samples collected in the mining areas of La Zanja and Colquirrumi (Department of Cajamarca) and Julcani (Department of Huancavelica). Our study proposed geochemical baseline values for heavy metals in a natural region (La Zanja) from samples collected during the period of the environmental impact study (2006), that is, from an earlier period which occurred at the beginning of the exploitation of the current gold mine. The baseline values obtained were as follows: 8.26 mg kg−1 for Cr; 56.97 mg kg−1 for Ni; 22, 20 mg kg−1 for the Cu; 47.42 mg kg−1 for Zn; 27.50 mg kg−1 for As; 4.36 mg kg−1 for Cd; 4.89 mg kg−1 for Hg, and 44.87 mg kg−1 for Pb. Through the use of different indices of heavy metal contamination (geo-accumulation index (Igeo), improved Nemerow index (IIN) and potential ecological risk index (RI)), the degree of pollution caused by mining activities in two areas, Colquirrumi and Julcani, which have a high density of mining sites in operation, was determined. The values obtained from these indices indicated that the Colquirrumi region was the most contaminated, followed by Julcani. The area of La Zanja, despite being free of mining operations, presented slight diffuse pollution. Several positive correlations were obtained, with a high level of significance, between pH, organic carbon content, cation exchange capacity, and the Cr, Pb and Ni concentrations of the soils. The spatial distribution of the heavy metals was realized by means of the interpolation method of ordinary kriging. The results obtained and the experience gained in this work were necessary to facilitate the identification of soil contamination processes in high altitude areas of the Andes Western Cordillera (Peru) as a basis for taking appropriate measures when restoring soils, during mine closure processes, and to protect the quality of soil resources. Full article

(This article belongs to the Special Issue A Policy Focused Approach to Public Health and Air, Water and/or Soil Pollution)

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11 pages, 909 KiB

Open AccessArticle

Residence in Proximity of a Coal-Oil-Fired Thermal Power Plant and Risk of Lung and Bladder Cancer in North-Eastern Italy. A Population-Based Study: 1995–2009

by Paolo Collarile, Ettore Bidoli, Fabio Barbone, Loris Zanier, Stefania Del Zotto, Simonetta Fuser, Fulvio Stel, Chiara Panato, Irene Gallai and Diego Serraino

Int. J. Environ. Res. Public Health 2017, 14(8), 860; https://doi.org/10.3390/ijerph14080860 - 31 Jul 2017

Cited by 25 | Viewed by 6096

Abstract

This study investigated the risk of lung and bladder cancers in people residing in proximity of a coal-oil-fired thermal power plant in an area of north-eastern Italy, covered by a population-based cancer registry. Incidence rate ratios (IRR) by sex, age, and histology were [...] Read more.

This study investigated the risk of lung and bladder cancers in people residing in proximity of a coal-oil-fired thermal power plant in an area of north-eastern Italy, covered by a population-based cancer registry. Incidence rate ratios (IRR) by sex, age, and histology were computed according to tertiles of residential exposure to benzene, nitrogen dioxide (NO2), particular matter, and sulfur dioxide (SO2) among 1076 incident cases of lung and 650 cases of bladder cancers. In men of all ages and in women under 75 years of age, no significant associations were observed. Conversely, in women aged ≥75 years significantly increased risks of lung and bladder cancers were related to high exposure to benzene (IRR for highest vs. lowest tertile: 2.00 for lung cancer and 1.94 for bladder cancer) and NO2 (IRR: 1.72 for lung cancer; and 1.94 for bladder cancer). In these women, a 1.71-fold higher risk of lung cancer was also related to a high exposure to SO2. Acknowledging the limitations of our study, in particular that we did not have information regarding cigarette smoking habits, the findings of this study indicate that air pollution exposure may have had a role with regard to the risk of lung and bladder cancers limited to women aged ≥75 years. Such increased risk warrants further analytical investigations. Full article

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

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13 pages, 1509 KiB

Open AccessArticle

Removal Efficiency and Risk Assessment of Polycyclic Aromatic Hydrocarbons in a Typical Municipal Wastewater Treatment Facility in Guangzhou, China

by Zhineng Liu, Qing Li, Qihang Wu, Dave T. F. Kuo, Shejun Chen, Xiaodong Hu, Mingjun Deng, Haozhi Zhang and Min Luo

Int. J. Environ. Res. Public Health 2017, 14(8), 861; https://doi.org/10.3390/ijerph14080861 - 1 Aug 2017

Cited by 37 | Viewed by 5569

Abstract

The loading and removal efficiency of 16 US EPA polycyclic aromatic hydrocarbons (PAHs) were examined in an inverted A²/O wastewater treatment plant (WWTP) located in an urban area in China. The total PAH concentrations were 554.3 to 723.2 ng/L in the [...] Read more.

The loading and removal efficiency of 16 US EPA polycyclic aromatic hydrocarbons (PAHs) were examined in an inverted A²/O wastewater treatment plant (WWTP) located in an urban area in China. The total PAH concentrations were 554.3 to 723.2 ng/L in the influent and 189.6 to 262.7 ng/L in the effluent. The removal efficiencies of ∑PAHs in the dissolved phase ranged from 63 to 69%, with the highest observed in naphthalene (80% removal). Concentration and distribution of PAHs revealed that the higher molecular weight PAHs became more concentrated with treatment in both the dissolved phase and the dewatered sludge. The sharpest reduction was observed during the pretreatment and the biological phase. Noncarcinogenic risk, carcinogenic risk, and total health risk of PAHs found in the effluent and sewage sludge were also assessed. The effluent BaP toxic equivalent quantities (TEQ_BaP) were above, or far above, standards in countries. The potential toxicities of PAHs in sewage effluent were approximately 10 to 15 times higher than the acceptable risk level in China. The health risk associated with the sewage sludge also exceeded international recommended levels and was mainly contributed from seven carcinogenic PAHs. Given that WWTP effluent is a major PAH contributor to surface water bodies in China and better reduction efficiencies are achievable, the present study highlights the possibility of utilizing WWTPs for restoring water quality in riverine and coastal regions heavily impacted by PAHs contamination. Full article

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

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19 pages, 535 KiB

Open AccessArticle

Using a Co-Creational Approach to Develop, Implement and Evaluate an Intervention to Promote Physical Activity in Adolescent Girls from Vocational and Technical Schools: A Case Control Study

by Maïté Verloigne, Teatske Maria Altenburg, Mai Jeanette Maidy Chinapaw, Sebastien Chastin, Greet Cardon and Ilse De Bourdeaudhuij

Int. J. Environ. Res. Public Health 2017, 14(8), 862; https://doi.org/10.3390/ijerph14080862 - 1 Aug 2017

Cited by 42 | Viewed by 6305

Abstract

Background: As physical inactivity is particularly prevalent amongst lower-educated adolescent girls, interventions are needed. Using a co-creational approach increases their engagement and might be effective. This study aimed to: (1) describe the co-creation process, (2) evaluate how girls experienced co-creation, and (3) evaluate [...] Read more.

Background: As physical inactivity is particularly prevalent amongst lower-educated adolescent girls, interventions are needed. Using a co-creational approach increases their engagement and might be effective. This study aimed to: (1) describe the co-creation process, (2) evaluate how girls experienced co-creation, and (3) evaluate the effect of the co-creational interventions on physical activity, individual, sociocultural and school-based factors. Methods: Three intervention schools (n = 91) and three control schools (n = 105) across Flanders participated. A questionnaire was completed pre (September–October 2014) and post (April–May 2015). In between, sessions with a co-creation group were organised to develop and implement the intervention in each intervention school. Focus groups were conducted to evaluate the co-creational process. Results: School 1 organised sport sessions for girls, school 2 organised a fitness activity and set up a Facebook page, school 3 organised a lunch walk. Girls were positive about having a voice in developing an intervention. No significant effects were found, except for small effects on extracurricular sports participation and self-efficacy. Conclusions: Using a co-creational approach amongst adolescent girls might be a feasible approach. However, as interventions were minimal, effects were limited or undetectable. Future co-creation projects could consider the most optimal co-creation process, evaluation design and intensively test this approach. Full article

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

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18 pages, 542 KiB

Open AccessReview

Stunting, Wasting and Underweight in Sub-Saharan Africa: A Systematic Review

by Blessing J. Akombi, Kingsley E. Agho, John J. Hall, Nidhi Wali, Andre M. N. Renzaho and Dafna Merom

Int. J. Environ. Res. Public Health 2017, 14(8), 863; https://doi.org/10.3390/ijerph14080863 - 1 Aug 2017

Cited by 274 | Viewed by 22830

Abstract

Introduction: Child undernutrition is a major public health problem. One third of all undernourished children globally reside in Sub-Saharan Africa (SSA). The aim of this study was to systematically review studies to determine the factors associated with stunting, wasting and underweight in [...] Read more.

Introduction: Child undernutrition is a major public health problem. One third of all undernourished children globally reside in Sub-Saharan Africa (SSA). The aim of this study was to systematically review studies to determine the factors associated with stunting, wasting and underweight in SSA and contribute to the existing body of evidence needed for the formulation of effective interventions. Methods: This systematic review was conducted using the 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Five computerized bibliographic databases were searched: Scopus, PubMed, PsycINFO, CINAHL and Embase. The included studies were rated using eight quality-appraisal criteria derived from the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist: sample size, sampling methodology, response rate, outcome measures, statistical analyses, control for confounding, study limitation, and ethical consideration. Results: Of a total of 2810 articles retrieved from the five databases, 49 studies met our inclusion criteria. The most consistent factors associated with childhood stunting, wasting and underweight in SSA were: low mother’s education, increasing child’s age, sex of child (male), wealth index/SES (poor household), prolonged duration of breastfeeding (>12 months), low birth weight, mother’s age (<20 years), source of drinking water (unimproved), low mother’s BMI (<18.5), birth size (small), diarrhoeal episode, low father’s education and place of residence (rural). Conclusions: The factors that predispose a child to undernutrition are multisectoral. To yield a sustainable improvement in child nutrition in SSA, a holistic multi-strategy community-based approach is needed that targets the factors associated with undernutrition, thereby setting the region on the path to achieving the WHO global nutrition target by 2025. Full article

(This article belongs to the Section Global Health)

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29 pages, 400 KiB

Open AccessReview

A Review of the Benefits of Nature Experiences: More Than Meets the Eye

by Lara S. Franco, Danielle F. Shanahan and Richard A. Fuller

Int. J. Environ. Res. Public Health 2017, 14(8), 864; https://doi.org/10.3390/ijerph14080864 - 1 Aug 2017

Cited by 289 | Viewed by 39175

Abstract

Evidence that experiences of nature can benefit people has accumulated rapidly. Yet perhaps because of the domination of the visual sense in humans, most research has focused on the visual aspects of nature experiences. However, humans are multisensory, and it seems likely that [...] Read more.

Evidence that experiences of nature can benefit people has accumulated rapidly. Yet perhaps because of the domination of the visual sense in humans, most research has focused on the visual aspects of nature experiences. However, humans are multisensory, and it seems likely that many benefits are delivered through the non-visual senses and these are potentially avenues through which a physiological mechanism could occur. Here we review the evidence around these lesser studied sensory pathways—through sound, smell, taste, touch, and three non-sensory pathways. Natural sounds and smells underpin experiences of nature for many people, and this may well be rooted in evolutionary psychology. Tactile experiences of nature, particularly beyond animal petting, are understudied yet potentially fundamentally important. Tastes of nature, through growing and consuming natural foods, have been linked with a range of health and well-being benefits. Beyond the five senses, evidence is emerging for other non-visual pathways for nature experiences to be effective. These include ingestion or inhalation of phytoncides, negative air ions and microbes. We conclude that (i) these non-visual avenues are potentially important for delivering benefits from nature experiences; (ii) the evidence base is relatively weak and often based on correlational studies; and (iii) deeper exploration of these sensory and non-sensory avenues is needed. Full article

(This article belongs to the Special Issue Evidence-Based Nature Therapy: Advances in Physiological Evaluation)

8 pages, 284 KiB

Open AccessArticle

Increased Frequency of Rheumatoid Arthritis and Allergic Rhinitis among Pesticide Sprayers and Associations with Pesticide Use

by Michalis Koureas, George Rachiotis, Andreas Tsakalof and Christos Hadjichristodoulou

Int. J. Environ. Res. Public Health 2017, 14(8), 865; https://doi.org/10.3390/ijerph14080865 - 1 Aug 2017

Cited by 23 | Viewed by 4228

Abstract

Objective: The aim of this study was to identify diseases linked with the pesticide sprayer occupation and explore possible associations with exposure history data. Methods: Α cross sectional study was conducted among pesticide sprayers (n = 80) and the general [...] Read more.

Objective: The aim of this study was to identify diseases linked with the pesticide sprayer occupation and explore possible associations with exposure history data. Methods: Α cross sectional study was conducted among pesticide sprayers (n = 80) and the general population (n = 90) in Thessaly (Greece). Medical history, demographic characteristics and detailed exposure history were recorded by conducting personal interviews. Lifetime exposure indicators were calculated for several pesticide chemical subclasses. Moreover, organophosphate metabolite levels were quantified in urine samples of all participants by using gas chromatography -mass spectrometry (GC-MS). Multinomial analysis was used to determine associations between occupational pesticide exposure and diseases or disorders. Results: In the pesticide sprayers group, significantly higher frequencies for rheumatoid arthritis (RA) and allergic rhinitis were observed compared with the control group (p = 0.002 and p = 0.024 respectively). Within the pesticide sprayers group, high lifetime pesticide exposure was associated with increased risk for reporting RA (OR: 43.07 95% CI: 3.09–600.67) and allergic rhinitis (OR: 9.72 95% CI: 2.31–40.89), compared with low pesticide exposure. Exposure to organophsphate, guanidine and quinone pesticides were associated with RA while organophosphates, pyrethroids and paraquat were associated with allergic rhinitis. Despite the higher levels of certain pesticide metabolites observed among participants with rheumatoid arthritis, the differences were not statistically significant. One metabolite (diethylthiophosphate) was found to be significantly increased in allergic rhinitis cases (p = 0.037). Conclusions: The results from the current study suggest a possible association of occupational pesticide exposure with RA and allergic rhinitis that should be further investigated. Full article

(This article belongs to the Section Environmental Health)

15 pages, 717 KiB

Open AccessArticle

Investigating the Spatial Dimension of Food Access

by Jackie Yenerall, Wen You and Jennie Hill

Int. J. Environ. Res. Public Health 2017, 14(8), 866; https://doi.org/10.3390/ijerph14080866 - 2 Aug 2017

Cited by 11 | Viewed by 4446

Abstract

The purpose of this article is to investigate the sensitivity of food access models to a dataset’s spatial distribution and the empirical definition of food access, which contributes to understanding the mixed findings of previous studies. Data was collected in the Dan River [...] Read more.

The purpose of this article is to investigate the sensitivity of food access models to a dataset’s spatial distribution and the empirical definition of food access, which contributes to understanding the mixed findings of previous studies. Data was collected in the Dan River Region in the United States using a telephone survey for individual-level variables (n = 784) and a store audit for the location of food retailers and grocery store quality. Spatial scanning statistics assessed the spatial distribution of obesity and detected a cluster of grocery stores overlapping with a cluster of obesity centered on a grocery store suggesting that living closer to a grocery store increased the likelihood of obesity. Logistic regression further examined this relationship while controlling for demographic and other food environment variables. Similar to the cluster analysis results, increased distance to a grocery store significantly decreased the likelihood of obesity in the urban subsample (average marginal effects, AME = −0.09, p-value = 0.02). However, controlling for grocery store quality nullified these results (AME = −0.12, p-value = 0.354). Our findings suggest that measuring grocery store accessibility as the distance to the nearest grocery store captures variability in the spatial distribution of the health outcome of interest that may not reflect a causal relationship between the food environment and health. Full article

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

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11 pages, 516 KiB

Open AccessArticle

Effect of Smoking Behavior before and during Pregnancy on Selected Birth Outcomes among Singleton Full-Term Pregnancy: A Murmansk County Birth Registry Study

by Olga A. Kharkova, Andrej M. Grjibovski, Alexandra Krettek, Evert Nieboer and Jon Ø. Odland

Int. J. Environ. Res. Public Health 2017, 14(8), 867; https://doi.org/10.3390/ijerph14080867 - 2 Aug 2017

Cited by 24 | Viewed by 7947

Abstract

The aim of our study was to assess associations between smoking behavior before and during pregnancy and selected adverse birth outcomes. This study is based on the Murmansk County Birth Registry (MCBR). Our study includes women who delivered a singleton pregnancy after 37 [...] Read more.

The aim of our study was to assess associations between smoking behavior before and during pregnancy and selected adverse birth outcomes. This study is based on the Murmansk County Birth Registry (MCBR). Our study includes women who delivered a singleton pregnancy after 37 weeks of gestation (N = 44,486). Smoking information was self-reported and assessed at the first antenatal visit during pregnancy. We adjusted for potential confounders using logistic regression. The highest proportion of infants with low values of birth weight, birth length, head circumference, ponderal index and of the Apgar score at 5 min was observed for women who smoked both before and during pregnancy. We observed a dose-response relationship between the number of cigarettes smoked per day during pregnancy and the odds of the aforementioned adverse birth outcomes; neither were there significant differences in their occurrences among non-smokers and those who smoked before but not during pregnancy. Moreover, smoking reduction during pregnancy relative to its pre-gestation level did not influence the odds of the adverse birth outcomes. Our findings emphasize a continued need for action against tobacco smoking during pregnancy. Full article

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

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15 pages, 1524 KiB

Open AccessArticle

Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in the Context of an Experimental Study in Four Asian Countries

by Jessica L. Reid, Seema Mutti-Packer, Prakash C. Gupta, Qiang Li, Jiang Yuan, Nigar Nargis, A. K. M. Ghulam Hussain and David Hammond

Int. J. Environ. Res. Public Health 2017, 14(8), 868; https://doi.org/10.3390/ijerph14080868 - 2 Aug 2017

Cited by 18 | Viewed by 7046

Abstract

Cigarette package health warnings can be an important and low-cost means of communicating the health risks of smoking. We examined whether viewing health warnings in an experimental study influenced beliefs about the health effects of smoking, by conducting surveys with ~500 adult male [...] Read more.

Cigarette package health warnings can be an important and low-cost means of communicating the health risks of smoking. We examined whether viewing health warnings in an experimental study influenced beliefs about the health effects of smoking, by conducting surveys with ~500 adult male smokers and ~500 male and female youth (age 16–18) in Beijing, China (n = 1070), Mumbai area, India (n = 1012), Dhaka, Bangladesh (n = 1018), and Republic of Korea (n = 1362). Each respondent was randomly assigned to view and rate pictorial health warnings for 2 of 15 different health effects, after which they reported beliefs about whether smoking caused 12 health effects. Respondents who viewed relevant health warnings (vs. other warnings) were significantly more likely to believe that smoking caused that particular health effect, for several health effects in each sample. Approximately three-quarters of respondents in China (Beijing), Bangladesh (Dhaka), and Korea (which had general, text-only warnings) thought that cigarette packages should display more health information, compared to approximately half of respondents in the Mumbai area, India (which had detailed pictorial warnings). Pictorial health warnings that convey the risk of specific health effects from smoking can increase beliefs and knowledge about the health consequences of smoking, particularly for health effects that are lesser-known. Full article

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

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13 pages, 346 KiB

Open AccessArticle

Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis

by Ana Cristina Lindsay, Mary L. Greaney, Sherrie F. Wallington, Julie A. Wright and Anne T. Hunt

Int. J. Environ. Res. Public Health 2017, 14(8), 869; https://doi.org/10.3390/ijerph14080869 - 2 Aug 2017

Cited by 13 | Viewed by 4926

Abstract

Latinos are the largest minority population group in the United States (U.S.), and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms [...] Read more.

Latinos are the largest minority population group in the United States (U.S.), and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15–44). Participants (n = 147) were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers′ Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish) administered by bilingual interviewers. About one-third (34%) of participants were classified as having obesity (BMI ≥ 30 kg/m²), 28.3% had elevated depressive symptoms (CES-D ≥ 16), and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR) = 2.80, 95% confidence interval (CI): 1.24–6.33). Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02–1.09). Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in the U.S. when designing interventions targeting Latina immigrants. Full article

(This article belongs to the Section Global Health)

17 pages, 1865 KiB

Open AccessArticle

Water Environment Assessment as an Ecological Red Line Management Tool for Marine Wetland Protection

by Yinan Zhang, Chunli Chu, Lei Liu, Shengguo Xu, Xiaoxue Ruan and Meiting Ju

Int. J. Environ. Res. Public Health 2017, 14(8), 870; https://doi.org/10.3390/ijerph14080870 - 2 Aug 2017

Cited by 10 | Viewed by 4919

Abstract

A ‘red line’ was established, identifying an area requiring for ecological protection in Tianjin, China. Within the protected area of the red line area, the Qilihai wetland is an important ecotope with complex ecological functions, although the ecosystem is seriously disturbed due to [...] Read more.

A ‘red line’ was established, identifying an area requiring for ecological protection in Tianjin, China. Within the protected area of the red line area, the Qilihai wetland is an important ecotope with complex ecological functions, although the ecosystem is seriously disturbed due to anthropogenic activities in the surrounding areas. This study assesses the water quality status of the Qilihai wetlands to identify the pollution sources and potential improvements based on the ecological red line policy, to improve and protect the waters of the Qilihai wetlands. An indicator system was established to assess water quality status using single factor evaluation and a comprehensive evaluation method, supported by data from 2010 to 2013. Assessment results show that not all indicators met the requirement of the Environmental Quality Standards for Surface Water (GB3838-2002) and that overall, waters in the Qilihai wetland were seriously polluted. Based on these findings we propose restrictions on all polluting anthropogenic activities in the red line area and implementation of restoration projects to improve water quality. Full article

(This article belongs to the Special Issue A Policy Focused Approach to Public Health and Air, Water and/or Soil Pollution)

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19 pages, 2841 KiB

Open AccessFeature PaperArticle

The Combined Effects of Aircraft and Road Traffic Noise and Aircraft and Railway Noise on Noise Annoyance—An Analysis in the Context of the Joint Research Initiative NORAH

by Jördis Wothge, Christin Belke, Ulrich Möhler, Rainer Guski and Dirk Schreckenberg

Int. J. Environ. Res. Public Health 2017, 14(8), 871; https://doi.org/10.3390/ijerph14080871 - 2 Aug 2017

Cited by 44 | Viewed by 6757

Abstract

The Noise Related Annoyance Cognition and Health (NORAH) research initiative is one of the most extensive studies on the physiological and psychological long-term effects of transportation noise in Europe. It includes research on the quality of life and annoyance as well as cardiovascular [...] Read more.

The Noise Related Annoyance Cognition and Health (NORAH) research initiative is one of the most extensive studies on the physiological and psychological long-term effects of transportation noise in Europe. It includes research on the quality of life and annoyance as well as cardiovascular effects, sleep disturbance, breast cancer, blood pressure, depression and the cognitive development of children. Within the realm of the annoyance module of the study approximately 10,000 residents of the Rhine-Main district were surveyed on the combined effects of transportation noise. This included combined noise from aircraft and road traffic noise (N = 4905), or aircraft and railway noise (N = 4777). Results show that judgment of the total noise annoyance of participants was strongly determined by the sound source which was judged as more annoying (in this case aircraft noise). To a lesser extent, the average sound pressure level of the two present sources was also of relevance. Full article

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

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15 pages, 536 KiB

Open AccessArticle

Effect of Job Strain on Job Burnout, Mental Fatigue and Chronic Diseases among Civil Servants in the Xinjiang Uygur Autonomous Region of China

by Suzhen Guan, Xiadiya Xiaerfuding, Li Ning, Yulong Lian, Yu Jiang, Jiwen Liu and Tzi Bun Ng

Int. J. Environ. Res. Public Health 2017, 14(8), 872; https://doi.org/10.3390/ijerph14080872 - 3 Aug 2017

Cited by 48 | Viewed by 7581

Abstract

Job strain is a major concern in view of its effects among civil servants associated with job burnout, mental fatigue and chronic diseases. The objective of this study was to assess the job strain level among civil servants and examine the effect of [...] Read more.

Job strain is a major concern in view of its effects among civil servants associated with job burnout, mental fatigue and chronic diseases. The objective of this study was to assess the job strain level among civil servants and examine the effect of job strain on job burnout, mental fatigue and the resulting chronic diseases. A cross-sectional study with a representative sample consisting of 5000 civil servants was conducted from March to August 2014. Using a structured questionnaire, the job strain level, job burnout and mental fatigue were measured by using the Personal Strain Questionnaire (PSQ), Maslach Burnout Inventory (MBI) and Multidimensional Fatigue Inventory (MFI-20), respectively. Overall, 33.8% of the civil servants were found to be afflicted with high and moderate job strain. The characteristics of most of the civil servants with a higher-job strain level were as follows: female, Uygur, lower educational level and job title rank, shorter working experience, married marital status, and lower income level. Civil servants suffering from chronic disease mainly had hypertension and coronary heart disease, which accounted for 18.5% of the diseases. Civil servants with a high-job strain level exhibited higher rates of burnout, mental fatigue scores and incidence of chronic diseases. There was a multiple linear regression model composed of three predictor variables in job burnout, which accounted for 45.0% of its occurrence: female gender, lower-income level, higher-job strain in civil servants, the greater the rate of job burnout was. Four factors—male gender, lower-job title rank, higher-job strain, shorter-job tenure of civil servants—explained 25.0% of the mental fatigue model. Binary logistic regression showed that intermediate-rank employees (OR = 0.442, 95% CI: 0.028–0.634; p < 0.05), job tenure of 10–20 years (OR = 0.632, 95% CI: 0.359–0.989; p < 0.05), and low-job strain (OR = 0.657, 95% CI: 0.052–0.698; p < 0.05) were all associated with significantly lower odds of chronic disease. The risk of chronic disease was higher in civil servants with high-job burnout scores and mental fatigue scores compared with civil servants with lower scores (OR = 1.139, 95% CI: 1.012–3.198; OR = 1.697, 95% CI: 1.097–2.962). These data provide evidence for the effects of job strain on job burnout, mental fatigue and chronic diseases among civil servants. Full article

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

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44 pages, 1279 KiB

Open AccessReview

WHO Environmental Noise Guidelines for the European Region: A Systematic Review of Transport Noise Interventions and Their Impacts on Health

by Alan Lex Brown and Irene Van Kamp

Int. J. Environ. Res. Public Health 2017, 14(8), 873; https://doi.org/10.3390/ijerph14080873 - 3 Aug 2017

Cited by 153 | Viewed by 15077

Abstract

This paper describes a systematic review (1980–2014) of evidence on effects of transport noise interventions on human health. The sources are road traffic, railways, and air traffic. Health outcomes include sleep disturbance, annoyance, cognitive impairment of children and cardiovascular diseases. A conceptual framework [...] Read more.

This paper describes a systematic review (1980–2014) of evidence on effects of transport noise interventions on human health. The sources are road traffic, railways, and air traffic. Health outcomes include sleep disturbance, annoyance, cognitive impairment of children and cardiovascular diseases. A conceptual framework to classify noise interventions and health effects was developed. Evidence was thinly spread across source types, outcomes, and intervention types. Further, diverse intervention study designs, methods of analyses, exposure levels, and changes in exposure do not allow a meta-analysis of the association between changes in noise level and health outcomes, and risk of bias in most studies was high. However, 43 individual transport noise intervention studies were examined (33 road traffic; 7 air traffic; 3 rail) as to whether the intervention was associated with a change in health outcome. Results showed that many of the interventions were associated with changes in health outcomes irrespective of the source type, the outcome or intervention type (source, path or infrastructure). For road traffic sources and the annoyance outcome, the expected effect-size can be estimated from an appropriate exposure–response function, though the change in annoyance in most studies was larger than could be expected based on noise level change. Full article

(This article belongs to the Special Issue WHO Noise and Health Evidence Reviews)

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15 pages, 3448 KiB

Open AccessFeature PaperArticle

Regional Assessment of Human Fecal Contamination in Southern California Coastal Drainages

by Yiping Cao, Meredith R. Raith, Paul D. Smith, John F. Griffith, Stephen B. Weisberg, Alexander Schriewer, Andrew Sheldon, Chris Crompton, Geremew G. Amenu, Jason Gregory, Joe Guzman, Kelly D. Goodwin, Laila Othman, Mayela Manasjan, Samuel Choi, Shana Rapoport, Syreeta Steele, Tommy Nguyen and Xueyuan Yu

Int. J. Environ. Res. Public Health 2017, 14(8), 874; https://doi.org/10.3390/ijerph14080874 - 4 Aug 2017

Cited by 21 | Viewed by 5347

Abstract

Host-associated genetic markers that allow for fecal source identification have been used extensively as a diagnostic tool to determine fecal sources within watersheds, but have not been used in routine monitoring to prioritize remediation actions among watersheds. Here, we present a regional assessment [...] Read more.

Host-associated genetic markers that allow for fecal source identification have been used extensively as a diagnostic tool to determine fecal sources within watersheds, but have not been used in routine monitoring to prioritize remediation actions among watersheds. Here, we present a regional assessment of human marker prevalence among drainages that discharge to the U.S. southern California coast. Approximately 50 samples were analyzed for the HF183 human marker from each of 22 southern California coastal drainages under summer dry weather conditions, and another 50 samples were targeted from each of 23 drainages during wet weather. The HF183 marker was ubiquitous, detected in all but two sites in dry weather and at all sites during wet weather. However, there was considerable difference in the extent of human fecal contamination among sites. Similar site ranking was produced regardless of whether the assessment was based on frequency of HF183 detection or site average HF183 concentration. However, site ranking differed greatly between dry and wet weather. Site ranking also differed greatly when based on enterococci, which do not distinguish between pollution sources, vs. HF183, which distinguishes higher risk human fecal sources from other sources, indicating the additional value of the human-associated marker as a routine monitoring tool. Full article

(This article belongs to the Special Issue Emerging Aquatic Microbial and Chemical Contaminants of Concern and Their Impact on Human Health)

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12 pages, 4056 KiB

Open AccessArticle

Unintentional Child and Adolescent Drowning Mortality from 2000 to 2013 in 21 Countries: Analysis of the WHO Mortality Database

by Yue Wu, Yun Huang, David C. Schwebel and Guoqing Hu

Int. J. Environ. Res. Public Health 2017, 14(8), 875; https://doi.org/10.3390/ijerph14080875 - 4 Aug 2017

Cited by 32 | Viewed by 7611

Abstract

Limited research considers change over time for drowning mortality among individuals under 20 years of age, or the sub-cause (method) of those drownings. We assessed changes in under-20 drowning mortality from 2000 to 2013 among 21 countries. Age-standardized drowning mortality data were obtained [...] Read more.

Limited research considers change over time for drowning mortality among individuals under 20 years of age, or the sub-cause (method) of those drownings. We assessed changes in under-20 drowning mortality from 2000 to 2013 among 21 countries. Age-standardized drowning mortality data were obtained through the World Health Organization (WHO) Mortality Database. Twenty of the 21 included countries experienced a reduction in under-20 drowning mortality rate between 2000 and 2013, with decreases ranging from −80 to −13%. Detailed analysis by drowning method presented large variations in the cause of drowning across countries. Data were missing due to unspecified methods in some countries but, when known, drowning in natural bodies of water was the primary cause of child and adolescent drowning in Poland (56–92%), Cuba (53–81%), Venezuela (43–56%), and Japan (39–60%), while drowning in swimming pools and bathtubs was common in the United States (26–37%) and Japan (28–39%), respectively. We recommend efforts to raise the quality of drowning death reporting systems and discuss prevention strategies that may reduce child and adolescent drowning risk, both in individual countries and globally. Full article

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

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2 pages, 238 KiB

Open AccessComment

Comment on Montagna, et al. Evaluation of Legionella air contamination in healthcare facilities by different sampling methods: An Italian multicenter study. Int. J. Environ. Res. Public Health 2017, 14, 670

by Samuel Collins and Jimmy Walker

Int. J. Environ. Res. Public Health 2017, 14(8), 876; https://doi.org/10.3390/ijerph14080876 - 4 Aug 2017

Cited by 2 | Viewed by 3093

Abstract

In their recent article, Montagna et al. describe a multicenter study investigating the presence of Legionella in water and air samples of Italian healthcare facilities [1].[...] Full article

12 pages, 715 KiB

Open AccessArticle

Type and Context of Alcohol-Related Injury among Patients Presenting to Emergency Departments in a Caribbean Country

by Sandra D. Reid and Jannel Gentius

Int. J. Environ. Res. Public Health 2017, 14(8), 877; https://doi.org/10.3390/ijerph14080877 - 4 Aug 2017

Cited by 5 | Viewed by 4169

Abstract

There is an association between alcohol consumption and injuries in Latin America and the Caribbean. This cross-sectional study explores the socio-contextual factors of alcohol-related injuries in Trinidad and Tobago. Data on drinking patterns, injury type, drinking context prior to injury, and demographics were [...] Read more.

There is an association between alcohol consumption and injuries in Latin America and the Caribbean. This cross-sectional study explores the socio-contextual factors of alcohol-related injuries in Trinidad and Tobago. Data on drinking patterns, injury type, drinking context prior to injury, and demographics were collected from patients presenting with injuries to the Emergency Departments (ED) of four hospitals. Findings show that 20.6% of patients had consumed alcohol, mainly beer, in the 6 h before injury. More than half were drinking at home (27%), or someone else’s home (27%). Injury most commonly occurred outdoors (36%) while in transit. Alcohol-related injuries occurred mainly because of falling or tripping (31.7%); these patients recorded the highest mean alcohol consumption prior to injury. Most persons who fell (50%) did so at home. Findings highlight the previously unreported significant risk of non-drivers sustaining injures through falling and tripping because of heavy alcohol use. Current interventions to reduce alcohol-related injury have focused on drink driving but there is a need for interventions targeting pedestrians and those who drink at home. A comprehensive multi-component approach including secondary prevention interventions in the medical setting, community educational interventions, enforcement of current legislative policies concerning the sale of alcohol, and policy initiatives surrounding road safety and alcohol outlet density should be implemented. Full article

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

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14 pages, 819 KiB

Open AccessArticle

Program Development and Effectiveness of Workplace Health Promotion Program for Preventing Metabolic Syndrome among Office Workers

by Hosihn Ryu, Jiyeon Jung, Jeonghyun Cho and Dal Lae Chin

Int. J. Environ. Res. Public Health 2017, 14(8), 878; https://doi.org/10.3390/ijerph14080878 - 4 Aug 2017

Cited by 21 | Viewed by 6527

Abstract

This paper aims to develop and analyze the effects of a socio-ecological model-based intervention program for preventing metabolic syndrome (MetS) among office workers. The intervention program was developed using regular health examinations, a “health behavior and need” assessment survey among workers, and a [...] Read more.

This paper aims to develop and analyze the effects of a socio-ecological model-based intervention program for preventing metabolic syndrome (MetS) among office workers. The intervention program was developed using regular health examinations, a “health behavior and need” assessment survey among workers, and a focus group study. According to the type of intervention, subjects took part in three groups: health education via an intranet-based web magazine (Group 1), self-monitoring with the U-health system (Group 2), and the target population who received intensive intervention (Group 3). The intervention programs of Group 1 and Group 2, which relied on voluntary participation, did not show significant effects. In Group 3, which relied on targeted and proactive programs, showed a decrease in waist circumference and in fasting glucose (p < 0.001). The MetS score in both males (−0.61 ± 3.35 versus −2.32 ± 2.55, p = 0.001) and females (−3.99 ± 2.05 versus −5.50 ± 2.19, p = 0.028) also showed a statistically significant decrease. In light of the effectiveness of the intensive intervention strategy for metabolic syndrome prevention among workers used in this study, companies should establish targeted and proactive health care programs rather than providing a healthcare system that is dependent on an individual’s voluntary participation. Full article

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

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15 pages, 296 KiB

Open AccessArticle

Workplace Violence toward Physicians and Nurses: Prevalence and Correlates in Macau

by Teris Cheung, Paul H. Lee and Paul S. F. Yip

Int. J. Environ. Res. Public Health 2017, 14(8), 879; https://doi.org/10.3390/ijerph14080879 - 4 Aug 2017

Cited by 87 | Viewed by 9868

Abstract

This paper sets out to estimate the prevalence of workplace violence in relation to socio-demographic characteristics of physicians and nurses working in healthcare settings in Macau. Background: Concerted efforts worldwide to reduce workplace violence (WPV) have not yet removed medical-related professionals from [...] Read more.

This paper sets out to estimate the prevalence of workplace violence in relation to socio-demographic characteristics of physicians and nurses working in healthcare settings in Macau. Background: Concerted efforts worldwide to reduce workplace violence (WPV) have not yet removed medical-related professionals from the threat of patients’, family members’, and colleagues’ physical and other assaults in Southeast Asia. Methods: The study employs a cross-sectional design to estimate the prevalence and examines the socio-economic and psychological correlates of WPV among medical doctors and nurses in Macau. The data collection period spanned from August to December 2014. Multiple logistic regression examines the prevalence rates of WPV and its associated factors in doctors and nurses. Results: A total of 107 doctors (14.9%) and 613 nurses (85.1%) participated in the study; 57.2% had suffered WPV in the preceding year. The most common forms of workplace violence were verbal abuse (53.4%), physical assault (16.1%), bullying/harassment (14.2%), sexual harassment (4.6%), and racial harassment (2.6%). Most violence was perpetrated by patients and their relatives, colleagues, and supervisors. Conclusions: WPV remains a significant concern in healthcare settings in Macau. Macau’s local health authority should consider putting in place a raft of zero-tolerance policies designed to prevent it. Full article

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

9 pages, 4708 KiB

Open AccessArticle

Gingival Pigmentation Affected by Smoking among Different Age Groups: A Quantitative Analysis of Gingival Pigmentation Using Clinical Oral Photographs

by Tomotaka Kato, Shinsuke Mizutani, Hiroya Takiuchi, Seiichi Sugiyama, Takashi Hanioka and Toru Naito

Int. J. Environ. Res. Public Health 2017, 14(8), 880; https://doi.org/10.3390/ijerph14080880 - 4 Aug 2017

Cited by 5 | Viewed by 6868

Abstract

The presence of any age-related differences in gingival pigmentation associated with smoking, particularly in a young population, remains to be fully investigated. The purpose of this study was to determine the age-related differences in smoking gingival pigmentation. Gingival pigmentation was analyzed using the [...] Read more.

The presence of any age-related differences in gingival pigmentation associated with smoking, particularly in a young population, remains to be fully investigated. The purpose of this study was to determine the age-related differences in smoking gingival pigmentation. Gingival pigmentation was analyzed using the gingival melanosis record (GMR) and Hedin’s classification with frontal oral photographs taken at 16 dental offices in Japan. Participants were categorized into 10-year age groups, and their baseline photographs were compared. In addition, to evaluate the effect of smoking cessation on gingival pigmentation, subjects were divided into a former smoker group (stopped smoking) and current smoker group. A total of 259 patients 19 to 79 years of age were analyzed. People in their 30s showed the most widespread gingival pigmentation. In addition, subjects in their 20s showed a weak effect of smoking cessation on gingival pigmentation. These findings suggested that the gingival pigmentation induced by smoking was more remarkable in young people than in middle-aged people. This information may be useful for anti-smoking education, especially among young populations with a high affinity for smoking. Full article

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

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11 pages, 307 KiB

Open AccessArticle

Comparison of Metabolic Syndrome Indicators in Two Samples of Central and South Americans Living in the Washington, D.C. Area in 1993–1994 and 2008–2009: Secular Changes in Metabolic Syndrome in Hispanics

by Regina Gill, Robert T. Jackson, Marguerite Duane, Allison Miner and Saira A. Khan

Int. J. Environ. Res. Public Health 2017, 14(8), 881; https://doi.org/10.3390/ijerph14080881 - 5 Aug 2017

Cited by 1 | Viewed by 3300

Abstract

The Central and South American populations are growing rapidly in the US; however, there is a paucity of information about their health status. Objectives: we estimated the prevalence of metabolic syndrome (MetS) and its individual components from two cohorts of Central and [...] Read more.

The Central and South American populations are growing rapidly in the US; however, there is a paucity of information about their health status. Objectives: we estimated the prevalence of metabolic syndrome (MetS) and its individual components from two cohorts of Central and South Americans. Methods: This cross-sectional, medical record extraction survey sampled 1641 adults from a Washington, D.C clinic. A questionnaire was used to collect socio-demographic, medical history, anthropometric, biochemical, and clinical data. Results: among the 1993–1994 cohort, the MetS prevalence was 19.7%. The most prevalent MetS components were low high-density lipoprotein (HDL) cholesterol (40.4% men and 51.3% women), elevated triglycerides (40.9% men and 33.1% women), and high body mass index (BMI) ≥ 25 kg/m² (27.6% men and 36.6% women). The overall prevalence of MetS in the 2008–2009 cohort was 28%. The most common abnormal metabolic indicator was an elevated BMI ≥ 25 kg/m² (75.6%). 43.2% of men and 50.7% of women had HDL levels below normal, while the prevalence of hypertriglyceridemia was 46.5% and 32.5% for men and women, respectively. Conclusion: the prevalence of MetS was significantly greater in 2008–2009 compared with 1993–1994 (p ≤ 0.05). Dyslipidemia and high BMI have increased. Although similar components were identified in both the 1993–1994 and 2008–2009 study populations, the risks of MetS have increased over time. Full article

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

26 pages, 5633 KiB

Open AccessArticle

A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden

by Ulrik Sidenius, Patrik Karlsson Nyed, Victoria Linn Lygum and Ulrika K. Stigsdotter

Int. J. Environ. Res. Public Health 2017, 14(8), 882; https://doi.org/10.3390/ijerph14080882 - 5 Aug 2017

Cited by 29 | Viewed by 7748

Abstract

The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a [...] Read more.

The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients’ health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health) indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases. Full article

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

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12 pages, 2634 KiB

Open AccessArticle

Predicting Urban Medical Services Demand in China: An Improved Grey Markov Chain Model by Taylor Approximation

by Jinli Duan, Feng Jiao, Qishan Zhang and Zhibin Lin

Int. J. Environ. Res. Public Health 2017, 14(8), 883; https://doi.org/10.3390/ijerph14080883 - 6 Aug 2017

Cited by 18 | Viewed by 4928

Abstract

The sharp increase of the aging population has raised the pressure on the current limited medical resources in China. To better allocate resources, a more accurate prediction on medical service demand is very urgently needed. This study aims to improve the prediction on [...] Read more.

The sharp increase of the aging population has raised the pressure on the current limited medical resources in China. To better allocate resources, a more accurate prediction on medical service demand is very urgently needed. This study aims to improve the prediction on medical services demand in China. To achieve this aim, the study combines Taylor Approximation into the Grey Markov Chain model, and develops a new model named Taylor-Markov Chain GM (1,1) (T-MCGM (1,1)). The new model has been tested by adopting the historical data, which includes the medical service on treatment of diabetes, heart disease, and cerebrovascular disease from 1997 to 2015 in China. The model provides a predication on medical service demand of these three types of disease up to 2022. The results reveal an enormous growth of urban medical service demand in the future. The findings provide practical implications for the Health Administrative Department to allocate medical resources, and help hospitals to manage investments on medical facilities. Full article

(This article belongs to the Section Health Economics)

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10 pages, 287 KiB

Open AccessArticle

Is Living near Healthier Food Stores Associated with Better Food Intake in Regional Australia?

by Hamid Moayyed, Bridget Kelly, Xiaoqi Feng and Victoria Flood

Int. J. Environ. Res. Public Health 2017, 14(8), 884; https://doi.org/10.3390/ijerph14080884 - 7 Aug 2017

Cited by 34 | Viewed by 5567

Abstract

High prevalence of obesity and non-communicable diseases is a global public health problem, in which the quality of food environments is thought to play an important role. Current scientific evidence is not consistent regarding the impact of food environments on diet. The relationship [...] Read more.

High prevalence of obesity and non-communicable diseases is a global public health problem, in which the quality of food environments is thought to play an important role. Current scientific evidence is not consistent regarding the impact of food environments on diet. The relationship between local food environments and diet quality was assessed across 10 Australian suburbs, using Australian-based indices devised to measure the two parameters. Data of dietary habits from the participants was gathered using a short questionnaire. The suburbs’ Food Environment Score (higher being healthier) was associated with higher consumption of fruit (χ² (40, 230) = 58.8, p = 0.04), and vegetables (χ² (40, 230) = 81.3, p = 0.03). The Food Environment Score identified a significant positive correlation with four of the diet scores: individual total diet score (r_s = 0.30, p < 0.01), fruit and vegetable score (r_s = 0.43, p < 0.01), sugary drink score (r_s = 0.13, p < 0.05), and discretionary food score (r_s = 0.15, p < 0.05). Moreover, the suburbs’ RFEI (Retail Food Environment Index, higher being unhealthier) showed a significant association with higher consumption of salty snacks (χ² (24, 230) = 43.9, p = 0.04). Food environments dominated by food outlets considered as ‘healthier’ were associated with healthier population food intakes, as indicated by a higher consumption of fruit, vegetables, and water, as well as a lower consumption of junk food, salty snacks, and sugary drinks. This association suggests that healthier diet quality is associated with healthier food environments in regional Australia. Full article

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

19 pages, 9485 KiB

Open AccessArticle

The Earth’s Population Can Reach 14 Billion in the 23rd Century without Significant Adverse Effects on Survivability

by Vladimir F. Krapivin, Costas A. Varotsos and Vladimir Yu. Soldatov

Int. J. Environ. Res. Public Health 2017, 14(8), 885; https://doi.org/10.3390/ijerph14080885 - 7 Aug 2017

Cited by 21 | Viewed by 4909

Abstract

This paper presents the results obtained from the study of the sustainable state between nature and human society on a global scale, focusing on the most critical interactions between the natural and anthropogenic processes. Apart from the conventional global models, the basic tool [...] Read more.

This paper presents the results obtained from the study of the sustainable state between nature and human society on a global scale, focusing on the most critical interactions between the natural and anthropogenic processes. Apart from the conventional global models, the basic tool employed herein is the newly proposed complex model entitled “nature-society system (NSS) model”, through which a reliable modeling of the processes taking place in the global climate-nature-society system (CNSS) is achieved. This universal tool is mainly based on the information technology that allows the adaptive conformance of the parametric and functional space of this model. The structure of this model includes the global biogeochemical cycles, the hydrological cycle, the demographic processes and a simple climate model. In this model, the survivability indicator is used as a criterion for the survival of humanity, which defines a trend in the dynamics of the total biomass of the biosphere, taking into account the trends of the biocomplexity dynamics of the land and hydrosphere ecosystems. It should be stressed that there are no other complex global models comparable to those of the CNSS model developed here. The potential of this global model is demonstrated through specific examples in which the classification of the terrestrial ecosystem is accomplished by separating 30 soil-plant formations for geographic pixels 4° × 5°. In addition, humanity is considered to be represented by three groups of economic development status (high, transition, developing) and the World Ocean is parameterized by three latitude zones (low, middle, high). The modelling results obtained show the dynamics of the CNSS at the beginning of the 23rd century, according to which the world population can reach the level of 14 billion without the occurrence of major negative impacts. Full article

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

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12 pages, 1277 KiB

Open AccessArticle

Health Risks and Contamination Levels of Heavy Metals in Dusts from Parks and Squares of an Industrial City in Semi-Arid Area of China

by Xiufeng Han, Xinwei Lu, Qinggeletu and Yongfu Wu

Int. J. Environ. Res. Public Health 2017, 14(8), 886; https://doi.org/10.3390/ijerph14080886 - 7 Aug 2017

Cited by 92 | Viewed by 6136

Abstract

The contamination characteristics and health risk of barium (Ba), cobalt (Co), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), vanadium (V), zinc (Zn), arsenic (As), mercury (Hg), and cadmium (Cd) in samples of dust gathered from squares and parks of Baotou [...] Read more.

The contamination characteristics and health risk of barium (Ba), cobalt (Co), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), vanadium (V), zinc (Zn), arsenic (As), mercury (Hg), and cadmium (Cd) in samples of dust gathered from squares and parks of Baotou city, an industrial city situated in a semi-arid location of the northwest China were investigated. The contents of Ba, Co, Cr, Cu, Mn, Ni, V, Pb, and Zn in the collected dust samples were determined using X-ray fluorescence spectrometry, while the contents of As and Hg in the dust were investigated by use of the ICP-MS. Further, cadmium was quantified through the atomic absorption spectrometry. Levels of contamination of heavy metals analyzed in the dust samples were evaluated using the Geo-Accumulation index (I_geo) as well as through a Pollution Load Index (PLI). Their health risks to children and adults were evaluated based on the US EPA model of health risk. The findings portrayed that the mean concentrations of Ba, Co Cr, Cu, Pb, V, Cd, and Hg were elevated as compared with their local soil background values. Mean values of I_geo illustrate the order of Co > Cr> Cd > Hg > Pb > Cu > Ba > V > Ni > Mn > Zn > As. It was evident that dusts from the parks and squares were “unpolluted” to “moderately polluted”. Assessment of health risk depicts that ingestion is the foremost route of exposure in regard to the heavy metals, then the dermal adsorption follows. Hg exposure from dust might also set impending health threats to children. Besides, the cancer risks of Co, Cr, Ni, Cd, and As are considered to be within the presently tolerable range. Full article

(This article belongs to the Collection Environmental Risk Assessment)

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12 pages, 335 KiB

Open AccessArticle

Bullying Behaviors among Macanese Adolescents—Association with Psychosocial Variables

by Xue Weng, Wing Hong Chui and Liu Liu

Int. J. Environ. Res. Public Health 2017, 14(8), 887; https://doi.org/10.3390/ijerph14080887 - 7 Aug 2017

Cited by 42 | Viewed by 6636

Abstract

Bullying is a widespread public health problem among school students. Using a large sample of Macanese school adolescents, the present study examines psychosocial conditions and demographic characteristics in discriminating the following four subgroups of students: victims; bullies; bully-victims; and a comparison group of [...] Read more.

Bullying is a widespread public health problem among school students. Using a large sample of Macanese school adolescents, the present study examines psychosocial conditions and demographic characteristics in discriminating the following four subgroups of students: victims; bullies; bully-victims; and a comparison group of adolescents. Participants included 2288 adolescents from 13 primary and secondary schools in Macau whose ages ranged from 10 to 20 years. Statistical results revealed significant differences among the groups and indicated that adolescents who are involved in school bullying experience worse psychosocial adjustment. Specifically, among the four subgroups of students, bully-victims reported the strongest feelings of anxiety, depression, and negative affectivity, and expressed the lowest satisfaction with life. Compared with students who were not involved in bullying and victimization, bullies experienced more anxiety and depression and victims had lower levels of satisfaction with life. In addition, boys were more likely to engage in bullying behaviors and younger students had a greater probability of being victimized by their peers at school. Implications for future research and practice on bullying perpetration and the prevention of peer victimization are discussed. Full article

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

19 pages, 334 KiB

Open AccessArticle

Adversity in University: Cyberbullying and Its Impacts on Students, Faculty and Administrators

by Wanda Cassidy, Chantal Faucher and Margaret Jackson

Int. J. Environ. Res. Public Health 2017, 14(8), 888; https://doi.org/10.3390/ijerph14080888 - 8 Aug 2017

Cited by 51 | Viewed by 10260

Abstract

This paper offers a qualitative thematic analysis of the impacts of cyberbullying on post-secondary students, faculty, and administrators from four participating Canadian universities. These findings were drawn from data obtained from online surveys of students and faculty, student focus groups, and semi-structured interviews [...] Read more.

This paper offers a qualitative thematic analysis of the impacts of cyberbullying on post-secondary students, faculty, and administrators from four participating Canadian universities. These findings were drawn from data obtained from online surveys of students and faculty, student focus groups, and semi-structured interviews with faculty members and university administrators. The key themes discussed include: negative affect, impacts on mental and physical health, perceptions of self, impacts regarding one’s personal and professional lives, concern for one’s safety, and the impact of authorities’ (non) response. Students reported primarily being cyberbullied by other students, while faculty were cyberbullied by both students and colleagues. Although students and faculty represent different age levels and statuses at the university, both groups reported similar impacts and similar frustrations at finding solutions, especially when their situations were reported to authorities. It is important that universities pay greater attention to developing effective research-based cyberbullying policies and to work towards fostering a more respectful online campus culture. Full article

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

17 pages, 326 KiB

Open AccessArticle

Estimated Maternal Pesticide Exposure from Drinking Water and Heart Defects in Offspring

by Jihye Kim, Michael D. Swartz, Peter H. Langlois, Paul A. Romitti, Peter Weyer, Laura E. Mitchell, Thomas J. Luben, Anushuya Ramakrishnan, Sadia Malik, Philip J. Lupo, Marcia L. Feldkamp, Robert E. Meyer, Jennifer J. Winston, Jennita Reefhuis, Sarah J. Blossom, Erin Bell, A. J. Agopian and The National Birth Defects Prevention Study

Int. J. Environ. Res. Public Health 2017, 14(8), 889; https://doi.org/10.3390/ijerph14080889 - 8 Aug 2017

Cited by 15 | Viewed by 5679

Abstract

Our objective was to examine the relationship between estimated maternal exposure to pesticides in public drinking water and the risk of congenital heart defects (CHD). We used mixed-effects logistic regression to analyze data from 18,291 nonsyndromic cases with heart defects from the Texas [...] Read more.

Our objective was to examine the relationship between estimated maternal exposure to pesticides in public drinking water and the risk of congenital heart defects (CHD). We used mixed-effects logistic regression to analyze data from 18,291 nonsyndromic cases with heart defects from the Texas Birth Defects Registry and 4414 randomly-selected controls delivered in Texas from 1999 through 2005. Water district-level pesticide exposure was estimated by linking each maternal residential address to the corresponding public water supply district’s measured atrazine levels. We repeated analyses among independent subjects from the National Birth Defects Prevention Study (NBDPS) (1620 nonsyndromic cases with heart defects and 1335 controls delivered from 1999 through 2005). No positive associations were observed between high versus low atrazine level and eight CHD subtypes or all included heart defects combined. These findings should be interpreted with caution, in light of potential misclassification and relatively large proportions of subjects with missing atrazine data. Thus, more consistent and complete monitoring and reporting of drinking water contaminants will aid in better understanding the relationships between pesticide water contaminants and birth defects. Full article

(This article belongs to the Section Environmental Health)

9 pages, 941 KiB

Open AccessArticle

Cost-Effectiveness of the Strategies to Reduce the Incidence of Dengue in Colima, México

by Oliver Mendoza-Cano, Carlos Moisés Hernandez-Suarez, Xochitl Trujillo, Héctor Ochoa Diaz-Lopez, Agustin Lugo-Radillo, Francisco Espinoza-Gomez, Miriam De la Cruz-Ruiz, Ramón Alberto Sánchez-Piña and Efrén Murillo-Zamora

Int. J. Environ. Res. Public Health 2017, 14(8), 890; https://doi.org/10.3390/ijerph14080890 - 8 Aug 2017

Cited by 11 | Viewed by 6007

Abstract

Dengue fever is considered to be one of the most important arboviral diseases globally. Unsuccessful vector-control strategies might be due to the lack of sustainable community participation. The state of Colima, located in the Western region of Mexico, is a dengue-endemic area despite [...] Read more.

Dengue fever is considered to be one of the most important arboviral diseases globally. Unsuccessful vector-control strategies might be due to the lack of sustainable community participation. The state of Colima, located in the Western region of Mexico, is a dengue-endemic area despite vector-control activities implemented, which may be due to an insufficient health economic analysis of these interventions. A randomized controlled community trial took place in five urban municipalities where 24 clusters were included. The study groups (n = 4) included an intervention to improve the community participation in vector control (A), ultra-low volume (ULV) spraying (B), both interventions (AB), and a control group. The main outcomes investigated were dengue cumulative incidence, disability-adjusted life years (DALYs), and the direct costs per intervention. The cumulative incidence of dengue was 17.4%, A; 14.3%, B; 14.4%, AB; and 30.2% in the control group. The highest efficiency and effectiveness were observed in group B (0.526 and 6.97, respectively) and intervention A was more likely to be cost-effective ($3952.84 per DALY avoided) followed by intervention B ($4472.09 per DALY avoided). Our findings suggest that efforts to improve community participation in vector control and ULV-spraying alone are cost-effective and may be useful to reduce the vector density and dengue incidence. Full article

(This article belongs to the Special Issue Mosquito Control Innovations into The 21st Century)

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11 pages, 800 KiB

Open AccessArticle

Diurnal Temperature Range in Relation to Daily Mortality and Years of Life Lost in Wuhan, China

by Yunquan Zhang, Chuanhua Yu, Jin Yang, Lan Zhang and Fangfang Cui

Int. J. Environ. Res. Public Health 2017, 14(8), 891; https://doi.org/10.3390/ijerph14080891 - 8 Aug 2017

Cited by 40 | Viewed by 6048

Abstract

Diurnal temperature range (DTR) is an important meteorological indicator associated with global climate change, and has been linked with mortality and morbidity in previous studies. To date, however, little evidence has been available regarding the association of DTR with years of life lost [...] Read more.

Diurnal temperature range (DTR) is an important meteorological indicator associated with global climate change, and has been linked with mortality and morbidity in previous studies. To date, however, little evidence has been available regarding the association of DTR with years of life lost (YLL). This study aimed to evaluate the DTR-related burden on both YLL and mortality. We collected individual records of all registered deaths and daily meteorological data in Wuhan, central China, between 2009 and 2012. For the whole population, every 1 °C increase in DTR at a lag of 0–1 days was associated with an increase of 0.65% (95% CI: 0.08–1.23) and 1.42 years (−0.88–3.72) for mortality and YLL due to non-accidental deaths, respectively. Relatively stronger DTR-mortality/YLL associations were found for cardiovascular deaths. Subgroup analyses (stratified by gender, age, and education level) showed that females, the elderly (75+ years old), and those with higher education attainment (7+ years) suffered more significantly from both increased YLL and mortality due to large DTR. Our study added additional evidence that short-term exposure to large DTR was associated with increased burden of premature death using both mortality incidence and YLL. Full article

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

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20 pages, 4394 KiB

Open AccessArticle

Spatio-Temporal Distribution of Vector-Host Contact (VHC) Ratios and Ecological Niche Modeling of the West Nile Virus Mosquito Vector, Culex quinquefasciatus, in the City of New Orleans, LA, USA

by Mohamed F. Sallam, Sarah R. Michaels, Claudia Riegel, Roberto M. Pereira, Wayne Zipperer, B. Graeme Lockaby and Philip G. Koehler

Int. J. Environ. Res. Public Health 2017, 14(8), 892; https://doi.org/10.3390/ijerph14080892 - 8 Aug 2017

Cited by 25 | Viewed by 7245

Abstract

The consistent sporadic transmission of West Nile Virus (WNV) in the city of New Orleans justifies the need for distribution risk maps highlighting human risk of mosquito bites. We modeled the influence of biophysical and socioeconomic metrics on the spatio-temporal distributions of presence/vector-host [...] Read more.

The consistent sporadic transmission of West Nile Virus (WNV) in the city of New Orleans justifies the need for distribution risk maps highlighting human risk of mosquito bites. We modeled the influence of biophysical and socioeconomic metrics on the spatio-temporal distributions of presence/vector-host contact (VHC) ratios of WNV vector, Culex quinquefasciatus, within their flight range. Biophysical and socioeconomic data were extracted within 5-km buffer radii around sampling localities of gravid female Culex quinquefasciatus. The spatio-temporal correlations between VHC data and 33 variables, including climate, land use-land cover (LULC), socioeconomic, and land surface terrain were analyzed using stepwise linear regression models (RM). Using MaxEnt, we developed a distribution model using the correlated predicting variables. Only 12 factors showed significant correlations with spatial distribution of VHC ratios (R² = 81.62, p < 0.01). Non-forested wetland (NFWL), tree density (TD) and residential-urban (RU) settings demonstrated the strongest relationship. The VHC ratios showed monthly environmental resilience in terms of number and type of influential factors. The highest prediction power of RU and other urban and built up land (OUBL), was demonstrated during May–August. This association was positively correlated with the onset of the mosquito WNV infection rate during June. These findings were confirmed by the Jackknife analysis in MaxEnt and independently collected field validation points. The spatial and temporal correlations of VHC ratios and their response to the predicting variables are discussed. Full article

(This article belongs to the Special Issue Mosquito Control Innovations into The 21st Century)

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11 pages, 349 KiB

Open AccessArticle

The Relationship between Lifestyle Factors and Body Compositionin Young Adults

by Lovro Štefan, Marko Čule, Ivan Milinović, Dora Juranko and Goran Sporiš

Int. J. Environ. Res. Public Health 2017, 14(8), 893; https://doi.org/10.3390/ijerph14080893 - 8 Aug 2017

Cited by 37 | Viewed by 5391

Abstract

Background: Little is known of how lifestyle factors might influence on body composition parameters in young adults from Croatia. The main purpose of the present study was to investigate the relationship between the lifestyle factors and body composition in young adults. Methods: In [...] Read more.

Background: Little is known of how lifestyle factors might influence on body composition parameters in young adults from Croatia. The main purpose of the present study was to investigate the relationship between the lifestyle factors and body composition in young adults. Methods: In this cross-sectional study, participants were 271 university students (59.0% of women). Body composition was measured by using bioelectric impendance analysis (BIA). Blood pressure and heart rate were measured according to standardized protocol and Mediterranean diet adherence (MD), physical activity (PA) and psychological distress (PD) were assessed with validated questionnaires. Results: Self-rated health (SRH) and PA were inversely associated with weight, body-mass index (BMI), fat-mass percentage and blood pressure in men and with weight, BMI, fat-mass percentage and heart rate in women. Higher levels of SRH and PA were positively associated with fat-free mass percentage in both men and women. Smoking was positively associatedwith BMI and fat-mass percentage in women and with heart rate in men. Alcohol consumption was positively associated with weight and BMI in women and fat-mass percentage and heart rate in men, yet inversely associated with fat-free mass percentage only in men. PD was positively associated with weight and blood pressure in men and with BMI, fat-mass percentage and blood pressure in women. Conclusions: Our study shows that higher levels of SRH, MD and PA are related with healthy body composition parameters in young adults. Special interventions and policies that enhance PA and MD and decrease substance use and misuse (SUM) and PD should be implemented within the university school systems. Full article

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

9 pages, 864 KiB

Open AccessArticle

How Do Countries’ Health Information Systems Perform in Assessing Asylum Seekers’ Health Situation? Developing a Health Information Assessment Tool on Asylum Seekers (HIATUS) and Piloting It in Two European Countries

by Kayvan Bozorgmehr, Simone Goosen, Amir Mohsenpour, Anna Kuehne, Oliver Razum and Anton E. Kunst

Int. J. Environ. Res. Public Health 2017, 14(8), 894; https://doi.org/10.3390/ijerph14080894 - 8 Aug 2017

Cited by 15 | Viewed by 5928

Abstract

Background: Accurate data on the health status, health behaviour and access to health care of asylum seekers is essential, but such data is lacking in many European countries. We hence aimed to: (a) develop and pilot-test an instrument that can be used to [...] Read more.

Background: Accurate data on the health status, health behaviour and access to health care of asylum seekers is essential, but such data is lacking in many European countries. We hence aimed to: (a) develop and pilot-test an instrument that can be used to compare and benchmark the country health information systems (HIS) with respect to the ability to assess the health status and health care situation of asylum seekers and (b) present the results of that pilot for The Netherlands (NL) and Germany (DE). Materials and Methods: Reviewing and adapting existing tools, we developed a Health Information Assessment Tool on Asylum Seekers (HIATUS) with 50 items to assess HIS performance across three dimensions: (1) availability and detail of data across potential data sources; (2) HIS resources and monitoring capacity; (3) general coverage and timeliness of publications on selected indicators. We piloted HIATUS by applying the tool to the HIS in DE and NL. Two raters per country independently assessed the performance of country HIS and the inter-rater reliability was analysed by Pearson’s rho and the intra-class correlation (ICC). We then applied a consensus-based group rating to obtain the final ratings which were transformed into a weighted summary score (range: 0–97). We assessed HIS performance by calculating total and domain-specific HIATUS scores by country as well as absolute and relative gaps in scores within and between countries. Results: In the independent rating, Pearson’s rho was 0.14 (NL) and 0.30 (DE), the ICC yielded an estimated reliability of 0.29 (NL) and 0.83 (DE) respectively. In the final consensus-based rating, the total HIATUS score was 47 in NL and 15 in DE, translating into a relative gap in HIS capacity of 52% (NL) and 85% (DE) respectively. Shortfalls in HIS capacity in both countries relate to the areas of HIS coordination, planning and policies, and to limited coverage of specific indicators such as self-reported health, mental health, socio-economic status and health behaviour. The relative gap in the HIATUS component “data sources and availability” was much higher in Germany (92%) than in NL (28%). Conclusions: The standardised tool (HIATUS) proved useful for assessment of country HIS performance in two countries by consensus-based rating. HIATUS revealed substantial limitations in HIS capacity to assess the health situation of asylum seekers in both countries. The tool allowed for between-country comparisons, revealing that capacities were lower in DE relative to NL. Monitoring and benchmarking gaps in HIS capacity in further European countries can help to strengthen HIS in the future. Full article

(This article belongs to the Special Issue Refugee Health)

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19 pages, 3735 KiB

Open AccessArticle

Removal of Arsenic (V) from Aqueous Solutions Using Chitosan–Red Scoria and Chitosan–Pumice Blends

by Tsegaye Girma Asere, Stein Mincke, Jeriffa De Clercq, Kim Verbeken, Dejene A. Tessema, Fekadu Fufa, Christian V. Stevens and Gijs Du Laing

Int. J. Environ. Res. Public Health 2017, 14(8), 895; https://doi.org/10.3390/ijerph14080895 - 9 Aug 2017

Cited by 36 | Viewed by 6327

Abstract

In different regions across the globe, elevated arsenic contents in the groundwater constitute a major health problem. In this work, a biopolymer chitosan has been blended with volcanic rocks (red scoria and pumice) for arsenic (V) removal. The effect of three blending ratios [...] Read more.

In different regions across the globe, elevated arsenic contents in the groundwater constitute a major health problem. In this work, a biopolymer chitosan has been blended with volcanic rocks (red scoria and pumice) for arsenic (V) removal. The effect of three blending ratios of chitosan and volcanic rocks (1:2, 1:5 and 1:10) on arsenic removal has been studied. The optimal blending ratio was 1:5 (chitosan: volcanic rocks) with maximum adsorption capacity of 0.72 mg/g and 0.71 mg/g for chitosan: red scoria (Ch–Rs) and chitosan: pumice (Ch–Pu), respectively. The experimental adsorption data fitted well a Langmuir isotherm (R² > 0.99) and followed pseudo-second-order kinetics. The high stability of the materials and their high arsenic (V) removal efficiency (~93%) in a wide pH range (4 to 10) are useful for real field applications. Moreover, the blends could be regenerated using 0.05 M NaOH and used for several cycles without losing their original arsenic removal efficiency. The results of the study demonstrate that chitosan-volcanic rock blends should be further explored as a potential sustainable solution for removal of arsenic (V) from water. Full article

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

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10 pages, 331 KiB

Open AccessArticle

The Prevalence of Fetal Alcohol Syndrome and Its Impact on a Child’s Classroom Performance: A Case Study of a Rural South African School

by Melissa Lubbe, Corné Van Walbeek and Nicole Vellios

Int. J. Environ. Res. Public Health 2017, 14(8), 896; https://doi.org/10.3390/ijerph14080896 - 9 Aug 2017

Cited by 9 | Viewed by 8145

Abstract

Alcohol consumption is high among farm labourers in the Western and Northern Cape of South Africa. Excessive alcohol consumption during pregnancy is common, resulting in a high prevalence of Fetal Alcohol Syndrome (FAS) among children. FAS causes intellectual and behavioural problems, which create [...] Read more.

Alcohol consumption is high among farm labourers in the Western and Northern Cape of South Africa. Excessive alcohol consumption during pregnancy is common, resulting in a high prevalence of Fetal Alcohol Syndrome (FAS) among children. FAS causes intellectual and behavioural problems, which create considerable obstacles to a child’s education. The aim of this study is to provide a prevalence estimate of FAS in a rural school and to examine the effects of FAS on learners’ educational outcomes. The study was conducted at a farm school near Clanwilliam in theWestern Cape of South Africa. The sample comprises 166 learners from Grades 1 to 4. Educational outcomes include class scores (Afrikaans home language and mathematics), reading ability, and classroom behaviour. A physician diagnosed FAS using a three-stage process. We find FAS prevalence of 127 per 1000 (12.7%). Children with FAS score significantly lower (at the 10% level) for home language and behaviour than children who do not have FAS. Large-scale interventions in rural areas of the Western and Northern Cape that specifically target females of child-bearing age, as well as children with FAS, are necessary Full article

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

12 pages, 2676 KiB

Open AccessArticle

Effects of Short Forest Bathing Program on Autonomic Nervous System Activity and Mood States in Middle-Aged and Elderly Individuals

by Chia-Pin Yu, Chia-Min Lin, Ming-Jer Tsai, Yu-Chieh Tsai and Chun-Yu Chen

Int. J. Environ. Res. Public Health 2017, 14(8), 897; https://doi.org/10.3390/ijerph14080897 - 9 Aug 2017

Cited by 156 | Viewed by 19074

Abstract

The present study investigated changes in autonomic nervous system activity and emotions after a short (2 h) forest bathing program in the Xitou Nature Education Area (XNEA), Taiwan. One hundred and twenty-eight (60.0 ± 7.44 years) middle-aged and elderly participants were recruited. Physiological [...] Read more.

The present study investigated changes in autonomic nervous system activity and emotions after a short (2 h) forest bathing program in the Xitou Nature Education Area (XNEA), Taiwan. One hundred and twenty-eight (60.0 ± 7.44 years) middle-aged and elderly participants were recruited. Physiological responses, pulse rate, systolic and diastolic blood pressure, heart rate variability (HRV), and psychological indices were measured before and after the program. We observed that pulse rate, systolic and diastolic blood pressure were significantly lower after the program, which indicated physiological benefits from stress recovery. The Profile of Mood States negative mood subscale scores of “tension-anxiety”, “anger-hostility”, “fatigue-inertia”, “depression-dejection”, and “confusion-bewilderment” were significantly lower, whereas the positive mood subscale score of “vigor-activity” was higher. Furthermore, participants exhibited significantly lower anxiety levels according to the State-Trait Anxiety Inventory. However, changes in sympathetic and parasympathetic nerve activity were nonsignificant. Our study determined that the short forest bathing program is a promising therapeutic method for enhancing heart rate and blood pressure functions as well as an effective psychological relaxation strategy for middle-aged and elderly individuals. Full article

(This article belongs to the Special Issue Evidence-Based Nature Therapy: Advances in Physiological Evaluation)

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12 pages, 306 KiB

Open AccessArticle

The Relationship between Obesity and Urban Environment in Seoul

by Jungah Kim, Changwoo Shon and Seonju Yi

Int. J. Environ. Res. Public Health 2017, 14(8), 898; https://doi.org/10.3390/ijerph14080898 - 9 Aug 2017

Cited by 9 | Viewed by 4604

Abstract

Obesity is a global pandemic that brings about a myriad of health consequences. In the past, policies for combating obesity mainly focused on improving individual health and behavior, but nowadays some policies have changed and now concentrate on improving the built environment believing [...] Read more.

Obesity is a global pandemic that brings about a myriad of health consequences. In the past, policies for combating obesity mainly focused on improving individual health and behavior, but nowadays some policies have changed and now concentrate on improving the built environment believing this can improve health through positive changes to health-related behaviors. We examined whether both individual and environmental factors were associated with body mass index in Seoul, the capital city of South Korea. Data from the 2011 and 2013 Community Health Surveys were used (n = 20,147 men and 25,300 women). We staged multilevel logistic regression models to estimate the effect of individual and environmental factors on obesity. Among individual covariates, high-risk drinking, the time spent watching TV and surfing the Internet, high salt intake, stress, and the negative recognition of health were significantly associated with obesity. When controlling individual covariates, the number of sports facilities, number of fried chicken stores, and food insecurity level were statistically associated with probability of obesity. Therefore, this study emphasizes that it is important not only to improve the health behavior of the individual, but also to improve the urban environment in order to reduce the obesity rates of city dwellers. Full article

13 pages, 1143 KiB

Open AccessArticle

Is Preoperative Patient-Reported Health Status Associated with Mortality after Total Hip Replacement?

by Peter Cnudde, Szilard Nemes, Maziar Mohaddes, John Timperley, Göran Garellick, Kristina Burström and Ola Rolfson

Int. J. Environ. Res. Public Health 2017, 14(8), 899; https://doi.org/10.3390/ijerph14080899 - 10 Aug 2017

Cited by 4 | Viewed by 4411

Abstract

The influence of comorbidities and worse physical status on mortality following total hip replacement (THR) leads to the idea that patient-reported health status may also be a predictor of mortality. The aim of this study was to investigate the relationship between patient-reported health [...] Read more.

The influence of comorbidities and worse physical status on mortality following total hip replacement (THR) leads to the idea that patient-reported health status may also be a predictor of mortality. The aim of this study was to investigate the relationship between patient-reported health status before THR and the risk of dying up to 5 years post-operatively. For these analyses, we used register data on 42,862 THR patients with primary hip osteoarthritis operated between 2008 and 2012. The relative survival ratio was calculated by dividing the observed survival in the patient group by age- and sex-adjusted expected survival of the general population. Pre-operative responses to the five EQ-5D-3L (EuroQol Group) dimensions along with age, sex, education status, year of surgery, and hospital type were used as independent variables. Results shown that, as a group, THR patients had a better survival than the general population. Broken down by the five EQ-5D-3L dimensions we observed differentiated survival patters. For all dimensions, those reporting extreme problems had higher mortality than those reporting moderate or no problems. In conclusion, worse health status according to the EQ-5-3L before THR is associated with higher mortality up to five years after surgery. EQ-5D-3L responses may be useful in a multifactorial individualized risk assessment before THR. Full article

(This article belongs to the Section Global Health)

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13 pages, 969 KiB

Open AccessArticle

Epidemiology of Fall Injury in Rural Bangladesh

by Shirin Wadhwaniya, Olakunle Alonge, Md. Kamran Ul Baset, Salim Chowdhury, Al-Amin Bhuiyan and Adnan A. Hyder

Int. J. Environ. Res. Public Health 2017, 14(8), 900; https://doi.org/10.3390/ijerph14080900 - 10 Aug 2017

Cited by 23 | Viewed by 6178

Abstract

Globally, falls are the second leading cause of unintentional injury deaths, with 80% occurring in low-and middle-income countries. The overall objective of this study is to describe the burden and risk factors of falls in rural Bangladesh. In 2013, a large household survey [...] Read more.

Globally, falls are the second leading cause of unintentional injury deaths, with 80% occurring in low-and middle-income countries. The overall objective of this study is to describe the burden and risk factors of falls in rural Bangladesh. In 2013, a large household survey covering a population of 1,169,593 was conducted in seven rural sub-districts of Bangladesh to assess the burden of all injuries, including falls. The recall periods for non-fatal and fatal injuries were six and 12 months, respectively. Descriptive, bivariate and multiple logistic regression analyses were conducted. The rates of non-fatal and fatal falls were 36.3 per 1000 and 5 per 100,000 population, respectively. The rates of both fatal and non-fatal falls were highest among the elderly. The risk of non-fatal falls was higher at extremes of age. Lower limb and waist injuries were frequent following a fall. Head injuries were frequent among infants (35%), while lower limb and waist injuries were frequent among the elderly (>65 years old). Injuries to all body parts (except the waist) were most frequent among men. More than half of all non-fatal falls occurred in a home environment. The injury patterns and risk factors of non-fatal falls differ by sociodemographic factors. Full article

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

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13 pages, 294 KiB

Open AccessArticle

by Anna Garus-Pakowska, Franciszek Szatko and Magdalena Ulrichs

Int. J. Environ. Res. Public Health 2017, 14(8), 901; https://doi.org/10.3390/ijerph14080901 - 10 Aug 2017

Cited by 17 | Viewed by 4787

Abstract

(1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist [...] Read more.

(1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist hospital, located in central Poland, in the period 2005–2015. The study group included paramedics who had an accident while being on duty; (3) Results: According to hospital records, 88 paramedics were involved in 390 accidents and 265 injuries caused by sharp instruments. The annual accident rate was 5.34/100 employed paramedics. Most of the accidents occurred at night. The most common reason for the accident was careless behaviour of the paramedic, which resulted in joint sprains and dislocations. Injuries accounted for a huge portion of the total number of events. As many as 45% of injuries were not officially recorded; (4) Conclusion: High rates of work-related accidents and injuries caused by sharp instruments in paramedics are a serious public health problem. Further studies should be conducted in order to identify risk factors of accidents, particularly injuries, and to implement preventative programmes, aiming to minimise rates of occupational hazards for paramedics. Full article

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

10 pages, 296 KiB

Open AccessArticle

Associations between Malocclusion and Oral Health-Related Quality of Life among Mongolian Adolescents

by Miyu Araki, Yuko Yasuda, Takuya Ogawa, Tsasan Tumurkhuu, Ganjargal Ganburged, Amarsaikhan Bazar, Takeo Fujiwara and Keiji Moriyama

Int. J. Environ. Res. Public Health 2017, 14(8), 902; https://doi.org/10.3390/ijerph14080902 - 10 Aug 2017

Cited by 26 | Viewed by 6093

Abstract

Malocclusion may affect oral health-related quality of life (OHR-QoL), however, the previously detected associations were affected by confounding factors. We hypothesized that there is indeed an association between OHR-QoL and malocclusion and investigated in a population-based study of 420 Mongolian adolescents mean age: [...] Read more.

Malocclusion may affect oral health-related quality of life (OHR-QoL), however, the previously detected associations were affected by confounding factors. We hypothesized that there is indeed an association between OHR-QoL and malocclusion and investigated in a population-based study of 420 Mongolian adolescents mean age: 12.6 (standard deviation (SD) = 1.09) years from two secondary schools, located in an urban and a suburban area. We randomly selected two classes from each school. The Index of Orthodontic Treatment Need (IOTN) was used to assess malocclusion. OHR-QoL was assessed using the Child Perceptions Questionnaire (CPQ). Multivariate analysis was used to determine whether malocclusion had an independent effect on OHR-QoL. Overall, the existence of any type of malocclusion was not significantly associated with CPQ results. However, increased overjet was significantly associated with oral symptoms (coefficient: 0.66, 95% CI: 0.14–1.19), functional limitations (coefficient: 0.62, 95% CI: 0.17–1.08), and social well-being (coefficient: 0.50, 95% CI: 0.06–0.93). Deep bite was also significantly associated with oral symptoms (coefficient: 0.54, 95% CI: 0.23–0.84) and functional limitations (coefficient: 0.45, 95% CI: 0.19–0.72). Although malocclusion per se was not significantly associated with OHR-QoL, specific types of malocclusion, i.e., increased overjet and deep bite, were associated with OHR-QoL. Full article

(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)

10 pages, 343 KiB

Open AccessArticle

Socioeconomic Inequalities in Visits to the Dentist to Receive Professionally Applied Topical Fluoride in a Developing Country

by Miriam Del Socorro Herrera, Carlo Eduardo Medina-Solís, América Patricia Pontigo-Loyola, Rubén De la Rosa-Santillana, Leticia Ávila-Burgos, Rogelio José Scougall-Vilchis, Sonia Márquez-Rodríguez, Mirna Minaya-Sánchez and Alejandro José Casanova-Rosado

Int. J. Environ. Res. Public Health 2017, 14(8), 903; https://doi.org/10.3390/ijerph14080903 - 11 Aug 2017

Cited by 4 | Viewed by 3924

Abstract

Objective: To determine the frequency and associated factors of visits to the dentist in the last year by Nicaraguan schoolchildren to receive professionally applied topical fluoride (PATF). Material and Methods: A cross-sectional study was designed in children from public schools in the city [...] Read more.

Objective: To determine the frequency and associated factors of visits to the dentist in the last year by Nicaraguan schoolchildren to receive professionally applied topical fluoride (PATF). Material and Methods: A cross-sectional study was designed in children from public schools in the city of León, Nicaragua, were included. A series of socioeconomic, sociodemographic, and behavioural variables were collected through a questionnaire. The dependent variable was the visit to the dentist to receive professionally applied topical fluoride in the last year, which was dichotomised as (0) Did not receive PATF and (1) Yes received PATF. In the statistical analysis, binary logistic regression was used. Results: The mean age of the students included was 9 years, and 49.9% were girls. The prevalence of visits to the dentist in the last year to receive PATF was 3.1%. In the multivariate model, the associated characteristics (p < 0.05) were: female (OR = 2.73, 95% CI = 1.34–4.50); the positive attitude of the mother to the oral health of her child (OR = 2.15, 95% CI = 1.03–4.50); and the best socioeconomic position (OR = 2.68, 95% CI = 1.36—5.31). Conclusions: The prevalence of visits to the dentist in the last year to receive professionally applied topical fluoride was very low (3.1%). The results of the socioeconomic position suggest the existence of certain inequalities in oral health. It is necessary to implement policies and programs aimed at improving this scenario. Full article

(This article belongs to the Section Health Economics)

9 pages, 291 KiB

Open AccessArticle

Effects of Lifetime Unemployment Experience and Job Insecurity on Two-Year Risk of Physician-Diagnosed Incident Depression in the German Working Population

by Natalia Wege, Peter Angerer and Jian Li

Int. J. Environ. Res. Public Health 2017, 14(8), 904; https://doi.org/10.3390/ijerph14080904 - 11 Aug 2017

Cited by 20 | Viewed by 4637

Abstract

Unemployment and job insecurity have been reported to be associated with a higher risk of depression. The purpose of this study was to evaluate the separate and combined effects of lifetime unemployment experience and job insecurity on the incidence of depression in an [...] Read more.

Unemployment and job insecurity have been reported to be associated with a higher risk of depression. The purpose of this study was to evaluate the separate and combined effects of lifetime unemployment experience and job insecurity on the incidence of depression in an unselected working population in Germany. Data from the German Socio-Economic Panel (GSOEP) study were used, as was a final sample of those currently employed, with complete data at baseline (2009) and follow-up (2011) restricted to those free of depression in 2009 (n = 7073). Poisson regression analysis was applied to test the prospective associations between unemployment, job insecurity, and a two-year incident of depression. Results showed that the experience of unemployment and perceived job insecurity were significantly associated with a higher risk of depression during the two-year follow-up (risk ratios 1.64; 95% confidence intervals (1.16, 2.31) and risk ratios 1.48; 95% confidence intervals (1.13, 1.92), respectively). Notably, the strongest risk was observed among participants with insecure jobs and past long-term unemployment (risk ratios 2.15; 95% confidence intervals (1.32; 3.52)). In conclusion, even during employment, the experience of lifetime unemployment led to a higher risk of depression. The combination of previous unemployment experience and anticipated job insecurity increased the risk of developing depression. Results support health promotion with special emphasis on unemployment and precarious working conditions. Full article

(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)

14 pages, 942 KiB

Open AccessArticle

A Randomized Crossover Trial on Acute Stress-Related Physiological Responses to Mountain Hiking

by Martin Niedermeier, Carina Grafetstätter, Arnulf Hartl and Martin Kopp

Int. J. Environ. Res. Public Health 2017, 14(8), 905; https://doi.org/10.3390/ijerph14080905 - 11 Aug 2017

Cited by 34 | Viewed by 11678

Abstract

Green exercise, defined as physical activity in natural environments, might have positive effects on stress-related physiological measures. Little is known about the acute effects of green exercise bouts lasting longer than 60 min. Therefore, the aim of the present study was to analyze [...] Read more.

Green exercise, defined as physical activity in natural environments, might have positive effects on stress-related physiological measures. Little is known about the acute effects of green exercise bouts lasting longer than 60 min. Therefore, the aim of the present study was to analyze the acute effects of a three-hour green exercise intervention (mountain hiking) on stress-related physiological responses. Using a randomized crossover design, 42 healthy participants were exposed to three different conditions in a field-based experiment: outdoor mountain hiking, indoor treadmill walking, and sedentary control condition (three hours each). At baseline and at follow-up (five minutes after the condition), stress-related physiological responses (salivary cortisol, blood pressure, and heart rate variability) were measured. Salivary cortisol decreased in all conditions, but showed a larger decrease after both mountain hiking and treadmill walking compared to the sedentary control situation (partial η² = 0.10). No differences were found between mountain hiking and treadmill walking in salivary cortisol. In heart rate variability and blood pressure, changes from baseline to follow-up did not significantly differ between the three conditions. The results indicate that three hours of hiking indoors or outdoors elicits positive effects on salivary cortisol concentration. Environmental effects seem to play a minor role in salivary cortisol, blood pressure, and heart rate variability. Full article

(This article belongs to the Section Environmental Health)

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2 pages, 243 KiB

Open AccessReply

Response to Comments on Montagna et al. “Evaluation of Legionella Air Contamination in Healthcare Facilities by Different Sampling Methods: An Italian Multicenter Study” Int. J. Environ. Res. Public Health 2017, 14, 670

by Maria Teresa Montagna, Osvalda De Giglio, Antonella Agodi and Cesira Pasquarella

Int. J. Environ. Res. Public Health 2017, 14(8), 906; https://doi.org/10.3390/ijerph14080906 - 11 Aug 2017

Cited by 20 | Viewed by 2768

Abstract

We would like to thank Collins andWalker for their comments and for acknowledging that this is an area requiring more research to improve our basic understanding of Legionella [1]. [...]
Full article

(This article belongs to the Section Environmental Health)

11 pages, 615 KiB

Open AccessArticle

Maintaining Traditions: A Qualitative Study of Early Childhood Caries Risk and Protective Factors in an Indigenous Community

by Ana Levin, Karen Sokal-Gutierrez, Anita Hargrave, Elizabeth Funsch and Kristin S. Hoeft

Int. J. Environ. Res. Public Health 2017, 14(8), 907; https://doi.org/10.3390/ijerph14080907 - 11 Aug 2017

Cited by 22 | Viewed by 7807

Abstract

In lower middle-income economies (LMIE), the nutrition transition from traditional diets to sugary foods and beverages has contributed to widespread early childhood dental caries. This qualitative study explores perceived risk and protective factors, and overall experiences of early childhood nutrition and oral health [...] Read more.

In lower middle-income economies (LMIE), the nutrition transition from traditional diets to sugary foods and beverages has contributed to widespread early childhood dental caries. This qualitative study explores perceived risk and protective factors, and overall experiences of early childhood nutrition and oral health in indigenous Ecuadorian families participating in a community-based oral health and nutrition intervention. Dental exams of 698 children age 6 months through 6 years determined each child’s caries burden. A convenience sample of 18 “outlier” families was identified: low-caries children with ≤2 carious teeth vs. high-caries children with ≥10 carious teeth. Semi-structured in-depth interviews with parents/caregivers explored the child’s diet, dental habits, and family factors related to nutrition and oral health. Interviews were transcribed and thematically analyzed using grounded theory. In the high-caries families, proximity to highway and stores, consumption of processed-food, and low parental monitoring of child behavior were identified as risk factors for ECC (early childhood caries). In the low-caries families, protective factors included harvesting and consuming food from the family farm, remote geography, and greater parental monitoring of child behavior. The study results suggest that maintaining traditional family farms and authoritative parenting to avoid processed foods/drinks and ensure tooth brushing could improve early childhood nutrition and oral health. Full article

(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)

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16 pages, 568 KiB

Open AccessArticle

Why Do People Like Loud Sound? A Qualitative Study

by David Welch and Guy Fremaux

Int. J. Environ. Res. Public Health 2017, 14(8), 908; https://doi.org/10.3390/ijerph14080908 - 11 Aug 2017

Cited by 44 | Viewed by 16702

Abstract

Many people choose to expose themselves to potentially dangerous sounds such as loud music, either via speakers, personal audio systems, or at clubs. The Conditioning, Adaptation and Acculturation to Loud Music (CAALM) Model has proposed a theoretical basis for this behaviour. To compare [...] Read more.

Many people choose to expose themselves to potentially dangerous sounds such as loud music, either via speakers, personal audio systems, or at clubs. The Conditioning, Adaptation and Acculturation to Loud Music (CAALM) Model has proposed a theoretical basis for this behaviour. To compare the model to data, we interviewed a group of people who were either regular nightclub-goers or who controlled the sound levels in nightclubs (bar managers, musicians, DJs, and sound engineers) about loud sound. Results showed four main themes relating to the enjoyment of loud sound: arousal/excitement, facilitation of socialisation, masking of both external sound and unwanted thoughts, and an emphasis and enhancement of personal identity. Furthermore, an interesting incidental finding was that sound levels appeared to increase gradually over the course of the evening until they plateaued at approximately 97 dBA Leq around midnight. Consideration of the data generated by the analysis revealed a complex of influential factors that support people in wanting exposure to loud sound. Findings were considered in terms of the CAALM Model and could be explained in terms of its principles. From a health promotion perspective, the Social Ecological Model was applied to consider how the themes identified might influence behaviour. They were shown to influence people on multiple levels, providing a powerful system which health promotion approaches struggle to address. Full article

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15 pages, 501 KiB

Open AccessReview

Miniaturized Monitors for Assessment of Exposure to Air Pollutants: A Review

by Francesca Borghi, Andrea Spinazzè, Sabrina Rovelli, Davide Campagnolo, Luca Del Buono, Andrea Cattaneo and Domenico M. Cavallo

Int. J. Environ. Res. Public Health 2017, 14(8), 909; https://doi.org/10.3390/ijerph14080909 - 12 Aug 2017

Cited by 74 | Viewed by 8334

Abstract

Air quality has a huge impact on different aspects of life quality, and for this reason, air quality monitoring is required by national and international regulations. Technical and procedural limitations of traditional fixed-site stations for monitoring or sampling of air pollutants are also [...] Read more.

Air quality has a huge impact on different aspects of life quality, and for this reason, air quality monitoring is required by national and international regulations. Technical and procedural limitations of traditional fixed-site stations for monitoring or sampling of air pollutants are also well-known. Recently, a different type of miniaturized monitors has been developed. These monitors, due to their characteristics (e.g., low cost, small size, high portability) are becoming increasingly important for individual exposure assessment, especially since this kind of instrument can provide measurements at high spatial and temporal resolution, which is a notable advantage when approaching assessment of exposure to environmental contaminants. The aim of this study is indeed to provide information regarding current knowledge regarding the use of miniaturized air pollutant sensors. A systematic review was performed to identify original articles: a literature search was carried out using an appropriate query for the search of papers across three different databases, and the papers were selected using inclusion/exclusion criteria. The reviewed articles showed that miniaturized sensors are particularly versatile and could be applied in studies with different experimental designs, helping to provide a significant enhancement to exposure assessment, even though studies regarding their performance are still sparse. Full article

(This article belongs to the Special Issue A Policy Focused Approach to Public Health and Air, Water and/or Soil Pollution)

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11 pages, 602 KiB

Open AccessArticle

Study on the Status of Health Service Utilization among Caregivers of Left-Behind Children in Poor Rural Areas of Hunan Province: A Baseline Survey

by Meimei Ji, Yefu Zhang, Jiaojiao Zou, Tong Yuan, Amber Tang, Jing Deng, Lina Yang, Mingzhi Li, Jihua Chen, Hong Qin and Qian Lin

Int. J. Environ. Res. Public Health 2017, 14(8), 910; https://doi.org/10.3390/ijerph14080910 - 12 Aug 2017

Cited by 16 | Viewed by 4647

Abstract

Background: The caregivers of left-behind children (CLBC) in China’s poor, rural areas are mostly elderly and women. Their health status and access to health services have not been previously characterized. This study aims to explore the status of CLBC in terms of their [...] Read more.

Background: The caregivers of left-behind children (CLBC) in China’s poor, rural areas are mostly elderly and women. Their health status and access to health services have not been previously characterized. This study aims to explore the status of CLBC in terms of their health service utilization and to provide a scientific basis for guiding effective implementation of health policy in rural Hunan. Methods: Random cluster sampling was used to survey CLBC in two rural counties. Face-to-face interviews and questionnaires were used to collect data, including socioeconomic status and health service utilization. The two-week prevalence rate was used to reflect health service needs, while the two-week visiting rate, annual hospitalization rate and participation in basic public health services were used to evaluate health service utilization. Results: Of the 518 respondents in the study, 95.9% were farmers and 88.4% were over 40 years old. The two-week prevalence rate was 36.1%. Furthermore, 40.1% of ill caregivers’ activities were partly restricted by illness and 3.7% needed to be on bed rest. The two-week visiting rate was 21.0%. The main reasons for not seeing a doctor were “self-medication” (39.1%) or “financial difficulties” (32.6%). The annual hospitalization rate of the CLBC was 22.6% and the non-hospitalization rate of those who needed hospitalization was 41.5%. “Lack of time” (22.3%) and “financial difficulties” (50.5%) were the major factors affecting the utilization of hospitalization services. In terms of participation in basic public health services, only 35.1% CLBC clearly knew that township hospitals have established health records for them. Only 50.6% of caregivers received free health examinations in village clinics or township hospitals and 81.3% of the caregivers did not participate in health education or lectures organized by local health institutions in 2014. Conclusions: The utilization rate of health services was extremely low, which may affect the quality of care for left-behind children. Better public health education through multi-sector cooperation is urgently needed to improve health cognition among CLBC in rural China. Full article

(This article belongs to the Section Health Economics)

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16 pages, 3437 KiB

Open AccessArticle

Health Risks Awareness of Electronic Waste Workers in the Informal Sector in Nigeria

by Chimere M. Ohajinwa, Peter M. Van Bodegom, Martina G. Vijver and Willie J. G. M. Peijnenburg

Int. J. Environ. Res. Public Health 2017, 14(8), 911; https://doi.org/10.3390/ijerph14080911 - 13 Aug 2017

Cited by 78 | Viewed by 9269

Abstract

Insight into the health risk awareness levels of e-waste workers is important as it may offer opportunities for better e-waste recycling management strategies to reduce the health effects of informal e-waste recycling. Therefore, this study assessed the knowledge, attitude, and practices associated with [...] Read more.

Insight into the health risk awareness levels of e-waste workers is important as it may offer opportunities for better e-waste recycling management strategies to reduce the health effects of informal e-waste recycling. Therefore, this study assessed the knowledge, attitude, and practices associated with occupational health risk awareness of e-waste workers compared with a control group (butchers) in the informal sector in Nigeria. A cross-sectional study was used to assess health risk awareness of 279 e-waste workers (repairers and dismantlers) and 221 butchers from the informal sector in three locations in Nigeria in 2015. A questionnaire was used to obtain information on socio-demographic backgrounds, occupational history, knowledge, attitude, and work practices. The data was analysed using Analysis of Variance. The three job designations had significantly different knowledge, attitude, and practice mean scores (p = 0.000), with butchers consistently having the highest mean scores. Only 43% of e-waste workers could mention one or more Personal Protective Equipment needed for their job compared with 70% of the butchers. The health risk awareness level of the e-waste workers was significantly lower compared with their counterparts in the same informal sector. A positive correlation existed between the workers’ knowledge and their attitude and practice. Therefore, increasing the workers’ knowledge may decrease risky practices. Full article

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

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11 pages, 298 KiB

Open AccessArticle

Factors Affecting Depressive Symptoms among North Korean Adolescent Refugees Residing in South Korea

by Subin Park, Minji Lee and Jin Yong Jeon

Int. J. Environ. Res. Public Health 2017, 14(8), 912; https://doi.org/10.3390/ijerph14080912 - 14 Aug 2017

Cited by 28 | Viewed by 6022

Abstract

We examined factors affecting the depressive symptoms and the relationship between depression and quality of life among 131 North Korean adolescent refugees aged 12–24 years. We compared sociodemographic, social, and individual characteristics and perceived the quality of life between participants with and without [...] Read more.

We examined factors affecting the depressive symptoms and the relationship between depression and quality of life among 131 North Korean adolescent refugees aged 12–24 years. We compared sociodemographic, social, and individual characteristics and perceived the quality of life between participants with and without depression. Thirty-seven refugees (28.2%) had clinically significant depressive symptoms. The refugees with depression were younger (t = 2.67; p = 0.009), more likely to be male (χ² = 6.98; p = 0.009), and more likely to have a Chinese father (χ² = 9.05; p = 0.003) than those without depression. The refugees with depression had lower levels of psychological social support (t = 2.96; p = 0.004) and resilience (t = 4.24; p < 0.001) and higher levels of alcohol problems (t = −2.08; p = 0.043), aggression (t = −3.15; p = 0.003), and post-traumatic stress disorder (PTSD; t = −2.89; p = 0.004). They also reported lower levels of life satisfaction (t = 3.31; p = 0.001) and had a more negative view of their future (t = 2.68; p = 0.010). Interventions to increase resilience, to decrease the impact of traumatic events, and to provide psychological support may be helpful for North Korean adolescent refugees at risk of depression. Full article

(This article belongs to the Special Issue Refugee Health)

14 pages, 1328 KiB

Open AccessArticle

Effects of Short-Term Set-Aside Management Practices on Soil Microorganism and Enzyme Activity in China

by Guangyu Li and Cifang Wu

Int. J. Environ. Res. Public Health 2017, 14(8), 913; https://doi.org/10.3390/ijerph14080913 - 14 Aug 2017

Cited by 10 | Viewed by 5144

Abstract

Set-aside farmland can effectively improve the self-rehabilitation of arable soil. Long-term set-asides however cannot satisfy provisionment, therefore the use of short-term set-asides to restore cultivated soil is a better option. Few studies have compared short-term set-aside patterns, and the effects of set-asides on [...] Read more.

Set-aside farmland can effectively improve the self-rehabilitation of arable soil. Long-term set-asides however cannot satisfy provisionment, therefore the use of short-term set-asides to restore cultivated soil is a better option. Few studies have compared short-term set-aside patterns, and the effects of set-asides on soil microbial community and enzyme enzymes. We analyzed the bacterial structure, microbial biomass carbon/nitrogen and enzyme activity of farmland soil under different set-aside regimes in the Yellow River Delta of China. Bacterial alpha diversity was relatively lower under only irrigation, and farmyard manure applications showed clear advantages. Set-asides should consider their influence on soil organic carbon and nitrogen, which were correlated with microbial community structure. Nitrospira (0.47–1.67%), Acidobacteria Gp6 (8.26–15.91%) and unclassified Burkholderiales (1.50–2.81%) were significantly altered (p < 0.01). Based on functions of these genera, some set-aside patterns led to a relative balance in nitrogen and carbon turnover. Partial treatments showed a deficiency in organic matter. In addition, farmyard manure may lead to the increased consumption of organic matter, with the exception of native plants set-asides. Conventional farming (control group) displayed a significant enzyme activity advantage. Set-aside management practices guided soil microbial communities to different states. Integrated soil microbiota and the content of carbon and nitrogen, native plants with farmyard manure showed an equilibrium state relatively, which would be helpful to improve land quality in the short-term. Full article

(This article belongs to the Special Issue A Policy Focused Approach to Public Health and Air, Water and/or Soil Pollution)

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10 pages, 2326 KiB

Open AccessArticle

Assessment of Typical Heavy Metals in Human Hair of Different Age Groups and Foodstuffs in Beijing, China

by Gang Liang, Ligang Pan and Xinhui Liu

Int. J. Environ. Res. Public Health 2017, 14(8), 914; https://doi.org/10.3390/ijerph14080914 - 14 Aug 2017

Cited by 69 | Viewed by 7917

Abstract

Human hair of different age groups and foodstuff samples were collected in Beijing, China. The concerned metals—Cd, Cr, Pb, As, and Hg—were analyzed, and the metal levels in relation to age, gender, and dietary intake were further assessed. Results showed the highest level [...] Read more.

Human hair of different age groups and foodstuff samples were collected in Beijing, China. The concerned metals—Cd, Cr, Pb, As, and Hg—were analyzed, and the metal levels in relation to age, gender, and dietary intake were further assessed. Results showed the highest level of the metals was shown by Pb, with an average concentration of 1.557 ± 0.779 mg/kg, followed by Cr (0.782 ± 0.394), Hg (0.284 ± 0.094), As (0.127 ± 0.078), and Cd (0.071 ± 0.032), following a decreasing order of Pb > Cr > Hg > As > Cd, which were all below the upper limit of normal values in China. The heavy metal concentrations varied greatly among different age groups, and higher concentrations for Cd, Cr, Pb, and As appeared in female hair, whereas higher Hg concentration were found in male hair, suggesting that age and gender were not crucial factors for assessing metal concentrations in human hair. The ingestion of cereals and vegetables were the main route by which heavy metals in the environment create hazardous health effects for local inhabitants, but the estimated metal intakes through food consumption were all lower than the proposed limit of Provisional Tolerable Weekly Intake (PTWI), indicating that heavy metals posed no health risks for the inhabitants. Furthermore, little relationship was found between metal intakes and the corresponding metal levels in hair. Nevertheless, the results of this study can be used to analyze the internal heavy metal burden in the resident population of Beijing area and can also serve as reference for further studies. Full article

(This article belongs to the Section Environmental Health)

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12 pages, 698 KiB

Open AccessArticle

Pricing of Staple Foods at Supermarkets versus Small Food Stores

by Caitlin E. Caspi, Jennifer E. Pelletier, Lisa J. Harnack, Darin J. Erickson, Kathleen Lenk and Melissa N. Laska

Int. J. Environ. Res. Public Health 2017, 14(8), 915; https://doi.org/10.3390/ijerph14080915 - 15 Aug 2017

Cited by 44 | Viewed by 8949

Abstract

Prices affect food purchase decisions, particularly in lower-income communities, where access to a range of food retailers (including supermarkets) is limited. The aim of this study was to examine differences in staple food pricing between small urban food stores and the closest supermarkets, [...] Read more.

Prices affect food purchase decisions, particularly in lower-income communities, where access to a range of food retailers (including supermarkets) is limited. The aim of this study was to examine differences in staple food pricing between small urban food stores and the closest supermarkets, as well as whether pricing differentials varied based on proximity between small stores and larger retailers. In 2014, prices were measured for 15 staple foods during store visits in 140 smaller stores (corner stores, gas-marts, dollar stores, and pharmacies) in Minneapolis/St. Paul, MN and their closest supermarket. Mixed models controlling for store type were used to estimate the average price differential between: (a) smaller stores and supermarkets; (b) isolated smaller stores (>1 mile to closest supermarket) and non-isolated smaller stores; and (c) isolated smaller stores inside versus outside USDA-identified food deserts. On average, all items except white bread were 10–54% more expensive in smaller stores than in supermarkets (p < 0.001). Prices were generally not significantly different in isolated stores compared with non-isolated stores for most items. Among isolated stores, there were no price differences inside versus outside food deserts. We conclude that smaller food stores have higher prices for most staple foods compared to their closest supermarket, regardless of proximity. More research is needed to examine staple food prices in different retail spaces. Full article

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

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16 pages, 541 KiB

Open AccessArticle

Socioeconomic Inequalities in Green Space Quality and Accessibility—Evidence from a Southern European City

by Elaine Hoffimann, Henrique Barros and Ana Isabel Ribeiro

Int. J. Environ. Res. Public Health 2017, 14(8), 916; https://doi.org/10.3390/ijerph14080916 - 15 Aug 2017

Cited by 226 | Viewed by 19184

Abstract

Background: The provision of green spaces is an important health promotion strategy to encourage physical activity and to improve population health. Green space provision has to be based on the principle of equity. This study investigated the presence of socioeconomic inequalities in [...] Read more.

Background: The provision of green spaces is an important health promotion strategy to encourage physical activity and to improve population health. Green space provision has to be based on the principle of equity. This study investigated the presence of socioeconomic inequalities in geographic accessibility and quality of green spaces across Porto neighbourhoods (Portugal). Methods: Accessibility was evaluated using a Geographic Information System and all the green spaces were audited using the Public Open Space Tool. Kendall’s tau-b correlation coefficients and ordinal regression were used to test whether socioeconomic differences in green space quality and accessibility were statistically significant. Results: Although the majority of the neighbourhoods had an accessible green space, mean distance to green space increased with neighbourhood deprivation. Additionally, green spaces in the more deprived neighbourhoods presented significantly more safety concerns, signs of damage, lack of equipment to engage in active leisure activities, and had significantly less amenities such as seating, toilets, cafés, etc. Conclusions: Residents from low socioeconomic positions seem to suffer from a double jeopardy; they lack both individual and community resources. Our results have important planning implications and might contribute to understanding why deprived communities have lower physical activity levels and poorer health. Full article

(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)

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24 pages, 1630 KiB

Open AccessArticle

Dynamics of Implementation and Maintenance of Organizational Health Interventions

by Mohammad S. Jalali, Hazhir Rahmandad, Sally Lawrence Bullock and Alice Ammerman

Int. J. Environ. Res. Public Health 2017, 14(8), 917; https://doi.org/10.3390/ijerph14080917 - 15 Aug 2017

Cited by 15 | Viewed by 7505

Abstract

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion [...] Read more.

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes. Full article

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

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16 pages, 491 KiB

Open AccessReview

Well-Being and the Social Environment of Work: A Systematic Review of Intervention Studies

by Kevin Daniels, David Watson and Cigdem Gedikli

Int. J. Environ. Res. Public Health 2017, 14(8), 918; https://doi.org/10.3390/ijerph14080918 - 16 Aug 2017

Cited by 48 | Viewed by 11211

Abstract

There is consistent evidence that a good social environment in the workplace is associated with employee well-being. However, there has been no specific review of interventions to improve well-being through improving social environments at work. We conducted a systematic review of such interventions, [...] Read more.

There is consistent evidence that a good social environment in the workplace is associated with employee well-being. However, there has been no specific review of interventions to improve well-being through improving social environments at work. We conducted a systematic review of such interventions, and also considered performance as an outcome. We found eight studies of interventions. Six studies were of interventions that were based on introducing shared social activities into workgroups. Six out of the six studies demonstrated improvements in well-being across the sample (five studies), or for an identifiable sub-group (one study). Four out of the five studies demonstrated improvements in social environments, and four out of the five studies demonstrated improvements in indicators of performance. Analysis of implementation factors indicated that the interventions based on shared activities require some external facilitation, favorable worker attitudes prior to the intervention, and several different components. We found two studies that focused on improving fairness perceptions in the workplace. There were no consistent effects of these interventions on well-being or performance. We conclude that there is some evidence that interventions that increase the frequency of shared activities between workers can improve worker well-being and performance. We offer suggestions for improving the evidence base. Full article

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

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2 pages, 237 KiB

Open AccessComment

Comment on Piscitelli et al. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health. Int. J. Environ. Res. Public Health 2017, 14, 495

by Benedetto Terracini, Daniela Alessi, Elena Isaevska, Vanda Macerata, Corrado Magnani, Milena Manasievska, Milena Maule, Franco Merletti, Maria Luisa Mosso, Tiziana Rosso and Carlotta Sacerdote

Int. J. Environ. Res. Public Health 2017, 14(8), 919; https://doi.org/10.3390/ijerph14080919 - 16 Aug 2017

Cited by 2 | Viewed by 3530

Abstract

In the “Epikit study” [1], P. Piscitelli with 27 co-authors from 20 scientific institutions estimated the absolute number of hospital admissions for newly diagnosed cancer in people aged 0–19 in Italian provinces and regions in 2007–2011.[...] Full article

(This article belongs to the Section Environmental Health)

11 pages, 7427 KiB

Open AccessArticle

Impact of Orientation on the Vitamin D Weighted Exposure of a Human in an Urban Environment

by Michael Schrempf, Nadine Thuns, Kezia Lange and Gunther Seckmeyer

Int. J. Environ. Res. Public Health 2017, 14(8), 920; https://doi.org/10.3390/ijerph14080920 - 16 Aug 2017

Cited by 18 | Viewed by 5009

Abstract

The vitamin D₃-weighted UV exposure of a human with vertical posture was calculated for urban locations to investigate the impact of orientation and obstructions on the exposure. Human exposure was calculated by using the 3D geometry of a human and integrating [...] Read more.

The vitamin D₃-weighted UV exposure of a human with vertical posture was calculated for urban locations to investigate the impact of orientation and obstructions on the exposure. Human exposure was calculated by using the 3D geometry of a human and integrating the radiance, i.e., the radiant energy from the direct solar beam and the diffuse sky radiation from different incident and azimuth angles. Obstructions of the sky are derived from hemispherical images, which are recorded by a digital camera with a fisheye lens. Due to the low reflectivity of most surfaces in the UV range, the radiance from obstructed sky regions was neglected. For spring equinox (21 March), the exposure of a human model with winter clothing in an environment where obstructions cover 40% of the sky varies by up to 25%, depending on the orientation of the human model to the sun. The calculation of the accumulated vitamin D₃-weighted exposure of a human with winter clothing walking during lunch break shows that human exposure is reduced by the obstruction of buildings and vegetation by 40%. Full article

(This article belongs to the Section Environmental Health)

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9 pages, 806 KiB

Open AccessArticle

Association between Promoter Methylation of Gene ERCC3 and Benzene Hematotoxicity

by Min Zheng, Feiliang Lin, Fenxia Hou, Guilan Li, Caiying Zhu, Peiyu Xu, Caihong Xing and Qianfei Wang

Int. J. Environ. Res. Public Health 2017, 14(8), 921; https://doi.org/10.3390/ijerph14080921 - 16 Aug 2017

Cited by 14 | Viewed by 4534

Abstract

Benzene is a primary industrial chemical and a ubiquitous environmental pollutant. ERCC3 is a key player in nucleotide excision repair. Recent studies suggested that site-specific methylation is a possible mechanism of the transcriptional dysregulation by blocking transcription factors binding. We previously found that [...] Read more.

Benzene is a primary industrial chemical and a ubiquitous environmental pollutant. ERCC3 is a key player in nucleotide excision repair. Recent studies suggested that site-specific methylation is a possible mechanism of the transcriptional dysregulation by blocking transcription factors binding. We previously found that the average promoter methylation level of ERCC3 was increased in benzene-exposed workers. In order to test whether specific CpG sites of ERCC3 play an important role in benzene-induced epigenetic changes and whether the specific methylation patterns are associated with benzene hematotoxicity, we analyzed the promoter methylation levels of individual CpG sites, transcription factor binding motif and the correlation between aberrant CpG methylation and hematotoxicity in 76 benzene-exposed workers and 24 unexposed controls in China. Out of all the CpGs analyzed, two CpG units located 43 bp upstream and 99 bp downstream of the transcription start site of ERCC3 (CpG 2–4 and CpG 17–18, respectively), showed the most pronounced increase in methylation levels in benzene-exposed workers, compared with unexposed controls (Mean ± SD: 5.86 ± 2.77% vs. 4.92 ± 1.53%, p = 0.032; 8.45 ± 4.09% vs. 6.79 ± 2.50%, p = 0.024, respectively). Using the JASPAR CORE Database, we found that CpG 2–4 and CpG 17–18 were bound by three putative transcription factors (TFAP2A, E2F4 and MZF1). Furthermore, the methylation levels for CpG 2–4 were correlated negatively with the percentage of neutrophils (β = −0.676, p = 0.005) in benzene-exposed workers. This study demonstrates that CpG-specific DNA methylation in the ERCC3 promoter region may be involved in benzene-induced epigenetic modification and it may contribute to benzene-induced hematotoxicity. Full article

(This article belongs to the Section Environmental Health)

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28 pages, 589 KiB

Open AccessReview

An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults

by Alice W. Y. Leung, Ruth S. M. Chan, Mandy M. M. Sea and Jean Woo

Int. J. Environ. Res. Public Health 2017, 14(8), 922; https://doi.org/10.3390/ijerph14080922 - 16 Aug 2017

Cited by 127 | Viewed by 12779

Abstract

This review aims to provide an overview of the factors associated with adherence reported in existing literature on lifestyle modification programs for weight management among the adult population. An electronic search was performed using PubMed, Medline, PsycINFO and PsycARTICLE to identify studies that [...] Read more.

This review aims to provide an overview of the factors associated with adherence reported in existing literature on lifestyle modification programs for weight management among the adult population. An electronic search was performed using PubMed, Medline, PsycINFO and PsycARTICLE to identify studies that examined the factors of adherence to lifestyle modification programs with explicit definition of adherence indicators. We identified 19 studies published between 2004 and 2016. The most commonly used indicator of adherence was attrition, followed by attendance, self-monitoring and dietary adherence. A broad array of factors has been studied but only few studies exploring each factor. Limited evidence suggested older age, higher education, healthier eating and physical activity behaviours, higher stage of change at baseline and higher initial weight loss may predict better adherence. On the other hand, having depression, stress, strong body shape concern, more previous weight loss attempts and being unemployed may predict poor adherence. Inconsistent findings were obtained for self-efficacy, motivation and male gender. This review highlights the need for more rigorous studies to enhance our knowledge on factors related to adherence. Identification of the factors of adherence could provide important implication for program improvement, ultimately improving the effectiveness and the cost-effectiveness of lifestyle modification program. Full article

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

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11 pages, 1272 KiB

Open AccessProtocol

A Youth-Led, Social Marketing Intervention Run by Adolescents to Encourage Healthy Lifestyles among Younger School Peers (EYTO-Kids Project): A Protocol for Pilot Cluster Randomized Controlled Trial (Spain)

by Lucia Tarro, Magaly Aceves-Martins, Ignasi Papell-Garcia, Lluís Arola, Montse Giralt, Elisabet Llauradó and Rosa Solà

Int. J. Environ. Res. Public Health 2017, 14(8), 923; https://doi.org/10.3390/ijerph14080923 - 17 Aug 2017

Cited by 8 | Viewed by 5187

Abstract

Introduction: The EYTO-kids (European Youth Tackling Obesity in Adolescents and Children) study aims to increase fruit and/or vegetable consumption and physical activity, decrease sedentary lifestyles, and reduce the intake of sugary drinks and fast food using an innovative methodology based on social marketing [...] Read more.

Introduction: The EYTO-kids (European Youth Tackling Obesity in Adolescents and Children) study aims to increase fruit and/or vegetable consumption and physical activity, decrease sedentary lifestyles, and reduce the intake of sugary drinks and fast food using an innovative methodology based on social marketing and youth involvement. Methods: This study is a pilot school-based cluster randomized controlled 10-month intervention spanning two academic years (2015–2016 and 2016–2017), with eight primary schools and three high schools randomized into and designated the control group and eight primary schools and four high schools designated the intervention group in Reus, Spain. At least 301 younger school peers per group should be included. At the intervention high schools, the adolescent creators (ACs) receive an initial 16-h training session. In total, 26–32 high school ACs (12–14 years) from the four high schools will design and implement four health-promotion activities (1 h/each) for their younger (8–10 years), primary school peers. The control group will not receive any intervention. The outcomes (fruit, vegetable, fast food and sugary drink consumption; physical activity; and sedentary behaviors) of the control and intervention groups will be measured pre- and post-intervention. Conclusion: This study describes a protocol for pilot, peer-led, social marketing and youth-involved intervention, where adolescents design and implement activities for their younger peers to promote healthy lifestyles. Full article

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9 pages, 758 KiB

Open AccessArticle

Quality of Vegetables Based on Total Phenolic Concentration Is Lower in More Rural Consumer Food Environments in a Rural American State

by Selena Ahmed and Carmen Byker Shanks

Int. J. Environ. Res. Public Health 2017, 14(8), 924; https://doi.org/10.3390/ijerph14080924 - 17 Aug 2017

Cited by 11 | Viewed by 6568

Abstract

While daily consumption of fruits and vegetables (FVs) is widely recognized to be associated with supporting nutrition and health, disparities exist in consumer food environments regarding access to high-quality produce based on location. The purpose of this study was to evaluate FV quality [...] Read more.

While daily consumption of fruits and vegetables (FVs) is widely recognized to be associated with supporting nutrition and health, disparities exist in consumer food environments regarding access to high-quality produce based on location. The purpose of this study was to evaluate FV quality using total phenolic (TP) scores (a phytochemical measure for health-promoting attributes, flavor, appearance, and shelf-life) in consumer food environments along a rural to urban continuum in the rural state of Montana, United States. Significant differences were found in the means of the FV TP scores (p < 0.0001) and vegetable TP scores (p < 0.0001) on the basis of rurality, while no significant difference was found for fruit TP scores by rurality (p < 0.2158). Specifically, FV TP scores and vegetable TP scores were highest for the least rural stores and lowest for the most rural stores. Results indicate an access gap to high-quality vegetables in more rural and more health-disparate consumer food environments of Montana compared to urban food environments. Findings highlight that food and nutrition interventions should aim to increase vegetable quality in rural consumer food environments in the state of Montana towards enhancing dietary quality and food choices. Future studies are called for that examine TP scores of a wide range of FVs in diverse food environments globally. Studies are further needed that examine linkages between FV quality, food choices, diets, and health outcomes towards enhancing food environments for public health. Full article

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11 pages, 3107 KiB

Open AccessArticle

Forecasting the Incidence of Mumps in Zibo City Based on a SARIMA Model

by Qinqin Xu, Runzi Li, Yafei Liu, Cheng Luo, Aiqiang Xu, Fuzhong Xue, Qing Xu and Xiujun Li

Int. J. Environ. Res. Public Health 2017, 14(8), 925; https://doi.org/10.3390/ijerph14080925 - 17 Aug 2017

Cited by 29 | Viewed by 6168

Abstract

This study aimed to predict the incidence of mumps using a seasonal autoregressive integrated moving average (SARIMA) model, and provide theoretical evidence for early warning prevention and control in Zibo City, Shandong Province, China. Monthly mumps data from Zibo City gathered between 2005 [...] Read more.

This study aimed to predict the incidence of mumps using a seasonal autoregressive integrated moving average (SARIMA) model, and provide theoretical evidence for early warning prevention and control in Zibo City, Shandong Province, China. Monthly mumps data from Zibo City gathered between 2005 and 2013 were used as a training set to construct a SARIMA model, and the monthly mumps in 2014 were defined as a test set for the model. From 2005 to 2014, a total of 8722 cases of mumps were reported in Zibo City; the male-to-female ratio of cases was 1.85:1, the age group of 1–20 years old accounted for 94.05% of all reported cases, and students made up the largest proportion (65.89%). The main serious endemic areas of mumps were located in Huantai County, Linzi District, and Boshan District of Zibo City. There were two epidemic peaks from April to July and from October to January in next year. The fitted model SARIMA (0, 1, 1) (0, 1, 1)₁₂ was established (AIC = 157.528), which has high validity and reasonability. The SARIMA model fitted dynamic changes of mumps in Zibo City well. It can be used for short-term forecasting and early warning of mumps. Full article

(This article belongs to the Section Global Health)

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14 pages, 6747 KiB

Open AccessArticle

Estimation of the Vertical Distribution of Radiocesium in Soil on the Basis of the Characteristics of Gamma-Ray Spectra Obtained via Aerial Radiation Monitoring Using an Unmanned Helicopter

by Kotaro Ochi, Miyuki Sasaki, Mutsushi Ishida, Shoichiro Hamamoto, Taku Nishimura and Yukihisa Sanada

Int. J. Environ. Res. Public Health 2017, 14(8), 926; https://doi.org/10.3390/ijerph14080926 - 17 Aug 2017

Cited by 5 | Viewed by 4521

Abstract

After the Fukushima Daiichi Nuclear Power Plant accident, the vertical distribution of radiocesium in soil has been investigated to better understand the behavior of radiocesium in the environment. The typical method used for measuring the vertical distribution of radiocesium is troublesome because it [...] Read more.

After the Fukushima Daiichi Nuclear Power Plant accident, the vertical distribution of radiocesium in soil has been investigated to better understand the behavior of radiocesium in the environment. The typical method used for measuring the vertical distribution of radiocesium is troublesome because it requires collection and measurement of the activity of soil samples. In this study, we established a method of estimating the vertical distribution of radiocesium by focusing on the characteristics of gamma-ray spectra obtained via aerial radiation monitoring using an unmanned helicopter. The estimates are based on actual measurement data collected at an extended farm. In this method, the change in the ratio of direct gamma rays to scattered gamma rays at various depths in the soil was utilized to quantify the vertical distribution of radiocesium. The results show a positive correlation between the abovementioned and the actual vertical distributions of radiocesium measured in the soil samples. A vertical distribution map was created on the basis of this ratio using a simple equation derived from the abovementioned correlation. This technique can provide a novel approach for effective selection of high-priority areas that require decontamination. Full article

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

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10 pages, 1305 KiB

Open AccessArticle

Drinking Water Uranium and Potential Health Effects in the German Federal State of Bavaria

by Andre Banning and Mira Benfer

Int. J. Environ. Res. Public Health 2017, 14(8), 927; https://doi.org/10.3390/ijerph14080927 - 18 Aug 2017

Cited by 53 | Viewed by 7694

Abstract

Mainly due to its nephrotoxic and osteotoxic potential, uranium (U) increasingly finds itself in the spotlight of environmental and health-related research. Germany decided on a binding U guideline value in drinking water of 10 µg/L, valid since 2011. It is yet widely unknown [...] Read more.

Mainly due to its nephrotoxic and osteotoxic potential, uranium (U) increasingly finds itself in the spotlight of environmental and health-related research. Germany decided on a binding U guideline value in drinking water of 10 µg/L, valid since 2011. It is yet widely unknown if and how public health was affected by elevated U concentrations before that. In this ecological study we summarized available drinking water U data for the German federal state of Bavaria (703 analyses in total for 553 different municipalities) at county level (for 76 out of 96 Bavarian counties, representing about 83% of Bavaria’s and about 13% of Germany’s total population) in terms of mean and maximum U concentration. Bavaria is known to regionally exhibit mainly geogenically elevated groundwater U with a maximum value of 40 µg/L in the database used here. Public health data were obtained from federal statistical authorities at county resolution. These included incidence rates of diagnosed diseases suspected to be potentially associated with chronic U uptake, e.g., diseases of the skeleton, the liver or the thyroid as well as tumor and genito-urinary diseases. The datasets were analyzed for interrelations and mutual spatial occurrence using statistical approaches and GIS as well as odds ratios and relative risks calculations. Weak but significant positive associations between maximum U concentrations and aggregated ICD-10 diagnose groups for growths/tumors as well as liver diseases were observed, elevated incidence rates of thyroid diseases seem to occur where mean drinking water U concentrations exceed 2 µg/L. Here, we discuss obtained results and their implications for potential impacts of hydrochemistry on public health in southeast Germany. Full article

(This article belongs to the Special Issue Proceedings from the 3rd International Symposium on Environment and Health)

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9 pages, 330 KiB

Open AccessArticle

Personal Hygiene Practices among Urban Homeless Persons in Boston, MA

by Jessica H. Leibler, Daniel D. Nguyen, Casey León, Jessie M. Gaeta and Debora Perez

Int. J. Environ. Res. Public Health 2017, 14(8), 928; https://doi.org/10.3390/ijerph14080928 - 18 Aug 2017

Cited by 34 | Viewed by 16752

Abstract

Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors [...] Read more.

Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors among people experiencing homelessness has received limited attention. We conducted a cross-sectional study of individuals experiencing homelessness in Boston, MA (n = 194) to identify hygiene-related self-care practices and risk factors for reduced hygiene in this population. Most participants (72%) reported taking a daily shower. More than 60% reported hand washing with soap five or more times each day, and use of hand sanitizer was widespread (89% reported using sanitizer in the last week). A majority (86%) used a laundromat or laundry machine to wash clothing, while 14% reported washing clothing in the sink. Heavy drinking, injection drug use, and sleeping outdoors were identified as significant risk factors for reduced hygiene practices. People experiencing homelessness who also engage in these activities may be among the most difficult to reach for intervention, yet targeted efforts may decrease illness risk associated with reduced hygiene. Housed friends and family play a critical role in assisting homeless individuals maintain hygiene by providing showers and laundry facilities. Full article

(This article belongs to the Special Issue Health and Health Care for Homeless People in Various Contexts)

11 pages, 311 KiB

Open AccessArticle

Beverage Intake among Children: Associations with Parent and Home-Related Factors

by Arwa Zahid, Cynthia Davey and Marla Reicks

Int. J. Environ. Res. Public Health 2017, 14(8), 929; https://doi.org/10.3390/ijerph14080929 - 18 Aug 2017

Cited by 47 | Viewed by 5874

Abstract

Beverage intake can influence child diet quality in a positive or negative manner depending on the beverage type and amounts consumed. Parenting practices such as role modeling and control of home beverage availability have been associated with child beverage intake, whereas examination of [...] Read more.

Beverage intake can influence child diet quality in a positive or negative manner depending on the beverage type and amounts consumed. Parenting practices such as role modeling and control of home beverage availability have been associated with child beverage intake, whereas examination of the influence of parental beverage nutrition knowledge has been more limited. The purpose of this study was to examine the relationships between sugar-sweetened and dairy beverage intake among children (9–12 years) and home and parental factors. A questionnaire was administered among a convenience sample of parents (n = 194) to assess beverage nutrition knowledge, beverage intake and home availability of beverages. Children completed a questionnaire to estimate usual beverage intake. Daily sugar-sweetened beverage intake by children ranged from 0.4 to 48 oz. Logistic regression analysis was used to examine relationships. Parents were mostly female, white, well educated, and employed. Home availability of sugar-sweetened and dairy beverages was positively associated with child sugar-sweetened (OR = 1.48, p = 0.03) and dairy beverage intake (OR = 1.34, p = 0.03), respectively. Parent dairy beverage intake was associated with child dairy beverage intake (OR = 1.06, p = 0.01). Parent knowledge about sugar in beverages was related to child dairy beverage intake (OR = 1.46, p = 0.02), whereas calcium/dairy knowledge and general beverage nutrition knowledge were not related to child beverage intake. Parenting practices and knowledge may play a role in determining child beverage intake. Full article

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

14 pages, 1393 KiB

Open AccessArticle

Cycle Tracks and Parking Environments in China: Learning from College Students at Peking University

by Changzheng Yuan, Yangbo Sun, Jun Lv and Anne C. Lusk

Int. J. Environ. Res. Public Health 2017, 14(8), 930; https://doi.org/10.3390/ijerph14080930 - 18 Aug 2017

Cited by 17 | Viewed by 7441

Abstract

China has a historic system of wide cycle tracks, many of which are now encroached by cars, buses and bus stops. Even with these conditions, college students still bicycle. On campuses, students park their bikes on facilities ranging from kick-stand-plazas to caged sheds [...] Read more.

China has a historic system of wide cycle tracks, many of which are now encroached by cars, buses and bus stops. Even with these conditions, college students still bicycle. On campuses, students park their bikes on facilities ranging from kick-stand-plazas to caged sheds with racks, pumps and an attendant. In other countries, including Canada, some of the newer cycle tracks need to be wider to accommodate an increasing number of bicyclists. Other countries will also need to improve their bike parking, which includes garage-basement cages and two-tiered racks. China could provide lessons about cycle tracks and bike parking. This study applied the Maslow Transportation Level of Service (LOS) theory, i.e., for cycle tracks and bike parking, only after the basic needs of safety and security are met for both vehicle occupants and bicyclists can the higher needs of convenience and comfort be met. With random clustering, a self-administered questionnaire was collected from 410 students in six dormitory buildings at Peking University in Beijing and an environmental scan of bicycle parking conducted in school/office and living areas. Cycle tracks (1 = very safe/5 = very unsafe) shared with moving cars were most unsafe (mean = 4.6), followed by sharing with parked cars (4.1) or bus stop users (4.1) (p < 0.001). Close to half thought campus bike parking lacked order. The most suggested parking facilities were sheds, security (guard or camera), bicycle racks and bicycle parking services (pumps, etc.). If parking were improved, three quarters indicated they would bicycle more. While caged sheds were preferred, in living areas with 1597 parked bikes, caged sheds were only 74.4% occupied. For the future of China’s wide cycle tracks, perhaps a fence-separated bus lane beside a cycle track might be considered or, with China’s recent increase in bike riding, shared bikes and E-bikes, perhaps cars/buses could be banned from the wide cycle tracks. In other countries, a widened cycle track entrance should deter cars. Everywhere, bike parking sheds could be built and redesigned with painted lines to offer more space and order, similar to car parking. Full article

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

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9 pages, 706 KiB

Open AccessArticle

Population-Based Study on the Effect of a Forest Environment on Salivary Cortisol Concentration

by Hiromitsu Kobayashi, Chorong Song, Harumi Ikei, Bum-Jin Park, Juyoung Lee, Takahide Kagawa and Yoshifumi Miyazaki

Int. J. Environ. Res. Public Health 2017, 14(8), 931; https://doi.org/10.3390/ijerph14080931 - 18 Aug 2017

Cited by 42 | Viewed by 7650

Abstract

The purpose of this study was to evaluate the effect of a forest environment on salivary cortisol concentration, particularly on the characteristics of its distribution. The participants were 348 young male subjects. The experimental sites were 34 forests and 34 urban areas across [...] Read more.

The purpose of this study was to evaluate the effect of a forest environment on salivary cortisol concentration, particularly on the characteristics of its distribution. The participants were 348 young male subjects. The experimental sites were 34 forests and 34 urban areas across Japan. The subjects viewed the landscape (forest or urban environment) for a period of 15 min while sitting in a chair. Saliva was sampled from the participants at the end of this 15-min period and then analyzed for cortisol concentration. Differences in the skewness and kurtosis of the distributions between the two environments were tested by performing a permutation test. The cortisol concentrations exhibited larger skewness (0.76) and kurtosis (3.23) in a forest environment than in an urban environment (skewness = 0.49; kurtosis = 2.47), and these differences were statistically significant. The cortisol distribution exhibited a more peaked and longer right-tailed curve in a forest environment than in an urban environment. Full article

(This article belongs to the Special Issue Evidence-Based Nature Therapy: Advances in Physiological Evaluation)

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9 pages, 285 KiB

Open AccessArticle

Urinary Levels of 4-Nonylphenol and 4-t-Octylphenol in a Representative Sample of the Korean Adult Population

by Hyejin Park and Kisok Kim

Int. J. Environ. Res. Public Health 2017, 14(8), 932; https://doi.org/10.3390/ijerph14080932 - 18 Aug 2017

Cited by 33 | Viewed by 4380

Abstract

4-Nonylphenol (4-NP) and 4-t-octylphenol (4-t-OP) are xenoestrogen compounds to which humans are exposed via contaminated food, water, and air. This study assessed the body burden of 4-NP and 4-t-OP in Koreans aged 18–69 years using data from the Korean National Human Biomonitoring Survey [...] Read more.

4-Nonylphenol (4-NP) and 4-t-octylphenol (4-t-OP) are xenoestrogen compounds to which humans are exposed via contaminated food, water, and air. This study assessed the body burden of 4-NP and 4-t-OP in Koreans aged 18–69 years using data from the Korean National Human Biomonitoring Survey conducted in 2009. Based on data from 1865 representative Koreans, 83.2% and 91.8% had urinary 4-NP and 4-t-OP concentrations >0.05 ng/mL (limit of detection). Of the Korean adult population, the geometric mean urinary concentrations of 4-NP and 4-t-OP were 3.70 ng/mL (95% confidence interval (CI) = 3.20–4.27) and 0.60 ng/mL (95% CI = 0.55–0.66), respectively. Urine 4-NP concentrations were significantly associated with place of residence and smoking status, whereas urine 4-t-OP concentrations were not correlated with any of the demographic factors. These findings suggest that most Koreans have detectable levels of 4-NP and 4-t-OP in their urine and that the body burden of 4-NP, but not 4-t-OP, varies according to some demographic factors. Full article

(This article belongs to the Section Environmental Health)

13 pages, 1942 KiB

Open AccessArticle

Odorous Compounds from Poultry Manure Induce DNA Damage, Nuclear Changes, and Decrease Cell Membrane Integrity in Chicken Liver Hepatocellular Carcinoma Cells

by Adriana Nowak, Tadeusz Bakuła, Katarzyna Matusiak, Remigiusz Gałęcki, Sebastian Borowski and Beata Gutarowska

Int. J. Environ. Res. Public Health 2017, 14(8), 933; https://doi.org/10.3390/ijerph14080933 - 18 Aug 2017

Cited by 17 | Viewed by 5761

Abstract

Animal breeding and management of organic wastes pose a serious problem to the health of livestock and workers, as well as the nearby residents. The aim of the present study was to determine the mechanisms of toxicity of selected common odorous compounds from [...] Read more.

Animal breeding and management of organic wastes pose a serious problem to the health of livestock and workers, as well as the nearby residents. The aim of the present study was to determine the mechanisms of toxicity of selected common odorous compounds from poultry manure, including ammonia, dimethylamine (DMA), trimethylamine (TMA), butyric acid, phenol, and indole. We measured their genotoxic and cytotoxic activity in the model chicken cell line (LMH), in vitro, by comet assay and lactate dehydrogenase assay, respectively. We also made microscopic observations of any morphological changes in these cells by DAPI staining. Four compounds, namely ammonia, DMA, TMA, and butyric acid increased DNA damage in a dose-dependent manner (p < 0.05), reaching genotoxicity as high as 73.2 ± 1.9%. Phenol and indole induced extensive DNA damage independent of the concentration used. Ammonia, DMA, and TMA caused a dose-dependent release of lactate dehydrogenase (p < 0.05). The IC₅₀ values were 0.02%, 0.05%, and 0.1% for DMA, ammonia and TMA, respectively. These compounds also induced nuclear morphological changes, such as chromatin condensation, shrinkage, nuclear fragmentation (apoptotic bodies), and chromatin lysis. Our study exhibited the damaging effects of odorous compounds in chick LMH cell line. Full article

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

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17 pages, 667 KiB

Open AccessArticle

Identifying Key Performance Indicators for Holistic Hospital Management with a Modified DEMATEL Approach

by Sheng-Li Si, Xiao-Yue You, Hu-Chen Liu and Jia Huang

Int. J. Environ. Res. Public Health 2017, 14(8), 934; https://doi.org/10.3390/ijerph14080934 - 19 Aug 2017

Cited by 65 | Viewed by 11636

Abstract

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the [...] Read more.

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the limited resources. A feasible way is to identify the central and influential indicators to improve healthcare performance in a stepwise manner. In this paper, we propose a hybrid multiple criteria decision making (MCDM) approach to identify key performance indicators (KPIs) for holistic hospital management. First, through integrating evidential reasoning approach and interval 2-tuple linguistic variables, various assessments of performance indicators provided by healthcare experts are modeled. Then, the decision making trial and evaluation laboratory (DEMATEL) technique is adopted to build an interactive network and visualize the causal relationships between the performance indicators. Finally, an empirical case study is provided to demonstrate the proposed approach for improving the efficiency of healthcare management. The results show that “accidents/adverse events”, “nosocomial infection”, ‘‘incidents/errors”, “number of operations/procedures” are significant influential indicators. Also, the indicators of “length of stay”, “bed occupancy” and “financial measures” play important roles in performance evaluation of the healthcare organization. The proposed decision making approach could be considered as a reference for healthcare administrators to enhance the performance of their healthcare institutions. Full article

(This article belongs to the Section Health Economics)

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14 pages, 531 KiB

Open AccessArticle

Changes in Urinary Phthalate Metabolite Levels Before and After the Phthalate Contamination Event and Identification of Exposure Sources in a Cohort of Taiwanese Children

by Chian-Feng Huang and I-Jen Wang

Int. J. Environ. Res. Public Health 2017, 14(8), 935; https://doi.org/10.3390/ijerph14080935 - 19 Aug 2017

Cited by 10 | Viewed by 4924

Abstract

In 2011, the Taiwan Food and Drug Administration inadvertently discovered that, for decades, manufacturers had replaced expensive natural emulsifiers in food products with diethylhexyl phthalate (DEHP). We wanted to compare urinary phthalate metabolite levels of children before and after the DEHP food contamination [...] Read more.

In 2011, the Taiwan Food and Drug Administration inadvertently discovered that, for decades, manufacturers had replaced expensive natural emulsifiers in food products with diethylhexyl phthalate (DEHP). We wanted to compare urinary phthalate metabolite levels of children before and after the DEHP food contamination event and identify source(s) of phthalate exposure in addition to the illegal food additives. In the present study, morning urine samples were collected from a cohort of 453 children in 2010 in Taipei. After the DEHP food contamination event, there were 200 cohort children left at follow-up in 2013. The geometric means (GMs) of urinary mono(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP) levels before and after the event were 9.39 and 13.34 µg/g of creatinine, respectively, with no significant difference (p = 0.093). After the DEHP food contamination event, we found that urinary phthalate metabolite levels were significantly higher in people who frequently consumed microwave-heated food and used fragrance-containing products (p < 0.05). In addition, children who did not frequently wash hands before eating had significantly higher urinary phthalate metabolite levels than those who did (p < 0.05). These results demonstrate that urinary phthalate metabolite levels did not decrease after the DEHP food contamination event, thus, other sources must contribute to phthalate exposure in daily life. Public awareness of approaches to reducing phthalate exposure is necessary. Full article

(This article belongs to the Section Environmental Health)

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18 pages, 476 KiB

Open AccessArticle

I Walk My Dog Because It Makes Me Happy: A Qualitative Study to Understand Why Dogs Motivate Walking and Improved Health

by Carri Westgarth, Robert M. Christley, Garry Marvin and Elizabeth Perkins

Int. J. Environ. Res. Public Health 2017, 14(8), 936; https://doi.org/10.3390/ijerph14080936 - 19 Aug 2017

Cited by 82 | Viewed by 44080

Abstract

Dog walking is a popular everyday physical activity. Dog owners are generally more active than non-owners, but some rarely walk with their dog. The strength of the dog–owner relationship is known to be correlated with dog walking, and this qualitative study investigates why. [...] Read more.

Dog walking is a popular everyday physical activity. Dog owners are generally more active than non-owners, but some rarely walk with their dog. The strength of the dog–owner relationship is known to be correlated with dog walking, and this qualitative study investigates why. Twenty-six interviews were combined with autoethnography of dog walking experiences. Dog walking was constructed as “for the dog”, however, owners represented their dog’s needs in a way which aligned with their own. Central to the construction of need was perceptions of dog personality and behaviour. Owners reported deriving positive outcomes from dog walking, most notably, feelings of “happiness”, but these were “contingent” on the perception that their dogs were enjoying the experience. Owner physical activity and social interaction were secondary bonuses but rarely motivating. Perceptions and beliefs of owners about dog walking were continually negotiated, depending on how the needs of the owner and dog were constructed at that time. Complex social interactions with the “significant other” of a pet can strongly motivate human health behaviour. Potential interventions to promote dog walking need to account for this complexity and the effect of the dog-owner relationship on owner mental wellbeing. Full article

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

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16 pages, 8335 KiB

Open AccessArticle

A Geographical Analysis of Emergency Medical Service Calls and Extreme Heat in King County, WA, USA (2007–2012)

by Aubrey C. DeVine, Phuong T. Vu, Michael G. Yost, Edmund Y. W. Seto and Tania M. Busch Isaksen

Int. J. Environ. Res. Public Health 2017, 14(8), 937; https://doi.org/10.3390/ijerph14080937 - 20 Aug 2017

Cited by 11 | Viewed by 6432

Abstract

This research analyzed the relationship between extreme heat and Emergency Medical Service (EMS) calls in King County, WA, USA between 2007 and 2012, including the effect of community-level characteristics. Extreme heat thresholds for the Basic Life Support (BLS) data and the Advanced Life [...] Read more.

This research analyzed the relationship between extreme heat and Emergency Medical Service (EMS) calls in King County, WA, USA between 2007 and 2012, including the effect of community-level characteristics. Extreme heat thresholds for the Basic Life Support (BLS) data and the Advanced Life Support (ALS) data were found using a piecewise generalized linear model with Akaike Information Criterion (AIC). The association between heat exposure and EMS call rates was investigated using a generalized estimating equations with Poisson mean model, while adjusting for community-level indicators of poverty, impervious surface, and elderly population (65+). In addition, we examined the effect modifications of these community-level factors. Extreme-heat thresholds of 31.1 °C and 33.5 °C humidex were determined for the BLS and ALS data, respectively. After adjusting for other variables in the model, increased BLS call volume was significantly associated with occurring on a heat day (relative rate (RR) = 1.080, p < 0.001), as well as in locations with higher percent poverty (RR = 1.066, p < 0.001). No significant effect modification was identified for the BLS data on a heat day. Controlling for other variables, higher ALS call volume was found to be significantly associated with a heat day (RR = 1.067, p < 0.001), as well as in locations with higher percent impervious surface (RR = 1.015, p = 0.039), higher percent of the population 65 years or older (RR = 1.057, p = 0.005), and higher percent poverty (RR = 1.041, p = 0.016). Furthermore, percent poverty and impervious surface were found to significantly modify the relative rate of ALS call volumes between a heat day and non-heat day. We conclude that EMS call volume increases significantly on a heat day compared to non-heat day for both call types. While this study shows that there is some effect modification between the community-level variables and call volume on a heat day, further research is necessary. Our findings also suggest that with adequate power, spatially refined analyses may not be necessary to accurately estimate the extreme-heat effect on health. Full article

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

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8 pages, 290 KiB

Open AccessArticle

An Experiment Assessing Punitive versus Wellness Framing of a Tobacco-Free Campus Policy on Students’ Perceived Level of University Support

by Joseph G. L. Lee, Christopher J. Purcell and Beth H. Chaney

Int. J. Environ. Res. Public Health 2017, 14(8), 938; https://doi.org/10.3390/ijerph14080938 - 20 Aug 2017

Cited by 6 | Viewed by 5163

Abstract

The objective of this study was to examine how different ways of describing a hypothetical tobacco-free campus policy would impact college students’ perceived level of support from the college. In the spring of 2016, we randomized 1885 undergraduate students in a required course [...] Read more.

The objective of this study was to examine how different ways of describing a hypothetical tobacco-free campus policy would impact college students’ perceived level of support from the college. In the spring of 2016, we randomized 1885 undergraduate students in a required course to three message conditions in an online survey: control (no message), wellness (emphasizing promoting health and quitting support), and punitive (emphasizing consequences for violating the policy). The dependent variable was perceived organizational support. We selected items previously shown to be relevant for college students (alpha = 0.92 in our data). Given significant non-normality, we used non-parametric Kruskal-Wallis tests with pairwise comparisons to examine differences in perceived organizational support across the three conditions. We examined results by smoking status and if the participant correctly reported the message they received. We found no significant difference in perceived organizational support among students exposed to different tobacco-free campus policy announcements (p = 0.75). We also found no significant difference among smokers (p = 0.66). However, among smokers who correctly reported the message they received, we found significantly lower perceived university support (p = 0.01). Messages about tobacco-free campus policies should focus on the role of policy in supporting a healthy environment instead of punitive enforcement. Campus administrators should use caution when using message frames focusing on consequences of violating newly adopted policies. Full article

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

15 pages, 315 KiB

Open AccessArticle

Taking a Stand: The Effects of Standing Desks on Task Performance and Engagement

by Laura E. Finch, A. Janet Tomiyama and Andrew Ward

Int. J. Environ. Res. Public Health 2017, 14(8), 939; https://doi.org/10.3390/ijerph14080939 - 21 Aug 2017

Cited by 31 | Viewed by 12403

Abstract

Time spent sitting is associated with negative health outcomes, motivating some individuals to adopt standing desk workstations. This study represents the first investigation of the effects of standing desk use on reading comprehension and creativity. In a counterbalanced, within-subjects design, 96 participants completed [...] Read more.

Time spent sitting is associated with negative health outcomes, motivating some individuals to adopt standing desk workstations. This study represents the first investigation of the effects of standing desk use on reading comprehension and creativity. In a counterbalanced, within-subjects design, 96 participants completed reading comprehension and creativity tasks while both sitting and standing. Participants self-reported their mood during the tasks and also responded to measures of expended effort and task difficulty. In addition, participants indicated whether they expected that they would perform better on work-relevant tasks while sitting or standing. Despite participants’ beliefs that they would perform worse on most tasks while standing, body position did not affect reading comprehension or creativity performance, nor did it affect perceptions of effort or difficulty. Mood was also unaffected by position, with a few exceptions: Participants exhibited greater task engagement (i.e., interest, enthusiasm, and alertness) and less comfort while standing rather than sitting. In sum, performance and psychological experience as related to task completion were nearly entirely uninfluenced by acute (~30-min) standing desk use. Full article

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

17 pages, 6483 KiB

Open AccessArticle

Assessment of Urban Ecosystem Health Based on Matter Element Analysis: A Case Study of 13 Cities in Jiangsu Province, China

by Xuefeng Xie and Lijie Pu

Int. J. Environ. Res. Public Health 2017, 14(8), 940; https://doi.org/10.3390/ijerph14080940 - 21 Aug 2017

Cited by 25 | Viewed by 5369

Abstract

Urban public health is an important global issue and receives public concern. The urban ecosystem health (UEH) indicator system was constructed with 27 assessment indicators selected from vigor, organization, resilience, service function, and population health, then the matter element analysis (MEA) and analytic [...] Read more.

Urban public health is an important global issue and receives public concern. The urban ecosystem health (UEH) indicator system was constructed with 27 assessment indicators selected from vigor, organization, resilience, service function, and population health, then the matter element analysis (MEA) and analytic hierarchy process (AHP) weighting method were used to assess the UEH of each city in Jiangsu Province during the period of 2000–2014. The results show that the overall ecosystem health status of each city shows continuous improvement. The UEH status of each city gradually transferred from poor, general, and medium condition to good and excellent condition. From the perspective of spatial distribution, the city’s UEH showing a steady status after increasing for 10 years, and their spatial variations have gradually reduced. The UEH status in Southern Jiangsu and Central Jiangsu was better than that of Northern Jiangsu Province. From each component point of view, the vigor, resilience, and population health of each city in Jiangsu Province showed a trend of continuous improvement, while the organization and service function first increased and then decreased. The common limiting factors of UEH in Jiangsu Province were Engel’s coefficient of urban households, number of beds of hospitals, health centers per 10,000 people, and total investment in the treatment of environmental pollution as percent GDP. These results help decision makers to make suitable decisions to maintain the UEH of each city in Jiangsu Province. Full article

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

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11 pages, 846 KiB

Open AccessArticle

Grip Strength and Its Relationship to Police Recruit Task Performance and Injury Risk: A Retrospective Cohort Study

by Robin Orr, Rodney Pope, Michael Stierli and Benjamin Hinton

Int. J. Environ. Res. Public Health 2017, 14(8), 941; https://doi.org/10.3390/ijerph14080941 - 21 Aug 2017

Cited by 83 | Viewed by 8012

Abstract

Suitable grip strength is a police occupational requirement. The aim of this study was to investigate the association between grip strength, task performance and injury risk in a police population. Retrospective data of police recruits (n = 169) who had undergone basic recruit [...] Read more.

Suitable grip strength is a police occupational requirement. The aim of this study was to investigate the association between grip strength, task performance and injury risk in a police population. Retrospective data of police recruits (n = 169) who had undergone basic recruit training were provided, including handgrip strength results, occupational task performance measures (consisting of police task simulations [SIM], tactical options [TACOPS] and marksmanship assessments) and injury records. Left hand grip strength (41.91 ± 8.29 kg) measures showed a stronger correlation than right hand grip strength (42.15 ± 8.53 kg) with all outcome measures. Recruits whose grip strength scores were lower were significantly more susceptible to failing the TACOPS occupational task assessment than those with greater grip strength scores, with significant (p ≤ 0.003) weak to moderate, positive correlations found between grip strength and TACOPS performance. A significant (p < 0.0001) correlation was found between grip strength, most notably of the left hand, and marksmanship performance, with those performing better in marksmanship having higher grip strength. Left hand grip strength was significantly associated with injury risk (r = −0.181, p = 0.018) but right hand grip strength was not. A positive association exists between handgrip strength and police recruit task performance (notably TACOPS and marksmanship) with recruits who scored poorly on grip strength being at greatest risk of occupational assessment task failure. Full article

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

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8 pages, 269 KiB

Open AccessReview

Trapped in Statelessness: Rohingya Refugees in Bangladesh

by Abul Hasnat Milton, Mijanur Rahman, Sumaira Hussain, Charulata Jindal, Sushmita Choudhury, Shahnaz Akter, Shahana Ferdousi, Tafzila Akter Mouly, John Hall and Jimmy T. Efird

Int. J. Environ. Res. Public Health 2017, 14(8), 942; https://doi.org/10.3390/ijerph14080942 - 21 Aug 2017

Cited by 107 | Viewed by 34097

Abstract

The Rohingya people are one of the most ill-treated and persecuted refugee groups in the world, having lived in a realm of statelessness for over six generations, and who are still doing so. In recent years, more than 500,000 Rohingyas fled from Myanmar [...] Read more.

The Rohingya people are one of the most ill-treated and persecuted refugee groups in the world, having lived in a realm of statelessness for over six generations, and who are still doing so. In recent years, more than 500,000 Rohingyas fled from Myanmar (Burma) to neighboring countries. This article addresses the Rohingya refugee crisis in Bangladesh, with special emphasis on the living conditions of this vulnerable population. We reviewed several documents on Rohingya refugees, visited a registered refugee camp (Teknaf), collected case reports, and conducted a series of meetings with stakeholders in the Cox’s Bazar district of Bangladesh. A total of 33,131 registered Rohingya refugees are living in two registered camps in Cox’s Bazar, and up to 80,000 additional refugees are housed in nearby makeshift camps. Overall, the living conditions of Rohingya refugees inside the overcrowded camps remain dismal. Mental health is poor, proper hygiene conditions are lacking, malnutrition is endemic, and physical/sexual abuse is high. A concerted diplomatic effort involving Bangladesh and Myanmar, and international mediators such as the Organization of Islamic Countries and the United Nations, is urgently required to effectively address this complex situation. Full article

(This article belongs to the Special Issue Refugee Health)

10 pages, 306 KiB

Open AccessArticle

Further Evidence of a Specific Psychopathology of Addiction. Differentiation from Other Psychiatric Psychopathological Dimensions (Such as Obesity)

by Angelo G.I. Maremmani, Luca Cerniglia, Silvia Cimino, Silvia Bacciardi, Luca Rovai, Alessandro Pallucchini, Vincenza Spera, Giulio Perugi and Icro Maremmani

Int. J. Environ. Res. Public Health 2017, 14(8), 943; https://doi.org/10.3390/ijerph14080943 - 21 Aug 2017

Cited by 41 | Viewed by 4888

Abstract

Introduction: In this study, we used a symptomatology checklist (SCL-90) to substantiate the hypothesis that Substance Use Disorder (SUD) has its own five-dimensional psychopathology. The aim of the present study was to test whether this psychopathology can be differentiated from other psychiatric [...] Read more.

Introduction: In this study, we used a symptomatology checklist (SCL-90) to substantiate the hypothesis that Substance Use Disorder (SUD) has its own five-dimensional psychopathology. The aim of the present study was to test whether this psychopathology can be differentiated from other psychiatric psychopathological dimensions (such as obesity). Methods: The severity and frequency of each of the five dimensions were investigated, at univariate and multivariate levels, by comparing 972 Heroin Use Disorder (HUD) patients (83.5% male, mean age 30.12 ± 6.6, range: 16–59) and 106 obese individuals (50.0% male, mean age 37.59 ± 7.6, range: 24–52). The correlations between the Body Mass Index (BMI) of obese individuals with these psychopathological dimensions were also studied. Results: Obese individuals showed higher SCL-90 total scores, global severity index scores, number of items rated positively, and positive symptoms distress index scores than HUD patients. The severity of all psychopathological dimensions was significantly higher in obese individuals. Discriminant analysis showed that Panic-Anxiety and Violence-Suicide severity were more frequent in obese patients, sufficiently so to allow differentiation between HUD (lower severity) and obese individuals (greater severity). At the reclassification level, 70.8% of obese individuals in the sample were reclassified as HUD patients. Psychopathological subtypes characterized by Panic-Anxiety and Violence-Suicide typology were more frequent in obese patients and sufficiently so as to discriminate between groups. Of obese patients, 47.2% were reclassified as HUD patients. The severity of the Worthlessness-Being Trapped dimension was sufficient to predict the BMI of obese individuals. Conclusions: Our results suggest that the five-factor psychopathology found in HUD can discriminate between HUD and obese patients, but that there is an area of overlap between the forms of psychopathology found in SUD and those found in obese patients. Full article

(This article belongs to the Section Global Health)

19 pages, 1358 KiB

Open AccessArticle

Biometeorological Assessment of Mortality Related to Extreme Temperatures in Helsinki Region, Finland, 1972–2014

by Reija Ruuhela, Kirsti Jylhä, Timo Lanki, Pekka Tiittanen and Andreas Matzarakis

Int. J. Environ. Res. Public Health 2017, 14(8), 944; https://doi.org/10.3390/ijerph14080944 - 22 Aug 2017

Cited by 49 | Viewed by 7474

Abstract

Climate change is expected to increase heat-related and decrease cold-related mortality. The extent of acclimatization of the population to gradually-changing thermal conditions is not well understood. We aimed to define the relationship between mortality and temperature extremes in different age groups in the [...] Read more.

Climate change is expected to increase heat-related and decrease cold-related mortality. The extent of acclimatization of the population to gradually-changing thermal conditions is not well understood. We aimed to define the relationship between mortality and temperature extremes in different age groups in the Helsinki-Uusimaa hospital district in Southern Finland, and changes in sensitivity of the population to temperature extremes over the period of 1972–2014. Time series of mortality were made stationary with a method that utilizes 365-day Gaussian smoothing, removes trends and seasonality, and gives relative mortality as the result. We used generalized additive models to examine the association of relative mortality to physiologically equivalent temperature (PET) and to air temperature in the 43-year study period and in two 21-year long sub-periods (1972–1992 and 1994–2014). We calculated the mean values of relative mortality in percentile-based categories of thermal indices. Relative mortality increases more in the hot than in the cold tail of the thermal distribution. The increase is strongest among those aged 75 years and older, but is somewhat elevated even among those younger than 65 years. Above the 99th percentile of the PET distribution, the all-aged relative mortality decreased in time from 18.3 to 8.6%. Among those ≥75 years old, the decrease in relative mortality between the sub-periods were found to be above the 90th percentile. The dependence of relative mortality on cold extremes was negligible, except among those ≥75 years old, in the latter period. Thus, heat-related mortality is also remarkable in Finland, but the sensitivity to heat stress has decreased over the decades. Full article

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

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27 pages, 386 KiB

Open AccessFeature PaperArticle

“You Think You’re Helping Them, But They’re Helping You Too”: Experiences of Scottish Male Young Offenders Participating in a Dog Training Program

by Rebecca J. Leonardi, Hannah M. Buchanan-Smith, Gill McIvor and Sarah-Jane Vick

Int. J. Environ. Res. Public Health 2017, 14(8), 945; https://doi.org/10.3390/ijerph14080945 - 22 Aug 2017

Cited by 30 | Viewed by 10391

Abstract

Interaction with animals can be beneficial to humans and animal-assisted interventions (AAIs) are increasingly popular in a range of contexts. Dog training programs (DTPs) are the most popular form of AAI in custodial contexts; prisoners often have multiple needs and DTPs seem to [...] Read more.

Interaction with animals can be beneficial to humans and animal-assisted interventions (AAIs) are increasingly popular in a range of contexts. Dog training programs (DTPs) are the most popular form of AAI in custodial contexts; prisoners often have multiple needs and DTPs seem to facilitate a diverse range of positive outcomes, including improvements in well-being, behavior, and offending behavior. However, evidence on the efficacy of prison-based DTPs is still limited and these evaluations often lack detail or methodological rigor. We examined the experiences of male young offenders (N = 70) using thematic analysis of semi-structured interviews conducted following completion of a DTP. The themes that emerged indicated a broad range of inter-related experiences and positive outcomes. The most prevalent theme related to their experiences with Dogs (including feelings and attitudes), and there were perceived improvements categorized as: Positive Effects (including mood and well-being), Motivation, Charitable Purpose, Self-Efficacy, Improved Skills, Impulsivity, and Emotional Management. These themes mapped well onto outcomes previously identified in research on DTPs, and to the program’s core aims of improving behavior, educational engagement, employability, and well-being. The diversity and nature of these themes indicates that DTPs have considerable potential to engage and benefit those individuals with multiple needs, such as young offenders, and ultimately to achieve positive long-term outcomes with significant social, health, and economic impact. Full article

(This article belongs to the Special Issue Animal Assisted Interventions and Activities for Health and Wellbeing)

11 pages, 597 KiB

Open AccessArticle

Perceived Injury Risk among Junior Cricketers: A Cross Sectional Survey

by Prasanna J. Gamage, Lauren V. Fortington and Caroline F. Finch

Int. J. Environ. Res. Public Health 2017, 14(8), 946; https://doi.org/10.3390/ijerph14080946 - 22 Aug 2017

Cited by 8 | Viewed by 6930

Abstract

Understanding how junior athletes perceive injury risks when participating in sport and the environment they play in is an important component of injury prevention. This study investigates how Sri Lankan junior cricketers (n = 365, aged 11–14 years, boys) perceive injury risks [...] Read more.

Understanding how junior athletes perceive injury risks when participating in sport and the environment they play in is an important component of injury prevention. This study investigates how Sri Lankan junior cricketers (n = 365, aged 11–14 years, boys) perceive injury risks associated with playing cricket. The study used a Sri Lankan modification of an Australian junior cricket injury risk perception survey that considered playing cricket versus other sports, different cricket playing positions and roles, and different ground conditions. The risk of playing cricket was considered to be greater than that for cycling, but lower than that for rugby and soccer. Fast-bowlers, batters facing fast-bowlers, fielding close in the field, and wicket-keeping without a helmet were perceived to pose greater risks of injury than other scenarios. Playing on hard, bumpy and/or wet ground conditions were perceived to have a high risk opposed to playing on a grass field. Fielding in the outfield and wicket-keeping to fast-bowlers whilst wearing a helmet were perceived as low risk actions. The risk perceptions of junior cricketers identified in this study, do not necessarily reflect the true injury risk in some instances. This information will inform the development of injury prevention education interventions to address these risk perceptions in junior cricketers. Full article

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

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9 pages, 315 KiB

Open AccessArticle

Surface Sampling Collection and Culture Methods for Escherichia coli in Household Environments with High Fecal Contamination

by Natalie G. Exum, Margaret N. Kosek, Meghan F. Davis and Kellogg J. Schwab

Int. J. Environ. Res. Public Health 2017, 14(8), 947; https://doi.org/10.3390/ijerph14080947 - 22 Aug 2017

Cited by 6 | Viewed by 5481

Abstract

Empiric quantification of environmental fecal contamination is an important step toward understanding the impact that water, sanitation, and hygiene interventions have on reducing enteric infections. There is a need to standardize the methods used for surface sampling in field studies that examine fecal [...] Read more.

Empiric quantification of environmental fecal contamination is an important step toward understanding the impact that water, sanitation, and hygiene interventions have on reducing enteric infections. There is a need to standardize the methods used for surface sampling in field studies that examine fecal contamination in low-income settings. The dry cloth method presented in this manuscript improves upon the more commonly used swabbing technique that has been shown in the literature to have a low sampling efficiency. The recovery efficiency of a dry electrostatic cloth sampling method was evaluated using Escherichia coli and then applied to household surfaces in Iquitos, Peru, where there is high fecal contamination and enteric infection. Side-by-side measurements were taken from various floor locations within a household at the same time over a three-month period to compare for consistency of quantification of E. coli bacteria. The dry cloth sampling method in the laboratory setting showed 105% (95% Confidence Interval: 98%, 113%) E. coli recovery efficiency off of the cloths. The field application demonstrated strong agreement of side-by-side results (Pearson correlation coefficient for dirt surfaces was 0.83 (p < 0.0001) and 0.91 (p < 0.0001) for cement surfaces) and moderate agreement for results between entrance and kitchen samples (Pearson (0.53, p < 0.0001) and weighted Kappa statistic (0.54, p < 0.0001)). Our findings suggest that this method can be utilized in households with high bacterial loads using either continuous (quantitative) or categorical (semi-quantitative) data. The standardization of this low-cost, dry electrostatic cloth sampling method can be used to measure differences between households in intervention and non-intervention arms of randomized trials. Full article

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

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Int. J. Environ. Res. Public Health, Volume 14, Issue 8 (August 2017) – 118 articles

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