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Int. J. Environ. Res. Public Health, Volume 16, Issue 18 (September-2 2019)

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Cover Story (view full-size image) Climate change is increasing the risk of flooding in countries like the UK. The economic costs are [...] Read more.
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Open AccessArticle
Occurrence of Cortical Arousal at Recovery from Respiratory Disturbances during Deep Propofol Sedation
Int. J. Environ. Res. Public Health 2019, 16(18), 3482; https://doi.org/10.3390/ijerph16183482 (registering DOI) - 18 Sep 2019
Abstract
Abstract: Recent evidences suggest that non-arousal mechanisms can restore and stabilize breathing in sleeping patients with obstructive sleep apnea. This possibility can be examined under deep sedation which increases the cortical arousal threshold. We examined incidences of cortical arousal at termination [...] Read more.
Abstract: Recent evidences suggest that non-arousal mechanisms can restore and stabilize breathing in sleeping patients with obstructive sleep apnea. This possibility can be examined under deep sedation which increases the cortical arousal threshold. We examined incidences of cortical arousal at termination of apneas and hypopneas in elderly patients receiving propofol sedation which increases the cortical arousal threshold. Ten elderly patients undergoing advanced endoscopic procedures under propofol-sedation were recruited. Standard polysomnographic measurements were performed to assess nature of breathing, consciousness, and occurrence of arousal at recovery from apneas and hypopneas. A total of 245 periodic apneas and hypopneas were identified during propofol-induced sleep state. Cortical arousal only occurred in 55 apneas and hypopneas (22.5%), and apneas and hypopneas without arousal and desaturation were most commonly observed (65.7%) regardless of the types of disordered breathing. Chi-square test indicated that incidence of no cortical arousal was significantly associated with occurrence of no desaturation. Higher dose of propofol was associated with a higher apnea hypopnea index (r = 0.673, p = 0.033). In conclusion, even under deep propofol sedation, apneas and hypopneas can be terminated without cortical arousal. However, extensive suppression of the arousal threshold can lead to critical hypoxemia suggesting careful respiratory monitoring. Full article
(This article belongs to the Special Issue Sleep Apnea Syndrome)
Open AccessReview
Practical Guidance for Interventions in Adults with Metabolic Syndrome: Diet and Exercise vs. Changes in Body Composition
Int. J. Environ. Res. Public Health 2019, 16(18), 3481; https://doi.org/10.3390/ijerph16183481 (registering DOI) - 18 Sep 2019
Abstract
(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this [...] Read more.
(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this systematic review of randomized clinical trials (RCT) is based on the guidelines recommended by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Criteria of selection: ≥18 years of age; patients diagnosed with MS; intervention programs including diet, physical exercise and/or modifications in the style of life as treatment, as well as the magnitude of changes in body composition (BC); randomized clinical trial published between 2004 and 2018. (3) Results: the multidisciplinary interventions describe major changes in BC, and the recurring pattern in these clinical trials is an energy reduction and control in the percentage of intake of macronutrients along with the performance of regularly structured exercise; the most analyzed parameter was waist circumference (88.9% of the trials), followed by body weight (85.2%), BMI (77.8%) and body fat (55.6%). (4) Conclusions: The analysis of the information here reported sheds light for the design of future clinical trials in adults with MS. The best anthropometric parameters and units of measurement to monitor the interventions are related to dietary and physical exercise interventions. A list of practical advice that is easy to implement in daily practice in consultation is here proposed in order to guarantee the best results in changes of body composition. Full article
Open AccessArticle
Spatiotemporal Dynamics of Ecological Total-Factor Energy Efficiency and Their Drivers in China at the Prefecture Level
Int. J. Environ. Res. Public Health 2019, 16(18), 3480; https://doi.org/10.3390/ijerph16183480 (registering DOI) - 18 Sep 2019
Abstract
Improvement of ecological total-factor energy efficiency (ETFEE) is crucial for transformation of China’s economic growth pattern, energy conservation and emissions abatement. Here we combined the epsilon-based measure (EBM) and the Global Malmquist-Luenberger (GML) productivity index to evaluate ETFEE and ecological total-factor energy productivity [...] Read more.
Improvement of ecological total-factor energy efficiency (ETFEE) is crucial for transformation of China’s economic growth pattern, energy conservation and emissions abatement. Here we combined the epsilon-based measure (EBM) and the Global Malmquist-Luenberger (GML) productivity index to evaluate ETFEE and ecological total-factor energy productivity (ETFEP) and its decompositions for 283 prefecture-level cities in China between 2003 and 2013. A spatial econometric model is used to investigate factors influencing ETFEE and ETFEP. Results indicated that ETFEE, ETFEP and corresponding trends differ significantly depending on whether environmental constraints are considered. No convergence trend was found in ETFEE between prefecture-level cities. Technical progress plays the largest role in increasing ETFEP growth. Pure efficiency change and scale efficiency change, however, are the main hindering factors. Boosting cumulative technological progress, cumulative scale efficiency growth rate and cumulative pure efficiency growth rate are important means of increasing ETFEP. I also found that areas with high levels of economic development do not completely overlap with areas of high ETFEE. Surprisingly, the fiscal expenditure on scientific undertakings and technological spillover effects from foreign direct investment (FDI) have not substantially increased ETFEE. Whereas increased industrialization hinders the improvement of ETFEE. Furthermore, reducing per capita energy consumption help boost ETFEE. In addition, endowment advantages of factors of production have a positive overall effect on improving ETFEE. Lastly, important policy implications are inferred. Full article
(This article belongs to the Section Environmental Science and Engineering)
Open AccessArticle
Healthcare Supply Chain Network Coordination Through Medical Insurance Strategies with Reference Price Effect
Int. J. Environ. Res. Public Health 2019, 16(18), 3479; https://doi.org/10.3390/ijerph16183479 (registering DOI) - 18 Sep 2019
Abstract
China has established the universal medical insurance system and individual out of pocket costs have decreased, however, the average healthcare expenditure of the Chinese population and the expenses of the whole society have increased substantially. One major challenge which impedes the progress of [...] Read more.
China has established the universal medical insurance system and individual out of pocket costs have decreased, however, the average healthcare expenditure of the Chinese population and the expenses of the whole society have increased substantially. One major challenge which impedes the progress of attaining sustainable development of the social healthcare system in China is that the number of hospital admissions is disproportionate. Superior hospitals are overcrowded, whereas subordinate hospitals are experiencing low admissions. In this paper, we apply the game theory model to coordinate the healthcare supply chain network, which is composed of the government, medical insurance fund, superior hospitals, subordinate hospitals and patients. Especially by taking the reference price effect into account, this paper analyzes different medical insurance reimbursement strategies and their influence on patient choice and the healthcare supply chain network. The result shows that the reference price effect increases the leverage of medical insurance, guides patients’ choice, optimizes the allocation of medical resources and reduces the medical expends. In comparison to a decentralized decision- making strategy, a centralized decision- making strategy can stimulate both superior hospital and subordinate hospital’s cooperative intentions which benefits the social healthcare system. Full article
(This article belongs to the Special Issue Network Analytics in Healthcare Decision Making)
Open AccessReview
Evaluation of Public Health Emergency Management in China: A Systematic Review
Int. J. Environ. Res. Public Health 2019, 16(18), 3478; https://doi.org/10.3390/ijerph16183478 (registering DOI) - 18 Sep 2019
Abstract
To summarize the present status of health emergency management assessment in China, a comprehensive search of Chinese databases for research that explicitly mention health emergency assessment indicators and indicator systems was performed. Studies were evaluated using the Ekman quality assessment tool, and data [...] Read more.
To summarize the present status of health emergency management assessment in China, a comprehensive search of Chinese databases for research that explicitly mention health emergency assessment indicators and indicator systems was performed. Studies were evaluated using the Ekman quality assessment tool, and data were extracted with an original extraction form. Sixty-one studies were included. There are many types and methods of health emergency management assessment in China, and the dimensions and the indicators involved are complex. Legal, regulatory, and policy bases for such assessment need to be further strengthened. The relevance of the entire assessment process and its practical application should be enhanced. In the occupational practice, appropriate evaluation methods should be selected according to respective evaluation purposes, evaluation objects, and contents. Laws, regulations, and policies in the evaluation of health emergency management should be improved. Finally, further correlational research on health emergency management evaluation system processes should be explored and improved. Full article
Open AccessArticle
Occupational Class Differences in Long-Term Sickness Absence Due to Breast Cancer during 2005–2013: A Population-Based Study among Finnish Women
Int. J. Environ. Res. Public Health 2019, 16(18), 3477; https://doi.org/10.3390/ijerph16183477 (registering DOI) - 18 Sep 2019
Abstract
Breast cancer is the most common cancer among women in Western countries with clear socioeconomic differences. Higher occupational class is associated with higher breast cancer incidence but with better survival from the disease, whereas lower occupational class is associated with higher risk of [...] Read more.
Breast cancer is the most common cancer among women in Western countries with clear socioeconomic differences. Higher occupational class is associated with higher breast cancer incidence but with better survival from the disease, whereas lower occupational class is associated with higher risk of sickness absence. We are not aware of previous studies examining changes over time in occupational class differences in sickness absence due to breast cancer. This paper focuses on occupational class differences in the incidence and duration of sickness absence due to breast cancer over the period of 2005–2013. Age-adjusted occupational class differences in the cumulative incidence and duration of sickness absence due to breast cancer were calculated utilising a nationally representative 70% random sample of employed Finnish women aged 35–64 years (yearly N varying between 499,778 and 519,318). The results show that higher occupational class was associated with higher annual cumulative incidence of sickness absence due to breast cancer. Lower occupational class was associated with longer duration of absence. Occupational class differences in both cumulative incidence and duration of absence remained broadly stable. As a conclusion, these results suggest that measures should be targeted particularly to promotion of work capacity among employees with breast cancer in lower occupational classes. Full article
(This article belongs to the Special Issue Workplace Health and Wellbeing 2019)
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Open AccessArticle
Using Improved Principal Component Analysis to Explore Construction Accident Situations from the Multi-Dimensional Perspective: A Chinese Study
Int. J. Environ. Res. Public Health 2019, 16(18), 3476; https://doi.org/10.3390/ijerph16183476 (registering DOI) - 18 Sep 2019
Abstract
The improvement of the macro-level accident situation in the Chinese construction industry is currently an urgent task for the government due to the high accident rate. This study intends to use improved principal component analysis to explore the accident situations in the Chinese [...] Read more.
The improvement of the macro-level accident situation in the Chinese construction industry is currently an urgent task for the government due to the high accident rate. This study intends to use improved principal component analysis to explore the accident situations in the Chinese construction industry from a multi-dimensional perspective, aiming at providing targeted direction on the improvement of the accident situation for the government. Six composite indicators that can quantify the accident situation are firstly selected based on a wide review of the literature and interviews with safety experts, with the original data collected from China institutions. The classical principal component analysis is then improved to examine the correlations between indicators, and further to evaluate accident situations in China provinces. Finally, the features of accident situations are explored and analyzed from a multi-dimensional perspective. The findings show that the improved principal component analysis can retain more dispersion degree information of the original data. Meanwhile, three principal components including the accident frequency, trend, and severity were extracted to quantify the accident situation, and a hierarchical indicator system for the comprehensive evaluation of the accident situation was constructed to deeper understand multi-dimensional characteristics of China’s accident situations. Furthermore, there exist great regional differences of accident situations in Chinese provinces. From the overall perspective, the accident situation shows a declining trend from the western backward region to the highly developed eastern coastal region. This study provides a multi-dimensional perspective for the government to formulate safety regulations and improve the accident situation. Full article
Open AccessArticle
Bactericidal Activity of Ready-To-Use Alcohol-Based Commercial Wipes According to EN 16615 Carrier Standard
Int. J. Environ. Res. Public Health 2019, 16(18), 3475; https://doi.org/10.3390/ijerph16183475 (registering DOI) - 18 Sep 2019
Abstract
Background: The effectiveness of ready-to-use disinfectant wipes was previously assessed in standardized suspension tests, which were inadequate because they ignored that the wipes are rubbed against a surface. Thus, we assessed the effectiveness of commercially available disinfectant wipes impregnated with an alcoholic solution [...] Read more.
Background: The effectiveness of ready-to-use disinfectant wipes was previously assessed in standardized suspension tests, which were inadequate because they ignored that the wipes are rubbed against a surface. Thus, we assessed the effectiveness of commercially available disinfectant wipes impregnated with an alcoholic solution according to the 16615 standard, which includes a test with mechanical action. Methods: According to the EN 16615 standard, under clean conditions, four squares (5cm x 5 cm), placed next to one another, were marked on a test surface. Enterococcus hirae, Pseudomonas aeruginosa, and Staphylococcus aureus were inoculated on the leftmost square, and a wipe impregnated with an alcoholic solution was placed to the left of that square. Then, the wipe was pressed with a 2.5 kg weight and moved to the right and back to the left. After contact times of 1, 5, 10, or 15 minutes, we measured the reduction in bacterial load. Results: Alcohol-based ready-to-use commercial wipes did not show sufficient bactericidal activity at the contact times of 1, 5, 10 and 15 minutes. Wipes containing propan-1-ol and a mixture of propan-1-ol and propan-2-ol were active against Pseudomonas aeruginosa at the contact times of 1 minute and 15 minutes. None of the examined wipes were active against Enterococcus hirae or Staphylococcus aureus. Conclusion: Bactericidal parameters of ready-to-use disinfectant wipes should be determined in surface tests, in addition to suspension tests, because suspension tests do not simulate the conditions under which disinfectant wipes are used in practice. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle
Shift in Potential Malaria Transmission Areas in India, Using the Fuzzy-Based Climate Suitability Malaria Transmission (FCSMT) Model under Changing Climatic Conditions
Int. J. Environ. Res. Public Health 2019, 16(18), 3474; https://doi.org/10.3390/ijerph16183474 (registering DOI) - 18 Sep 2019
Abstract
The future implications of climate change on malaria transmission at the global level have already been reported, however such evidences are scarce and limited in India. Here our study aims to assess, identify and map the potential effects of climate change on Plasmodium [...] Read more.
The future implications of climate change on malaria transmission at the global level have already been reported, however such evidences are scarce and limited in India. Here our study aims to assess, identify and map the potential effects of climate change on Plasmodium vivax (Pv) and Plasmodium falciparum (Pf) malaria transmission in India. A Fuzzy-based Climate Suitability Malaria Transmission (FCSMT) model under the GIS environment was generated using Temperature and Relative Humidity data, extracted from CORDEX South Asia for Baseline (1976–2005) and RCP 4.5 scenario for future projection by the 2030s (2021–2040). National malaria data were used at the model analysis stage. Model outcomes suggest that climate change may significantly increase the spatial spread of Pv and Pf malaria with a numerical increase in the transmission window’s (TW) months, and a shift in the months of transmission. Some areas of the western Himalayan states are likely to have new foci of Pv malaria transmission. Interior parts of some southern and eastern states are likely to become more suitable for Pf malaria transmission. Study has also identified the regions with a reduction in transmission months by the 2030s, leading to unstable malaria, and having the potential for malaria outbreaks. Full article
(This article belongs to the Section Climate Change and Health)
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Open AccessReview
BIM-Based Visualization Research in the Construction Industry: A Network Analysis
Int. J. Environ. Res. Public Health 2019, 16(18), 3473; https://doi.org/10.3390/ijerph16183473 (registering DOI) - 18 Sep 2019
Abstract
Visualization is one of the main features of Building Information Modeling (BIM). It has many advantages throughout the lifecycle of a construction project, and it has become a timely research topic in recent years. However, no attempt has been made to give a [...] Read more.
Visualization is one of the main features of Building Information Modeling (BIM). It has many advantages throughout the lifecycle of a construction project, and it has become a timely research topic in recent years. However, no attempt has been made to give a holistic understanding of the existing BIM-based visualization research status. Thus, this study aims to conduct a scientometric analysis of the existing BIM-based visualization literature and to gain a snapshot of the research status during the period 2010–2019. A total of 255 articles were abstracted from the Scopus database. Then, the VOSviewer program was employed to visualize the research status from the perspectives of scholars, countries/regions, journals, articles, and co-occurring keywords. Results revealed that Wang X. published the greatest number of articles, while Cheng J.C.P. received the greatest average normalized citations. Furthermore, Automation in Construction was identified as the most influential journal and the article “Building information modeling (BIM): trends, benefits, risks, and challenges for the AEC industry” was the most cited paper. Through the keywords co-occurrence analysis, “virtual reality” and “visual programming language” were identified as the emerging themes in this field. The research findings can provide both researchers and practitioners with a better understanding of the status quo and trends of the BIM-based visualization research. Full article
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Open AccessArticle
Exploration of Medical Trajectories of Stroke Patients Based on Group-Based Trajectory Modeling
Int. J. Environ. Res. Public Health 2019, 16(18), 3472; https://doi.org/10.3390/ijerph16183472 (registering DOI) - 18 Sep 2019
Abstract
A high mortality rate is an issue with acute cerebrovascular disease (ACVD), as it often leads to a high medical expenditure, and in particular to high costs of treatment for emergency medical conditions and critical care. In this study, we used group-based trajectory [...] Read more.
A high mortality rate is an issue with acute cerebrovascular disease (ACVD), as it often leads to a high medical expenditure, and in particular to high costs of treatment for emergency medical conditions and critical care. In this study, we used group-based trajectory modeling (GBTM) to study the characteristics of various groups of patients hospitalized with ACVD. In this research, the patient data were derived from the 1 million sampled cases in the National Health Insurance Research Database (NHIRD) in Taiwan. Cases who had been admitted to hospitals fewer than four times or more than eight times were excluded. Characteristics of the ACVD patients were collected, including age, mortality rate, medical expenditure, and length of hospital stay for each admission. We then performed GBTM to examine hospitalization patterns in patients who had been hospitalized more than four times and fewer than or equal to eight times. The patients were divided into three groups according to medical expenditure: high, medium, and low groups, split at the 33rd and 66th percentiles. After exclusion of unqualified patients, a total of 27,264 cases (male/female = 15,972/11,392) were included. Analysis of the characteristics of the ACVD patients showed that there were significant differences between the two gender groups in terms of age, mortality rate, medical expenditure, and total length of hospital stay. In addition, the data were compared between two admissions, which included interval, outpatient department (OPD) visit after discharge, OPD visit after hospital discharge, and OPD cost. Finally, the differences in medical expenditure between genders and between patients with different types of stroke—ischemic stroke, spontaneous intracerebral hemorrhage (sICH), and subarachnoid hemorrhage (SAH)—were examined using GBTM. Overall, this study employed GBTM to examine the trends in medical expenditure for different groups of stroke patients at different admissions, and some important results were obtained. Our results demonstrated that the time interval between subsequent hospitalizations decreased in the ACVD patients, and there were significant differences between genders and between patients with different types of stroke. It is often difficult to decide when the time has been reached at which further treatment will not improve the condition of ACVD patients, and the findings of our study may be used as a reference for assessing outcomes and quality of care for stroke patients. Because of the characteristics of NHIRD, this study had some limitations; for example, the number of cases for some diseases was not sufficient for effective statistical analysis. Full article
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Open AccessArticle
Does Social Support Affect the Health of the Elderly in Rural China? A Meta-Analysis Approach
Int. J. Environ. Res. Public Health 2019, 16(18), 3471; https://doi.org/10.3390/ijerph16183471 (registering DOI) - 18 Sep 2019
Abstract
As the trend of aging in rural China has intensified, research on the factors affecting the health of the elderly in rural areas has become a hot issue. However, the conclusions of existing studies are inconsistent and even contradictory, making it difficult to [...] Read more.
As the trend of aging in rural China has intensified, research on the factors affecting the health of the elderly in rural areas has become a hot issue. However, the conclusions of existing studies are inconsistent and even contradictory, making it difficult to form constructive policies with practical value. To explore the reasons for the inconsistent conclusions drawn by relevant research, in this paper we constructed a meta-regression database based on 65 pieces of relevant literature published in the past 25 years. For more valid samples to reduce publication bias, we also set the statistical significance of social support to the health of the elderly in rural areas as a dependent variable. Finally, combined with multi-dimensional social support and its implications for the health of the elderly, meta-regression analysis was carried out on the results of 171 empirical studies. The results show that (1) subjective support rather than objective support can have a significant impact on the health of the elderly in rural areas, and there is no significant difference between other dimensions of social support and objective support; (2) the health status of the elderly in rural areas in samples involving western regions is more sensitive to social support than that in samples not involving the western regions; (3) among the elderly in rural areas, social support for the older male elderly is more likely to improve their health than that for the younger female elderly; and (4) besides this, both data sources and econometric models greatly affect the heterogeneity of the effect of social support on the health of the elderly in rural areas, but neither the published year nor the journal is significant. Finally, relevant policies and follow-up studies on the impact of social support on the health of the elderly in rural areas are discussed. Full article
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Open AccessArticle
Assessing the Effects on Health Inequalities of Differential Exposure and Differential Susceptibility of Air Pollution and Environmental Noise in Barcelona, 2007–2014
Int. J. Environ. Res. Public Health 2019, 16(18), 3470; https://doi.org/10.3390/ijerph16183470 (registering DOI) - 18 Sep 2019
Abstract
The hypotheses we intended to contrast were, first, that the most deprived neighborhoods in Barcelona, Spain, present high exposure to environmental hazards (differential exposure) and, secondly, that the health effects of this greater exposure were higher in the most deprived neighborhoods (differential susceptibility). [...] Read more.
The hypotheses we intended to contrast were, first, that the most deprived neighborhoods in Barcelona, Spain, present high exposure to environmental hazards (differential exposure) and, secondly, that the health effects of this greater exposure were higher in the most deprived neighborhoods (differential susceptibility). The population studied corresponded to the individuals residing in the neighborhoods of Barcelona in the period 2007–2014. We specified the association between the relative risk of death and environmental hazards and socioeconomic indicators by means of spatio-temporal ecological regressions, formulated as a generalized linear mixed model with Poisson responses. There was a differential exposure (higher in more deprived neighborhoods) in almost all the air pollutants considered, when taken individually. The exposure was higher in the most affluent in the cases of environmental noise. Nevertheless, for both men and women, the risk of dying due to environmental hazards in a very affluent neighborhood is about 30% lower than in a very depressed neighborhood. The effect of environmental hazards was more harmful to the residents of Barcelona’s most deprived neighborhoods. This increased susceptibility cannot be attributed to a single problem but rather to a set of environmental hazards that, overall, a neighborhood may present. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle
Risk of Endometriosis and Subsequent Ovary and Breast Cancers in Nurses: A Population-Based Cohort Study in Taiwan
Int. J. Environ. Res. Public Health 2019, 16(18), 3469; https://doi.org/10.3390/ijerph16183469 (registering DOI) - 18 Sep 2019
Abstract
Background: Endometriosis has been associated with the subsequent development of ovarian and breast cancers. This study evaluated whether nurses were at increased risks of developing endometriosis and subsequent ovarian and breast cancers. Methods: From Taiwan National Health Insurance Research Database during 2000 to [...] Read more.
Background: Endometriosis has been associated with the subsequent development of ovarian and breast cancers. This study evaluated whether nurses were at increased risks of developing endometriosis and subsequent ovarian and breast cancers. Methods: From Taiwan National Health Insurance Research Database during 2000 to 2011, we established 3 study cohorts, consisting of 23,801 nurses, 11,973 other hospital employees, and 143,096 general women free of endometriosis and cancer. Women in all cohorts were followed to the end of 2011 to measure the occurrences of endometriosis and subsequent ovarian and breast cancers. The incident endometriosis cases and related hazard ratio (HR) and 95% confidence interval (CI) were calculated. The incident cases of ovarian cancer and breast cancer and related odds ratio were calculated. Results: The incidence of endometriosis was the highest in the nurse cohort (4.23 per 100, n = 966) followed by other health professionals (3.74 per 100, n = 427) and control cohort (3.06 per 100, n = 4193), with adjusted hazard ratios of 1.28 (95% CI = 1.20–1.38) and 1.13 (95% CI = 1.02–1.25), respectively, comparing to controls. Among those who developed endometriosis, nurses had higher subsequent ovarian cancer and lower breast cancer, but not significant. Conclusions: Nurses are at a higher risk of developing endometriosis. However, the link between endometriosis and subsequent cancers is weak. Full article
Open AccessArticle
Development of TracMyAir Smartphone Application for Modeling Exposures to Ambient PM2.5 and Ozone
Int. J. Environ. Res. Public Health 2019, 16(18), 3468; https://doi.org/10.3390/ijerph16183468 (registering DOI) - 18 Sep 2019
Abstract
Air pollution epidemiology studies of ambient fine particulate matter (PM2.5) and ozone (O3) often use outdoor concentrations as exposure surrogates. Failure to account for the variability of the indoor infiltration of ambient PM2.5 and O3, and [...] Read more.
Air pollution epidemiology studies of ambient fine particulate matter (PM2.5) and ozone (O3) often use outdoor concentrations as exposure surrogates. Failure to account for the variability of the indoor infiltration of ambient PM2.5 and O3, and time indoors, can induce exposure errors. We developed an exposure model called TracMyAir, which is an iPhone application (“app”) that determines seven tiers of individual-level exposure metrics in real-time for ambient PM2.5 and O3 using outdoor concentrations, weather, home building characteristics, time-locations, and time-activities. We linked a mechanistic air exchange rate (AER) model, a mass-balance PM2.5 and O3 building infiltration model, and an inhaled ventilation model to determine outdoor concentrations (Tier 1), residential AER (Tier 2), infiltration factors (Tier 3), indoor concentrations (Tier 4), personal exposure factors (Tier 5), personal exposures (Tier 6), and inhaled doses (Tier 7). Using the application in central North Carolina, we demonstrated its ability to automatically obtain real-time input data from the nearest air monitors and weather stations, and predict the exposure metrics. A sensitivity analysis showed that the modeled exposure metrics can vary substantially with changes in seasonal indoor-outdoor temperature differences, daily home operating conditions (i.e., opening windows and operating air cleaners), and time spent outdoors. The capability of TracMyAir could help reduce uncertainty of ambient PM2.5 and O3 exposure metrics used in epidemiology studies. Full article
(This article belongs to the Special Issue Air Quality and Health Predictions)
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Open AccessArticle
Effect of Coach Encouragement on the Psychophysiological and Performance Responses of Young Tennis Players
Int. J. Environ. Res. Public Health 2019, 16(18), 3467; https://doi.org/10.3390/ijerph16183467 (registering DOI) - 18 Sep 2019
Abstract
This study aimed to compare the effects of coach encouragement during the on-court tennis training drills (OTDs) on the psychophysiological and performance responses of young tennis players. Twenty-five young male tennis players (14.0 ± 0.3 years of age) performed six bouts of each [...] Read more.
This study aimed to compare the effects of coach encouragement during the on-court tennis training drills (OTDs) on the psychophysiological and performance responses of young tennis players. Twenty-five young male tennis players (14.0 ± 0.3 years of age) performed six bouts of each of the four common OTDs; Star, Suicide, Box and Big X (30:60 s; 1:2 work to rest ratio). The heart rate (HR) and total distance covered were monitored using two portable multivariable integrated 10 Hz GPS monitoring devices during all OTDs, and the rating of perceived exertion (RPE-10) and short form Physical Activity Enjoyment Scale (PACES) values were determined after each OTDs bout. The results demonstrated that OTDs with coach encouragement induced significantly higher psychophysiological and performance responses compared to OTDs without coach encouragement (p < 0.05). The results of this study confirm that coach encouragement improves the intensity, performance and physical enjoyment level during OTDs. These findings might inform training practices in youth tennis players in order to improve tennis performance. Full article
(This article belongs to the Special Issue Physical Exercise as a Therapeutic Resource)
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Open AccessArticle
Mediterranean Coastal Lagoons: The Importance of Monitoring in Sediments the Biochemical Composition of Organic Matter
Int. J. Environ. Res. Public Health 2019, 16(18), 3466; https://doi.org/10.3390/ijerph16183466 - 18 Sep 2019
Abstract
Transitional water ecosystems are targeted by the European Union (EU) Water Framework Directive (WFD, CE 2000/60) monitoring programs in coastal zones. Concerning sediments, activities performed for the WFD focus on a few variables concerning the biochemical composition of organic matter. Our research reports [...] Read more.
Transitional water ecosystems are targeted by the European Union (EU) Water Framework Directive (WFD, CE 2000/60) monitoring programs in coastal zones. Concerning sediments, activities performed for the WFD focus on a few variables concerning the biochemical composition of organic matter. Our research reports the effects of oxygen availability on the biochemical composition of organic matter in sediments to highlight levels of targeted variables in time and, according to the depth of sediment layer, both under oxygenated and anoxic conditions in a mesocosm study on sediment cores. Results provide evidence that tested factors of interest (i.e., disturbance type, oxygenic versus anoxic conditions; persistence time of disturbance, 0–14 days; penetration through sedimentary layers, 0–10 cm depth) are able to significantly affect the biochemical composition of organic matter in sediments. Large part of the variables considered in this study (total organic carbon (TOC), total phosphorous (TP), total sulphur (TS), Fe, carbohydrates (CHO), total proteins (PRT), biopolymeric carbon (BPC), chlorophyll-a (Chl-a) are significantly affected and correlated to the oxygenation levels and could be good early indicators of important changes of environmental conditions. Monitoring activities performed under WFD guidelines and management strategies of Mediterranean coastal lagoon ecosystems shall include the biochemical composition of organic matter in sediment to provide an exhaustive picture of such dynamic ecosystems. Full article
(This article belongs to the Special Issue Marine Coastal Environment Monitoring)
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Open AccessArticle
Generalized Violence as a Threat to Health and Well-Being: A Qualitative Study of Youth Living in Urban Settings in Central America’s “Northern Triangle”
Int. J. Environ. Res. Public Health 2019, 16(18), 3465; https://doi.org/10.3390/ijerph16183465 - 18 Sep 2019
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Abstract
El Salvador, Guatemala, and Honduras rank among the top 10 countries experiencing violence in the world, despite not being at war. Although there is abundant literature on generalized violence in this “northern triangle” of Central America as a driver of out-migration to the [...] Read more.
El Salvador, Guatemala, and Honduras rank among the top 10 countries experiencing violence in the world, despite not being at war. Although there is abundant literature on generalized violence in this “northern triangle” of Central America as a driver of out-migration to the United States, very little is known about the perspectives and experiences of youth who do not migrate. This study aimed to elicit the emic perspectives of youth residing in the region on how the day-to-day generalized violence produces a pervasive threat to the overall health and human security of youth as well as the key protective factors and resiliencies at work. We conducted two separate waves of qualitative research in 2015 and 2018 over a 6-month period, which included 60 in-depth interviews and six focus groups among Salvadoran, Guatemalan and Honduran youth living in urban areas. Qualitative thematic analysis revealed two meta-themes: (1) ‘Lack of health,’ defined as not experiencing peace within the family, the community, and the country’ and (2) ‘Resilience.’ Thematic clusters that reflect the first meta-theme are: (1) violence as a common occurrence; (2) living in fear and insecurity; (3) victimization; and (4) lack of state protection and services. Thematic clusters for the second meta-theme are: (1) a positive future outlook and a commitment to education; (2) transnational and local family network support; and (3) engagement in community-based youth groups. To interpret the findings, we adopt the Latin American Social Medicine and Collective Health (LASM-CH) approach that prioritizes perspectives from the region. Generalized violence is conceptualized as a systemic phenomenon that is generated and reproduced through the complex interactions of structural inequities and unequal power relations. The findings of this study provide new insights into the implementation of a different approach to address the generalized violence, insights that may guide multi-sectoral health policies and interventions both in the region and transnationally. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
Association between the Occurrence of Primary Hypothyroidism and the Exposure of the Population Near to Industrial Pollutants in São Paulo State, Brazil
Int. J. Environ. Res. Public Health 2019, 16(18), 3464; https://doi.org/10.3390/ijerph16183464 - 18 Sep 2019
Viewed by 43
Abstract
Background: Environmental agents interfere with thyroid function at multiple levels. This study was to investigate the association between pollutant concentrations and the primary hypothyroidism (PH) occurrence odds in residents living in the Capuava Petrochemical Complex (CPC) influence area. Methods: This area was evaluated [...] Read more.
Background: Environmental agents interfere with thyroid function at multiple levels. This study was to investigate the association between pollutant concentrations and the primary hypothyroidism (PH) occurrence odds in residents living in the Capuava Petrochemical Complex (CPC) influence area. Methods: This area was evaluated with the combination of the AERMOD dispersion model with the Weather Research Forecast (WRF) meteorological model (2016). The concentration of atmospheric pollutants were analyzed in 2017 using meteorological data on the period from 2005 to 2009, correlating this data with the research done in 2003 to 2005. A home-based questionnaire was applied to evaluate 2004 residents, of both sexes, aged from 8 to 72 years, based on their proximity to the industrial areas; were select residents with PH. Results: Volatile organic compounds (VOCs), carbon monoxide (CO), and nitrogen dioxide (NO2) concentrations presented the highest correlations between the PH odds and pollutant concentrations. Conclusion: Air pollution associated with the presence of the CPC is an important environmental factor contributing to the development of PH in the nearby population. As the first study showing this association in Brazil, research should be continued to better understand the mechanisms and to find ways to compensate for or remedy to avoid health impacts in future populations. Full article
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Open AccessArticle
Exploring the Impact of the Rational Antibiotic Use System on Hospital Performance: The Direct Effect and the Spillover Effect
Int. J. Environ. Res. Public Health 2019, 16(18), 3463; https://doi.org/10.3390/ijerph16183463 - 18 Sep 2019
Viewed by 62
Abstract
Irrational antibiotic usage not only causes an increase in antibiotic-borne diseases, but also inflicts pain on patients, as a result of inappropriate treatment. In order to resolve the hazards caused by irrational antibiotic usage, a kind of e-health service, the Rational Antibiotic Use [...] Read more.
Irrational antibiotic usage not only causes an increase in antibiotic-borne diseases, but also inflicts pain on patients, as a result of inappropriate treatment. In order to resolve the hazards caused by irrational antibiotic usage, a kind of e-health service, the Rational Antibiotic Use System (RAUS), has been incorporated into the hospital information system. The RAUS provides doctors and patients with the functions of antibiotic usage monitoring, antibiotic information consultation and antibiotic prescription support. Though existing literature has already proved the usefulness of the RAUS on monitoring doctors’ behavior, the effects on hospital performance from an organizational perspective has rarely been measured by empirical data. Therefore, our study has explored the effects of the RAUS on the performance of a large Chinese hospital, which has implemented the RAUS since March 2014. Through empirical research, we quantified the effects of the implementation of the RAUS on a hospital’s performance from both the direct effects on the “drug income” and the spillover effect on the “treatment income”. The results indicate a significant positive spillover effect on the treatment incomes of a hospital in its inpatient activities (seen as significant in the long term) and in its outpatient activities (seen as significant in both the short and long terms). In addition, this research provides certain theoretical and practical implications for the dilemma of e-health services application in irrational antibiotic usage. Full article
(This article belongs to the Special Issue E-Health Services)
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Open AccessArticle
Factors Correlated with Smoking Cessation Success in Older Adults: A Retrospective Cohort Study in Taiwan
Int. J. Environ. Res. Public Health 2019, 16(18), 3462; https://doi.org/10.3390/ijerph16183462 - 18 Sep 2019
Viewed by 47
Abstract
Smoking cessation in the elderly is very important. This study aims to explore the success rate of smoking cessation in the elderly and the factors that predict the success of smoking cessation. We collected data from smokers ≥60 years who visited a medical [...] Read more.
Smoking cessation in the elderly is very important. This study aims to explore the success rate of smoking cessation in the elderly and the factors that predict the success of smoking cessation. We collected data from smokers ≥60 years who visited a medical center in Taiwan during 2017. All patients were prescribed either varenicline or nicotine replacement therapy (NRT) for smoking cessation. The participants were asked about their smoking status after treatment. In total, 129 participants were enrolled. The three- or six-month point abstinence rate was 48.1%. No significant difference was found among baseline characteristics (including age, gender, underlying diseases, smoking duration, daily consumption amount of cigarette, carbon monoxide concentration, Fagerström test for nicotine dependence scores, and treatment method) between quitters and non-quitters, except for the type of medication used. The proportion of quitters using varenicline was significantly higher than that of non-quitters. Multivariate regression analyses showed that the patients who received varenicline were 3.22 times more likely to quit smoking than those who received NRT. Therefore, we suggest that varenicline use may help in smoking cessation in older adults, compared to NRT. Other baseline characteristics may not affect the success rate of smoking cessation in this population. Full article
Open AccessArticle
Trends in Diabetes Prevalence, Awareness, Treatment and Control in Yangon Region, Myanmar, Between 2004 and 2014, Two Cross-Sectional Studies
Int. J. Environ. Res. Public Health 2019, 16(18), 3461; https://doi.org/10.3390/ijerph16183461 - 18 Sep 2019
Viewed by 91
Abstract
Myanmar is currently facing the burden of non-communicable diseases due to changes in lifestyle and dietary patterns linked to socio-economic development. However, evidence is scarce about changes in the prevalence of diabetes mellitus (DM) over time. We aimed to investigate changes in the [...] Read more.
Myanmar is currently facing the burden of non-communicable diseases due to changes in lifestyle and dietary patterns linked to socio-economic development. However, evidence is scarce about changes in the prevalence of diabetes mellitus (DM) over time. We aimed to investigate changes in the prevalence, awareness, treatment and control of DM from 2004 to 2014, among adults aged 25–74 years, in the Yangon region. Two cross-sectional household-based studies, according to World Health Organization STEPwise approach to surveillance (WHO STEPS) methodology, were conducted in 2004 (n = 4448) and 2014 (n = 1372). The overall age-standardized prevalence of DM was 8.3% (95% CI 6.5–10.6) in 2004 and 10.2% (7.6–13.6) in 2014 (p = 0.296). The DM prevalence increased between the study years among elderly participants only, from 14.6% (11.7–18.1) to 31.9% (21.1–45.0) (p = 0.009). Awareness of having DM increased from 44.3% (39.2, 49.6) to 69.4% (62.9–75.2) (p < 0.001). Among participants who were aware of having DM, the proportion under treatment increased from 55.1% (46.8–63.1) to 68.6% (61.5–74.8) (p = 0.015). There was no change in proportion with controlled DM. Adjusted for age, sex and education, mean fasting plasma glucose levels in 2014 were 0.56 mmol/L (0.26–0.84) higher than in 2004. Preventive measures to halt future increases in DM prevalence and to increase the detection of undiagnosed DM cases are needed. Full article
(This article belongs to the collection Health Behaviors, Risk Factors, NCDs and Health Promotion)
Open AccessArticle
The Effect of Improving Cycleway Environment on the Recreational Benefits of Bicycle Tourism
Int. J. Environ. Res. Public Health 2019, 16(18), 3460; https://doi.org/10.3390/ijerph16183460 - 17 Sep 2019
Viewed by 139
Abstract
Bicycle tourism is one of the popular physical activities for sport tourists. Since the physical environment may affect bicycling behavior, it becomes an important determinant for cyclists to choose a cycleway. Exploratory factor analysis is performed to extract the perception of environmental quality [...] Read more.
Bicycle tourism is one of the popular physical activities for sport tourists. Since the physical environment may affect bicycling behavior, it becomes an important determinant for cyclists to choose a cycleway. Exploratory factor analysis is performed to extract the perception of environmental quality of cyclists into five main factors, including safety, light facilities, lane design, landscape, and environment cleanliness. The contingent behavior method (CBM) is adopted to measure the quality improvement projects in different scenarios of light facility and landscape improvement. The results showed that the improvement projects increased the intended number of trips and the recreational benefits of cyclists. Full article
Open AccessArticle
Relationship between Air Pollution and Urban Forms: Evidence from Prefecture-Level Cities of the Yangtze River Basin
Int. J. Environ. Res. Public Health 2019, 16(18), 3459; https://doi.org/10.3390/ijerph16183459 - 17 Sep 2019
Viewed by 145
Abstract
Urban forms, such as size, shape, density, compactness, and fragmentation, are associated with local air pollution concentrations. However, empirical analyses on how urban form improves or degrades urban air quality are still limited and inconclusive, especially for those rapidly expanding cities in developing [...] Read more.
Urban forms, such as size, shape, density, compactness, and fragmentation, are associated with local air pollution concentrations. However, empirical analyses on how urban form improves or degrades urban air quality are still limited and inconclusive, especially for those rapidly expanding cities in developing countries. In this study, by using the improved STIRPAT (stochastic impacts by regression on population, affluence, and technology) model, the quantitative impact of urban form on near-surface PM2.5 and NO2 concentrations was identified in the 10 prefecture-level cities of the Yangtze River Basin (YRB) from 2000 to 2013. Trend analyses showed a significant increasing trend in both PM2.5 (9.69 × 104 µg·m3·year1) and NO2 (1.73 × 10−4 ppb·year1) for the whole study period. Notably, a turning point of PM2.5 from increasing to decreasing trends occurred around 2007. In addition, both pollutants showed a spatial agglomeration. The STIRPAT model demonstrated that socioeconomic, transportation and urban form factors played an important role in alleviating the increase of PM2.5 and NO2. In particular, a 1% decrease in urban extent density (UED) significantly increased NO2 by 0.203%, but reduced PM2.5 by 0.033%. The proximity index (PI) measured as a city’s compactness was significantly negatively correlated with PM2.5 and NO2. Conversely, a significant positive relationship of PM2.5 and NO2 concentrations against the openness index (OI) was observed, an important variable for measuring a city’s fragmentation. In addition, the environmental Kuznets curve (EKC) hypothesis between per capita GDP and PM2.5 concentration was confirmed but failed in NO2. Overall, this study encouraged a less fragmented and more compact urban form, which helped alleviate local air pollution concentrations by enhancing urban connectivity, reducing vehicle dependence, and facilitating the use of bicycles and walking. Full article
(This article belongs to the Section Environmental Health)
Open AccessReview
Impacts of Climate Change on Outdoor Workers and their Safety: Some Research Priorities
Int. J. Environ. Res. Public Health 2019, 16(18), 3458; https://doi.org/10.3390/ijerph16183458 - 17 Sep 2019
Viewed by 143
Abstract
The literature on the potential impacts of climate change on the health of outdoor workers has received limited attention as a whole, and in sub-Saharan African countries in particular. Yet, substantial numbers of workers are experiencing the health effects of elevated temperature, in [...] Read more.
The literature on the potential impacts of climate change on the health of outdoor workers has received limited attention as a whole, and in sub-Saharan African countries in particular. Yet, substantial numbers of workers are experiencing the health effects of elevated temperature, in combination with changes in precipitation patterns, climate extremes and the effects of air pollution, which have a potential impact on their safety and wellbeing. With increased temperatures within urban settlements and frequent heats waves, there has been a sudden rise in the occurrence of heat-related illness leading to higher levels of mortality, as well as other adverse health impacts. This paper discusses the impacts of extreme heat exposure and health concerns among outdoor workers, and the resultant impacts on their productivity and occupational safety in tropical developing countries with a focus on Sub-Saharan Africa, where there is a dearth of such studies. Aside from the direct effects caused by extreme heat exposure, other indirect health hazards associated with increasing heat among this group includes exposures to hazardous chemicals and other vector-borne diseases. In addition, reduced work capacity in heat-exposed jobs will continue to rise and hinder economic and social development in such countries. There is an urgent need for further studies around the health and economic impacts of climate change in the workplace, especially in tropical developing countries, which may guide the implementation of the measures needed to address the problem. Full article
(This article belongs to the Section Climate Change and Health)
Open AccessArticle
The Association between Frailty Indicators and Blood-Based Biomarkers in Early-Old Community Dwellers of Thailand
Int. J. Environ. Res. Public Health 2019, 16(18), 3457; https://doi.org/10.3390/ijerph16183457 - 17 Sep 2019
Viewed by 142
Abstract
Thailand has officially reached the status of an “aged society” and become the developing country with the 2nd largest proportion of senior citizens in Southeast Asia. A cross-sectional study of 526 early-old community dwellers was conducted for the Fried frailty phenotype assessment, This [...] Read more.
Thailand has officially reached the status of an “aged society” and become the developing country with the 2nd largest proportion of senior citizens in Southeast Asia. A cross-sectional study of 526 early-old community dwellers was conducted for the Fried frailty phenotype assessment, This included five indicators: Weakness, slowness, physical activity, exhaustion, and weight loss. C-reactive protein (CRP), interleukin-6 (IL-6), insulin-like growth factor-1, and CD4+:CD8+ Ratio which serve as blood-based biomarkers of frailty. The prevalence of frailty and pre-frail in this population was found to be 15% and 69.6% respectively and was higher among women than men. Frail (n = 58) and non-frail (n = 60) participants were evaluated for the associations between the frail indicators and the blood-based biomarkers. Serum levels of IL-6 and CRP from frail group were significantly elevated when compared with the non-frail counterparts (p = 0.044 and 0.033, respectively), and were significantly associated with the frailty status with an Odd RatioIL-6 [OR] of 1.554-fold (95% confidence interval [CI], 1.229–1.966) and an ORCRP of 1.011-fold (95 CI, 1.006–1.016). Decreased hand-grip strength was the only frailty indicator that was significantly associated with both inflammatory biomarkers, (ORIL-6 of 1.470-fold and ORCRP of 1.008-fold). Our study is the first to assess the frailty status among the early-old population in Thailand. These findings will encourage general practitioners to combine frailty indicators and serum biomarkers as early detection tools for at-risk older adults to achieve the goal of healthy aging. Full article
(This article belongs to the collection Aging and Public Health)
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Open AccessArticle
Effect of Same-Sex Marriage Referendums on the Suicidal Ideation Rate among Nonheterosexual People in Taiwan
Int. J. Environ. Res. Public Health 2019, 16(18), 3456; https://doi.org/10.3390/ijerph16183456 - 17 Sep 2019
Viewed by 157
Abstract
: Taiwan held voter-initiated referendums to determine same-sex marriage legalization on 24 November 2018. This study aims to compare suicidal ideation rates in heterosexual and nonheterosexual participants of a first-wave survey (Wave 1, 23 months before the same-sex marriage referendums) and a second-wave [...] Read more.
: Taiwan held voter-initiated referendums to determine same-sex marriage legalization on 24 November 2018. This study aims to compare suicidal ideation rates in heterosexual and nonheterosexual participants of a first-wave survey (Wave 1, 23 months before the same-sex marriage referendums) and a second-wave survey (Wave 2, one week after the same-sex marriage referendums) in Taiwan and to examine the influence of gender, age, and sexual orientation on the change in suicidal ideation rates in nonheterosexual participants. In total, 3286 participants in Wave 1 and 1370 participants in Wave 2 were recruited through a Facebook advertisement. Each participant completed an online questionnaire assessing suicidal ideation. The proportions of heterosexual and nonheterosexual participants with suicidal ideation were compared between the Wave 1 and Wave 2 surveys. Suicidal ideation rates between participants in the Wave 1 and Wave 2 surveys were further compared by stratifying nonheterosexual participants according to gender, age, and sexual orientation. Nonheterosexual participants in the Wave 2 survey had a higher suicidal ideation rate than those in the Wave 1 survey, whereas no difference was observed in suicidal ideation rates between heterosexual participants in Wave 2 and Wave 1. Nonheterosexual participants who were female, younger, gay, lesbian, and bisexual in Wave 2 had a higher suicidal ideation rate than those in Wave 1. The suicidal ideation rate significantly increased in nonheterosexual participants experiencing the same-sex marriage referendums in Taiwan. Whether civil rights of sexual minority individuals can be determined through referendums should be evaluated. Full article
(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)
Open AccessArticle
Spatial and Temporal Variation of PM10 from Industrial Point Sources in a Rural Area in Limpopo, South Africa
Int. J. Environ. Res. Public Health 2019, 16(18), 3455; https://doi.org/10.3390/ijerph16183455 - 17 Sep 2019
Viewed by 152
Abstract
Air pollution from industrial point sources accounts for a large proportion of air pollution issues affecting many communities around the world. However, emissions from these sources are technically controllable by putting in place abatement technologies with feasible and stringent regulatory conditions in the [...] Read more.
Air pollution from industrial point sources accounts for a large proportion of air pollution issues affecting many communities around the world. However, emissions from these sources are technically controllable by putting in place abatement technologies with feasible and stringent regulatory conditions in the operation licenses. Pollution from other sources such as soil erosion, forest fires, road dust, and biomass burning, are subject to several unpredictable natural or economic factors. In this study, findings from dispersion modelling and spatial analysis of pollution were presented to evaluate the potential impacts of PM10 emissions from point sources in the Greater Tubatse Municipality of Limpopo, South Africa. The Air Pollution Model (TAPM) was used to model nested horizontal grids down to 10 km for meteorology and 4 km resolution for air pollution was used for simulation of PM10. An analysis of annual and seasonal variations of PM10 emissions from point sources was undertaken to demonstrate their impact on the environment and the surrounding communities based on 2016 emissions data. A simple Kriging method was used to generate interpolation surfaces for PM10 concentrations from industrial sources with the purpose of identifying their areas of impact. The results suggest that valley wind channeling is responsible for the distribution of pollutants in a complex terrain. The results revealed that PM10 concentrations were higher closer to the sources during the day and distributed over a wide area during the night. Full article
Open AccessArticle
Analysis of Epidemiological Characteristics of Scarlet Fever in Zhejiang Province, China, 2004–2018
Int. J. Environ. Res. Public Health 2019, 16(18), 3454; https://doi.org/10.3390/ijerph16183454 - 17 Sep 2019
Viewed by 152
Abstract
Objective: The aim of this study was to analyze the trends and epidemiological characteristics of scarlet fever in Zhejiang Province in 2004–2018, intending to provide a basis for targeted prevention and control of this disease. Method: We collated the epidemiological data for cases [...] Read more.
Objective: The aim of this study was to analyze the trends and epidemiological characteristics of scarlet fever in Zhejiang Province in 2004–2018, intending to provide a basis for targeted prevention and control of this disease. Method: We collated the epidemiological data for cases of scarlet fever from the China Information System for Disease Control and Prevention (CISDCP) in Zhejiang province between 1 January 2004 and 31 December 2018. Descriptive statistical analysis was used to analyze epidemiological characteristics of scarlet fever, whereas the Getis-Ord Gi* statistic was used to determine the hotspot incidence of scarlet fever. Results: In 2004–2018, a total of 22,194 cases of scarlet fever were reported in Zhejiang Province, with no death reports. The annual average of scarlet fever incidence was 2.82/100,000 (range,1.12 to 6.34/100,000). The male incidence was higher than that among female (χ2 = 999.834, p < 0.05), and a majority of the cases (86.42%) occurred in children aged 3–9 years. Each year, the incidence of scarlet fever in Zhejiang Province appeared two seasonal peaks: the first peak occurred from March to June (the constituent ratio was 49.06%), the second peak was lower than the first one during November and the following January (the constituent ratio was 28.67%). The two peaks were almost in accordance with the school spring semester and autumn–winter semester, respectively. The incidence in the northern regions of the province was generally higher than that in the southern regions. High-value clusters were detected in the central and northern regions, while low-value clusters occurred in the southern regions via the Getis-Ord Gi* statistical analysis. Conclusions: The prevalence of scarlet fever in Zhejiang Province showed a marked seasonality variation and mainly clustered in the central and northern regions in 2004–2018. Children under 15 years of age were most susceptible to scarlet fever. Kindergartens and primary schools should be the focus of prevention and control, and targeted strategies and measures should be taken to reduce the incidence. Full article
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Open AccessArticle
Prospective Application of Palm Oil Mill Boiler Ash as a Biosorbent: Effect of Microwave Irradiation and Palm Oil Mill Effluent Decolorization by Adsorption
Int. J. Environ. Res. Public Health 2019, 16(18), 3453; https://doi.org/10.3390/ijerph16183453 - 17 Sep 2019
Viewed by 154
Abstract
Common conventional biological treatment methods fail to decolorize palm oil mill effluent (POME). The present study focused on using the abundant palm oil mill boiler (POMB) ashes for POME decolorization. The POMB ashes were subjected to microwave irradiation and chemical treatment using H [...] Read more.
Common conventional biological treatment methods fail to decolorize palm oil mill effluent (POME). The present study focused on using the abundant palm oil mill boiler (POMB) ashes for POME decolorization. The POMB ashes were subjected to microwave irradiation and chemical treatment using H2SO4. The resultant adsorbents were characterized using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and Brunauer–Emmett–Teller (BET) analyses. The adsorption efficiency was evaluated at various pH levels (2–8.5), adsorption dosages (3–15 g) in 200 mL, and contact times (1–5 h). The microwave-irradiated POMB-retained ash recorded the highest color removal of 92.31%, for which the best conditions were pH 2, 15 g adsorbent dosage in 200 mL, and 5 h of contact time. At these best treatment conditions, the color concentration of the treated effluent was analyzed using the method proposed by the American Dye Manufacturers Institute (ADMI). The color concentration was 19.20 ADMI, which complies with the Malaysia discharge standard class A. The Freundlich isotherm model better fit the experimental data and had a high R2 of 0.9740. Based on these results, it can be deduced that microwave-irradiated POMB-retained ash has potential applications for POME decolorization via a biosorption process. Full article
(This article belongs to the Special Issue Water Quality Improvement and Ecological Restoration)
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