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Int. J. Environ. Res. Public Health, Volume 18, Issue 20 (October-2 2021) – 331 articles

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Review
The Interplay between Housing Environmental Attributes and Design Exposures and Psychoneuroimmunology Profile—An Exploratory Review and Analysis Paper in the Cancer Survivors’ Mental Health Morbidity Context
Int. J. Environ. Res. Public Health 2021, 18(20), 10891; https://doi.org/10.3390/ijerph182010891 (registering DOI) - 16 Oct 2021
Abstract
Adult cancer survivors have an increased prevalence of mental health comorbidities and other adverse late-effects interdependent with mental illness outcomes compared with the general population. Coronavirus Disease 2019 (COVID-19) heralds an era of renewed call for actions to identify sustainable modalities to facilitate [...] Read more.
Adult cancer survivors have an increased prevalence of mental health comorbidities and other adverse late-effects interdependent with mental illness outcomes compared with the general population. Coronavirus Disease 2019 (COVID-19) heralds an era of renewed call for actions to identify sustainable modalities to facilitate the constructs of cancer survivorship care and health care delivery through physiological supportive domestic spaces. Building on the concept of therapeutic architecture, psychoneuroimmunology (PNI) indicators—with the central role in low-grade systemic inflammation—are associated with major psychiatric disorders and late effects of post-cancer treatment. Immune disturbances might mediate the effects of environmental determinants on behaviour and mental disorders. Whilst attention is paid to the non-objective measurements for examining the home environmental domains and mental health outcomes, little is gathered about the multidimensional effects on physiological responses. This exploratory review presents a first analysis of how addressing the PNI outcomes serves as a catalyst for therapeutic housing research. We argue the crucial component of housing in supporting the sustainable primary care and public health-based cancer survivorship care model, particularly in the psychopathology context. Ultimately, we illustrate a series of interventions aiming at how housing environmental attributes can trigger PNI profile changes and discuss the potential implications in the non-pharmacological treatment of cancer survivors and patients with mental morbidities. Full article
(This article belongs to the Special Issue Innovations in Architecture for Mental Health)
Article
Generalized Anxiety as a Risk Factor for Dysfunctional Eating Behavior after Obesity Surgery during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(20), 10890; https://doi.org/10.3390/ijerph182010890 (registering DOI) - 16 Oct 2021
Abstract
Purpose: The present study investigates the impact of obesity surgery on mental health (i.e., eating behavior and distress) during the COVID-19 pandemic. Methods: Two hundred fifty-four participants were recruited via social media. One hundred fourteen (44.53%) of them were surgery candidates (waiting for [...] Read more.
Purpose: The present study investigates the impact of obesity surgery on mental health (i.e., eating behavior and distress) during the COVID-19 pandemic. Methods: Two hundred fifty-four participants were recruited via social media. One hundred fourteen (44.53%) of them were surgery candidates (waiting for obesity surgery), while 142 (55.46%) had already undergone surgery. Participants who underwent surgery were compared to participants that did not yet undergo surgery in terms of mental burden (depression and anxiety), as well as safety and eating behavior. Further moderation analyses attempted to identify risk factors for increased COVID-19-related dysfunctional eating behavior after surgery. Results: Participants who underwent surgery showed generally lower levels of depression and general anxiety on a trend level. Moderation analyses suggested that people with high levels of generalized anxiety actually show more dysfunctional COVID-19-specific eating behavior after obesity surgery. Conclusion: On a trend level, obesity surgery appears to attenuate symptoms of generalized anxiety and depression. Yet, surgery patients with high levels of generalized anxiety exhibit even higher levels of dysfunctional eating during the COVID-19 pandemic. It is therefore particularly important to support people at risk. Full article
Review
Efficacy of Communication Techniques and Health Outcomes of Bushfire Smoke Exposure: A Scoping Review
Int. J. Environ. Res. Public Health 2021, 18(20), 10889; https://doi.org/10.3390/ijerph182010889 (registering DOI) - 16 Oct 2021
Abstract
Public health officials communicate the relevant risks of bushfire smoke exposure and associated health protection measures to affected populations. Increasing global bushfire incidence in the context of climate change motivated this scoping review. English-language publications related to adverse health outcomes following bushfire smoke [...] Read more.
Public health officials communicate the relevant risks of bushfire smoke exposure and associated health protection measures to affected populations. Increasing global bushfire incidence in the context of climate change motivated this scoping review. English-language publications related to adverse health outcomes following bushfire smoke exposure and publications relating to communication during natural disasters were included. Bushfire smoke events potentially increase healthcare contact, especially presentations triggered by respiratory illness. At-risk populations include those with underlying cardiorespiratory disease, elderly, paediatric, pregnant persons, and First Nations people. We found that social media, television, and radio are among the most common information sources utilised in bushfire smoke events. Message style, content, and method of delivery can directly influence message uptake and behaviour modification. Age, rurality, and geographical location influence information source preferences. Culturally and linguistically diverse groups and those with hearing, vision, and mobility-related disabilities may benefit from targeted health recommendations. This review emphasises the health effects of bushfire smoke exposure and related communication recommendations during and after bushfire smoke events. Additional investigation may further clarify the health effects of bushfire smoke exposure and efficacy of related health messaging, particularly in at-risk populations. Quantitative comparison of communication methods may yield more specific recommendations for future bushfire smoke events. Full article
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Article
Socioeconomic Status and COVID-19-Related Psychological Panic in China: The Role of Trust in Government and Authoritarian Personality
Int. J. Environ. Res. Public Health 2021, 18(20), 10888; https://doi.org/10.3390/ijerph182010888 (registering DOI) - 16 Oct 2021
Abstract
Although the health and economic risks of COVID-19 may differ for higher- and lower-socioeconomic-status (SES) populations, some studies found that people with lower SES do not necessarily experience more psychological panic. In this research, we examine how SES is related with psychological panic [...] Read more.
Although the health and economic risks of COVID-19 may differ for higher- and lower-socioeconomic-status (SES) populations, some studies found that people with lower SES do not necessarily experience more psychological panic. In this research, we examine how SES is related with psychological panic during the COVID-19 pandemic using a large nationwide Chinese sample. Participants were 933 adults (mean age = 30.04, SD = 8.19) who completed an online questionnaire between 11 and 12 February 2020. Lower SES individuals have higher trust in government and thus experience less psychological panic, and the indirect effect of this trust suppresses the direct negative association between SES and psychological panic. In addition to this difference in trust in government between lower- and higher-status individuals, the indirect effect of the trust only exists among people with low (not high) authoritarian personalities. This study provides evidence that political trust may serve as a buffer, suppressing the negative association between SES and psychological panic; thus, policies and actions enhancing political trust are vital to support the mental health of individuals with lower SES during the pandemic, especially for citizens with low authoritarian personalities. Full article
(This article belongs to the Special Issue Mental Health in the Time of COVID-19)
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Article
The Route of Stress in Parents of Young Children with and without Autism: A Path-Analysis Study
Int. J. Environ. Res. Public Health 2021, 18(20), 10887; https://doi.org/10.3390/ijerph182010887 (registering DOI) - 16 Oct 2021
Abstract
We provide a conceptual model on the complex interaction between stress, psychological predisposition, and personality traits, accounting for gender, in parents of children with and without autism. We performed a path analysis using a structural equation modeling approach in a sample of parents [...] Read more.
We provide a conceptual model on the complex interaction between stress, psychological predisposition, and personality traits, accounting for gender, in parents of children with and without autism. We performed a path analysis using a structural equation modeling approach in a sample of parents including 60 ASD and 53 TD couples. In parents of typically developing children (TD), depression level and age are the main direct predictors of stress through the mediating effect of anxiety. Otherwise, in the ASD parent group, the personality trait ‘openness’ directly predicts the defensive response and stress levels without the mediating effect of anxiety. Our data suggest a route of action in promoting new behavioral strategies to prevent parenting stress, making families run smoothly. Full article
(This article belongs to the Special Issue Research on Autism Spectrum Disorders)
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Article
In-Hospital Mortality in Non-COVID-19-Related Diseases before and during the Pandemic: A Regional Retrospective Study
Int. J. Environ. Res. Public Health 2021, 18(20), 10886; https://doi.org/10.3390/ijerph182010886 (registering DOI) - 16 Oct 2021
Abstract
Italy was one of the nations most affected by SARS-CoV-2. During the pandemic period, the national government approved some restrictions to reduce diffusion of the virus. We aimed to evaluate changes in in-hospital mortality and its possible relation with patient comorbidities and different [...] Read more.
Italy was one of the nations most affected by SARS-CoV-2. During the pandemic period, the national government approved some restrictions to reduce diffusion of the virus. We aimed to evaluate changes in in-hospital mortality and its possible relation with patient comorbidities and different restrictive public health measures adopted during the 2020 pandemic period. We analyzed the hospital discharge records of inpatients from public and private hospitals in Apulia (Southern Italy) from 1 January 2019 to 31 December 2020. The study period was divided into four phases according to administrative restriction. The possible association between in-hospital deaths, hospitalization period, and covariates such as age group, sex, Charlson comorbidity index (CCI) class, and length of hospitalization stay (LoS) class was evaluated using a multivariable logistic regression model. The risk of death was slightly higher in men than in women (OR 1.04, 95% CI: 1.01–1.07) and was lower for every age group below the >75 years age group. The risk of in-hospital death was lower for hospitalizations with a lower CCI score. In summary, our analysis shows a possible association between in-hospital mortality in non-COVID-19-related diseases and restrictive measures of public health. The risk of hospital death increased during the lockdown period. Full article
(This article belongs to the Special Issue Data and Methods for Monitoring and Decisions in Public Health)
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Article
School-Level Economic Disparities in Police-Reported Crimes and Active Commuting to School
Int. J. Environ. Res. Public Health 2021, 18(20), 10885; https://doi.org/10.3390/ijerph182010885 (registering DOI) - 16 Oct 2021
Abstract
Perceived safety remains one of the main barriers for children to participate in active commuting to school (ACS). This ecological study examined the associations between the number of police-reported crimes in school neighborhoods and ACS. The percentage of active travel trips was assessed [...] Read more.
Perceived safety remains one of the main barriers for children to participate in active commuting to school (ACS). This ecological study examined the associations between the number of police-reported crimes in school neighborhoods and ACS. The percentage of active travel trips was assessed from a teacher tally survey collected from students across 63 elementary schools that were primarily classified as high-poverty (n = 27). Geographic Information System (GIS) was used to create a detailed measure of police-reported crimes during 2018 and neighborhood covariates that occurred within a one-mile Euclidean buffer of the schools. Statistical analyses included linear fixed effects regressions and negative binomial regressions. In fully-adjusted models, reported crime did not exhibit significant associations with ACS. Medium-poverty schools were indirectly associated with ACS when compared to high- and low-poverty schools in all models (p < 0.05). Connectivity and vehicle ownership were also directly associated with ACS (p < 0.05). Low- and medium-poverty schools were indirectly associated with all types of reported crime when compared to high-poverty schools (p < 0.05). Although reported crime was not associated with school-level ACS, differences in ACS and reported crime do exist across school poverty levels, suggesting a need to develop and promote safe and equitable ACS interventions. Full article
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Review
Factors Influencing Safety on Construction Projects (fSCPs): Types and Categories
Int. J. Environ. Res. Public Health 2021, 18(20), 10884; https://doi.org/10.3390/ijerph182010884 (registering DOI) - 16 Oct 2021
Abstract
Due to the fact of activity, environment and work dynamics, the construction industry is characterised by high accident rates. Different initiatives have emerged to reduce these figures, which focus on using new methodologies and technologies for safety management. Therefore, it is essential to [...] Read more.
Due to the fact of activity, environment and work dynamics, the construction industry is characterised by high accident rates. Different initiatives have emerged to reduce these figures, which focus on using new methodologies and technologies for safety management. Therefore, it is essential to know the key factors and their influence on safety in construction projects (fSCPs) to focus efforts on these elements. Through a systematic literature review, based on PRISMA methodology, this article identifies, describes and categorises 100 factors that affect construction safety. It thus contributes by providing a comprehensive general framework, unifying previous studies focused on specific geographic areas or case studies with factors not considered or insufficiently disaggregated, along with an absence of classifications focused on understanding where and how factors affect the different dimensions of construction projects. The 100 factors identified are described and categorised according to the dimensions and aspects of the project in which these have an impact, along with identifying whether they are shaping or immediate factors or originating influences for the generation of accidents. These factors, their description and classification are a key contribution to improving the systematic creation of safety and generating training and awareness materials to fully develop a safety culture in organisations. Full article
(This article belongs to the Special Issue Technical and Scientific Research on Occupational Health and Safety)
Article
The Mediating Effect of Disability Acceptance in Individuals with Spinal Cord Injury Participating in Sport for All
Int. J. Environ. Res. Public Health 2021, 18(20), 10883; https://doi.org/10.3390/ijerph182010883 (registering DOI) - 16 Oct 2021
Abstract
The purpose of this study is to examine the importance of disability acceptance among individuals with spinal cord injury (SCI) participating in the Sport for All program through self-help group activities with other individuals with SCI. This study investigated whether disability acceptance mediates [...] Read more.
The purpose of this study is to examine the importance of disability acceptance among individuals with spinal cord injury (SCI) participating in the Sport for All program through self-help group activities with other individuals with SCI. This study investigated whether disability acceptance mediates the relationship between self-efficacy and life satisfaction and between sense of belonging and life satisfaction. Subjects were 142 individuals with SCI participating in the self-help group with other sports activities including para table tennis, swimming, wheelchair rugby, and weight training. A simple mediation effect analysis showed that disability acceptance significantly mediated the relationship between self-efficacy and life satisfaction (indirect effect, b = 0.219) and between the sense of belonging and life satisfaction (indirect effect, b = 0.289). The results suggest the importance of disability acceptance for individuals with SCI participating in “Sports for All” programs. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Article
Visualizing the Invisible: Visual-Based Design and Efficacy in Air Quality Messaging
Int. J. Environ. Res. Public Health 2021, 18(20), 10882; https://doi.org/10.3390/ijerph182010882 (registering DOI) - 16 Oct 2021
Abstract
This study examines the effect and efficacy of visual designs for messages about poor air quality. The study utilized a 2 (message efficacy: high vs. low) × 2 (message design: visual vs. text) between-subjects experimental design, of N = 95 students from a [...] Read more.
This study examines the effect and efficacy of visual designs for messages about poor air quality. The study utilized a 2 (message efficacy: high vs. low) × 2 (message design: visual vs. text) between-subjects experimental design, of N = 95 students from a large Western university. This experiment assessed the effects of message design and efficacy of language on students’ visual comprehension, source credibility, self-efficacy, and protective behavioral intention. Hypotheses 1 and 2 were partially supported, finding that there were some statistically significant effects for efficacy and message design on students’ comprehension and protective behavioral intention. Future work should focus on strategies for more salient air quality health communication because wildfires will continue to impact the western United States. Full article
(This article belongs to the Special Issue Air Pollution Exposure and Health Risks)
Article
Effectiveness of Narrative Messaging Styles about the Social Determinants of Health and Health Inequities in Ontario, Canada
Int. J. Environ. Res. Public Health 2021, 18(20), 10881; https://doi.org/10.3390/ijerph182010881 (registering DOI) - 16 Oct 2021
Abstract
Health inequities are systemic, avoidable, and unjust differences in health between populations. These differences are often determined by social and structural factors, such as income and social status, employment and working conditions, or race/racism, which are referred to as the social determinants of [...] Read more.
Health inequities are systemic, avoidable, and unjust differences in health between populations. These differences are often determined by social and structural factors, such as income and social status, employment and working conditions, or race/racism, which are referred to as the social determinants of health (SDOH). According to public opinion, health is considered to be largely determined by the choices and behaviours of individuals. However, evidence suggests that social and structural factors are the key determinants of health. There is likely a lack of public understanding of the role that social and structural factors play in determining health and producing health inequities. Public opinion and priorities can drive governmental action, so the aim of this work was to determine the most impactful way to increase knowledge and awareness about the social determinants of health (SDOH) and health inequities in the province of Ontario, Canada. A study to test the effectiveness of four different messaging styles about health inequities and the SDOH was conducted with a sample of 805 adult residents of Ontario. Findings show that messages highlighting the challenges faced by those experiencing the negative effects of the SDOH, while still acknowledging individual responsibility for health, were the most effective for eliciting an empathetic response from Ontarians. These findings can be used to inform public awareness campaigns focused on changing the current public narrative about the SDOH toward a more empathetic response, with the goal of increasing political will to enact policies to address health inequities in Ontario. Full article
(This article belongs to the Special Issue Developing Interventions to Address Health Disparities)
Article
Mapping Institutional Interventions to Mitigate Suicides: A Study of Causes and Prevention
Int. J. Environ. Res. Public Health 2021, 18(20), 10880; https://doi.org/10.3390/ijerph182010880 (registering DOI) - 16 Oct 2021
Abstract
Suicide is an extreme, tragic act and an important subject for social inquiry. It is the rising public health issue prevalent in the Himalayan range of Pakistan. The young and educated population is more prone to suicide instead of using this prime phase [...] Read more.
Suicide is an extreme, tragic act and an important subject for social inquiry. It is the rising public health issue prevalent in the Himalayan range of Pakistan. The young and educated population is more prone to suicide instead of using this prime phase of age productively. Unfortunately, the suicide problem remains unaddressed, the causes remain undefined, solutions are not in the works, and in situations when others play a part in driving someone to commit suicide, no one is being held accountable. This study is aimed at uncovering the root causes of suicide and proposing some preventive measures to mitigate the problem. Our team studied three years’ worth of data (2017–2019) on suicides from the office of Human Rights Commission of Pakistan, Chitral. In addition, we conducted semi-structured interviews of different stakeholders, including family members, neighbors, lawyers, and police personnel. The findings revealed that extended family pressures, the power dynamic between sustainers and dependents, family conflicts, and inheritance cases were the major causes of the domestic violence that preceded suicide attempts. Mental health issues, forced marriages, academic competitions, and flawed litigation processes were also among the leading causes of suicide. Awareness through education and religious sermons, strengthening healthcare organizations, restructuring family systems, establishing police complaint centers, effective prosecution processes, and imparting lifesaving skills have been identified as measures to prevent suicide. This study has theoretical and practical implications, as it adds certain novel variables regarding the causes and solutions of suicide to the existing body of literature and guides public authorities to strengthen institutions to intervene effectively. Full article
(This article belongs to the Special Issue Understanding and Prevention of Suicide)
Article
Farmers’ Knowledge, Attitudes, and Perceptions Regarding Carcinogenic Pesticides in Fez Meknes Region (Morocco)
Int. J. Environ. Res. Public Health 2021, 18(20), 10879; https://doi.org/10.3390/ijerph182010879 (registering DOI) - 16 Oct 2021
Abstract
Pesticides play an important role in the improvement of agricultural production, but their use may result in adverse effects on the environment, consumers, and farmers’ health. As there are limited data focusing on the factors influencing safety behavior toward pesticide use in Morocco, [...] Read more.
Pesticides play an important role in the improvement of agricultural production, but their use may result in adverse effects on the environment, consumers, and farmers’ health. As there are limited data focusing on the factors influencing safety behavior toward pesticide use in Morocco, we conducted a cross-sectional survey in 15 rural communities of Morocco’s Fes Meknes region to assess the attitudes, knowledge, and practices regarding pesticide use. A structured questionnaire was completed, containing the data of the interviewed farmers, their behavior towards safety measures, the type of active ingredient used, as well as the perception of risks to their own health following exposure to pesticides by the existence of chronic, self-perceived symptoms. Non-probability (empirical) sampling with the quota method was carried out, which consists of constructing the sample. Results showed that most respondents have not been trained in the application of pesticides, with almost half of the farmers using a category of pesticides which are classified by the International Agency for Research on Cancer as probable human carcinogenic (i.e., Glyphosate, Malathion). In terms of pesticide storage, 40% of farmers said that they did not store pesticides in a separate room after purchasing or using them. The empty containers were buried or burnt by half of the responders, while the remainder were thrown at the edge of fields or in public dumps. Although the participants were aware of the negative effects on their own health and on the environment caused by the application of pesticides in use, the protection measures by individual equipment were insufficient. A canonical analysis indicates that these behaviors were influenced by the farming experience, the benefit of the agricultural council services, the follow-up of training, and the education level. These variables are important factors in explaining and understanding the dangers to both the environment and health caused by pesticides. The most recorded likely consequences of pesticide exposure were visual impairment (46%), followed by dizziness (44.3%), headache (39.4%), and excessive sweating (34.4%), and 30.2% of participants identified consequent respiratory problems. Extension services targeted at safety and protection measures should be developed and accompanied by educational programs to put farmers’ perceptions into practice and encourage them to adopt healthy and environmentally friendly behaviors. Full article
Brief Report
Examining Menthol Preference as a Correlate of Change in Cigarette Smoking Behavior over a One-Year Period
Int. J. Environ. Res. Public Health 2021, 18(20), 10878; https://doi.org/10.3390/ijerph182010878 (registering DOI) - 16 Oct 2021
Abstract
Menthol cigarette use has been shown to be a contributing factor in the changes in smoking over time among youth. The current study aim was to use prospective survey data to identify if menthol cigarette use was associated with changes in smoking among [...] Read more.
Menthol cigarette use has been shown to be a contributing factor in the changes in smoking over time among youth. The current study aim was to use prospective survey data to identify if menthol cigarette use was associated with changes in smoking among adults. A representative cohort from the 2010 U.S. Tobacco Use Supplement to the Current Population Survey was interviewed at two time points one year apart. Respondents were past-30-day cigarette smokers at Wave 1 or Wave 2 categorized by menthol vs. non-menthol flavor preference (n = 3668). Trajectories were categorized as maintained, increased, or decreased smoking behavior between Waves. Multinomial logistic regressions examined if menthol cigarette use was associated with an increase/decrease in smoking behavior, adjusting for age, race/ethnicity, and sex. Menthol cigarette use was not associated with change over time in cigarette smoking in adult smokers. Age, race/ethnicity and sex were associated with changes in cigarette smoking. Young (vs. older) adults were more likely to increase smoking. Black and Hispanic smokers (vs. white smokers) were more likely to report any change in smoking. Males were less likely than females to change smoking behavior. Menthol status was not associated with changes in smoking among adults; however, young age, race/ethnicity, and sex were, suggesting populations to target for intervention. Full article
(This article belongs to the Special Issue Inequalities and Tobacco Use)
Article
Menthol Smoking and Nicotine Dependence among Black/African American Women Smokers Living in Low-Resource, Rural Communities
Int. J. Environ. Res. Public Health 2021, 18(20), 10877; https://doi.org/10.3390/ijerph182010877 (registering DOI) - 16 Oct 2021
Abstract
Black/African American women from low-resource, rural communities bear a disproportionate burden of tobacco-related morbidity and mortality. This study examined associations between menthol smoking and socioeconomic deprivation with nicotine dependence and quitting behaviors among Black/African American women cigarette and/or little cigar/cigarillo smokers, aged 18–50 [...] Read more.
Black/African American women from low-resource, rural communities bear a disproportionate burden of tobacco-related morbidity and mortality. This study examined associations between menthol smoking and socioeconomic deprivation with nicotine dependence and quitting behaviors among Black/African American women cigarette and/or little cigar/cigarillo smokers, aged 18–50 living in low-resource, rural communities. Baseline survey data from a randomized controlled behavioral/intervention trial (#NCT03476837) were analyzed (n = 146). Outcomes included time to first tobacco product (cigarette/little cigar/cigarillo) use within 5 min of waking, Fagerstrom Test for Nicotine Dependence (FTND) score, and ever attempting to quit cigarettes. Socioeconomic deprivation measures included education, income, and receiving supplemental nutritional assistance (SNAP) program benefits. In adjusted regression analyses, menthol smoking was associated with both greater FTND scores and time to first tobacco product use within 5 min of waking, but not ever attempting to quit cigarettes. Regardless of menthol status, only 25.0% of smokers reported that they would quit smoking if menthol cigarettes were banned. The proportion of smokers who smoked their first tobacco product within 5 min of waking increased slightly with greater socioeconomic deprivation. Additional research and targeted efforts are needed to reduce nicotine dependence among Black/African American women smokers living in rural, low-resource communities where access to cessation services is limited. Full article
(This article belongs to the Special Issue Vulnerable Populations: Substance and Behavioral Addictions)
Article
Challenges for Workplace Risk Assessment in Home Offices—Results from a Qualitative Descriptive Study on Working Life during the First Wave of the COVID-19 Pandemic in Latvia
Int. J. Environ. Res. Public Health 2021, 18(20), 10876; https://doi.org/10.3390/ijerph182010876 (registering DOI) - 16 Oct 2021
Abstract
Epidemiological restrictions due to the COVID-19 pandemic have raised legal and practical questions related to the provision of workplace risk assessment in home offices of teleworkers. The objective of this qualitative study was to analyze practical experience of employers and occupational safety and [...] Read more.
Epidemiological restrictions due to the COVID-19 pandemic have raised legal and practical questions related to the provision of workplace risk assessment in home offices of teleworkers. The objective of this qualitative study was to analyze practical experience of employers and occupational safety and health experts performing workplace risk assessment in Latvia during the first wave of the COVID-19 pandemic. Our findings suggest that employers have not sufficiently implemented their legal obligations related to workplace risk assessment which can result in an increased number of physical and mental health problems of teleworkers in the short term and in the future. Work from home has shown how different working conditions can be for the same type of work (office work); therefore, the promotion of personalized workplace risk assessment should be encouraged. Even if virtual workplace visits using photos and videos are not the traditional way the workplace risk assessment should be done, it is effective; workers who report that their employers assessed their working conditions report fewer health effects. The experience of workers in participation in workplace risk assessment for telework might change the level and role of worker participation in the management of health and safety hazards at work in general. Full article
Article
Medical, Health and Wellness Tourism Research—A Review of the Literature (1970–2020) and Research Agenda
Int. J. Environ. Res. Public Health 2021, 18(20), 10875; https://doi.org/10.3390/ijerph182010875 (registering DOI) - 16 Oct 2021
Abstract
Medical, health and wellness tourism and travel represent a dynamic and rapidly growing multi-disciplinary economic activity and field of knowledge. This research responds to earlier calls to integrate research on travel medicine and tourism. It critically reviews the literature published on these topics [...] Read more.
Medical, health and wellness tourism and travel represent a dynamic and rapidly growing multi-disciplinary economic activity and field of knowledge. This research responds to earlier calls to integrate research on travel medicine and tourism. It critically reviews the literature published on these topics over a 50-year period (1970 to 2020) using CiteSpace software. Some 802 articles were gathered and analyzed from major databases including the Web of Science and Scopus. Markets (demand and behavior), destinations (development and promotion), and development environments (policies and impacts) emerged as the main three research themes in medical-health-wellness tourism. Medical-health-wellness tourism will integrate with other care sectors and become more embedded in policy-making related to sustainable development, especially with regards to quality of life initiatives. A future research agenda for medical-health-tourism is discussed. Full article
Editorial
Feature Paper in Environmental Chemistry and Technology
Int. J. Environ. Res. Public Health 2021, 18(20), 10874; https://doi.org/10.3390/ijerph182010874 (registering DOI) - 16 Oct 2021
Abstract
Attention to the environment and its problems has undergone unprecedented growth in recent years [...] Full article
(This article belongs to the Special Issue Feature Paper in Environmental Chemistry and Technology)
Article
Environmental Risk Factors and Their Different Effects in Depressive Symptoms of Left-Behind Children in Rural China Compared with Non-Left-Behind Children
Int. J. Environ. Res. Public Health 2021, 18(20), 10873; https://doi.org/10.3390/ijerph182010873 (registering DOI) - 16 Oct 2021
Abstract
In China, 61 million children were left behind in rural areas as a result of massive urbanization and migration of parents from the countryside to the cities in search of economic opportunities. This study explores the effects of environmental risk factors (i.e., peer [...] Read more.
In China, 61 million children were left behind in rural areas as a result of massive urbanization and migration of parents from the countryside to the cities in search of economic opportunities. This study explores the effects of environmental risk factors (i.e., peer victimization, perceived discrimination, and stressful life events) on depressive symptoms of left-behind children (LBC) and examines whether these risk factors have a higher impact on LBC compared with that of non-left-behind children (NLBC). Data collected involve 1548 first and second-year middle school students. Logistic regressions were conducted to examine the associations between environmental risk factors and LBC’s depressive symptoms, the moderating effect of the parental separation duration on these associations, and to compare if the risk factors had a higher impact on LBC’s depressive symptoms than on those of NLBC. Peer victimization is associated with an increased likelihood of depressive symptoms for LBC who were left behind for more than five years. Finally, stressful life events have a higher impact on LBC’s depressive symptoms, while peer victimization has a higher impact on NLBC’s depressive symptoms. The results suggest that stressful life events are an important risk factor that puts LBC at a disadvantage in terms of their mental health. Full article
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Article
Knowledge and Lifestyle Behaviors Related to COVID-19 Pandemic in People over 65 Years Old from Southern Italy
Int. J. Environ. Res. Public Health 2021, 18(20), 10872; https://doi.org/10.3390/ijerph182010872 (registering DOI) - 16 Oct 2021
Abstract
Background: Control measures adopted during the COVID-19 pandemic had a considerable impact on human daily life and lifestyles. Adherence to the recommended measures is influenced by knowledge and attitudes towards the disease. This cross-sectional study aimed to assess the level of knowledge regarding [...] Read more.
Background: Control measures adopted during the COVID-19 pandemic had a considerable impact on human daily life and lifestyles. Adherence to the recommended measures is influenced by knowledge and attitudes towards the disease. This cross-sectional study aimed to assess the level of knowledge regarding COVID-19, the related control measures, and lifestyle behaviors adopted during the pandemic in a sample of elderly Italian people. Methods: A web-based questionnaire investigating socio-demographic characteristics, knowledge of COVID-19, the related preventive measures, and lifestyle changes that occurred during the pandemic, were distributed to ≥65 years old people living in South Italy. Results: A satisfactory level of knowledge about COVID-19 and the related control measures has been found in the enrolled sample. However, a decrease in physical activity, as well as worsening sleeping and dietary habits, were found in roughly 60% of participants. Females were impacted greater by these lifestyle changes. Conclusions: Participants in this study showed a good level of knowledge regarding COVID-19 and its prevention. Nevertheless, they reported an increase in unhealthy habits that may have important health consequences in the long term and should be addressed by public health interventions targeted at older people. Full article
(This article belongs to the Section Environmental Health)
Article
Prevalence of Locomotive Organ Impairment and Associated Factors among Middle-Aged and Older People in Nan Province, Thailand
Int. J. Environ. Res. Public Health 2021, 18(20), 10871; https://doi.org/10.3390/ijerph182010871 (registering DOI) - 15 Oct 2021
Abstract
While locomotive organ impairment among older people is attracting worldwide attention, this issue has not yet been widely investigated in Thailand. This study aimed to measure locomotive organ impairment prevalence and identify the determinants of locomotive function decline among middle-aged and older people [...] Read more.
While locomotive organ impairment among older people is attracting worldwide attention, this issue has not yet been widely investigated in Thailand. This study aimed to measure locomotive organ impairment prevalence and identify the determinants of locomotive function decline among middle-aged and older people in Nan Province, Thailand. This cross-sectional study included anthropometric measurements, a two-step test to investigate locomotive function, and a structured questionnaire to obtain socio-demographic and related information. Logistic regression analysis and multiple regression analysis were used to identify the determinants of locomotive organ impairment. The study participants were aged 50–87 years old (n = 165), and 71.5% of them had begun experiencing declining locomotive function; < 6 years of school education (adjusted odds ratio: 4.46), body mass index ≥25 kg/m2 (AOR: 3.06), comorbidities (AOR: 2.55), and continuous walking for <15 min (AOR: 2.51) were identified as factors associated with locomotive organ impairment. Moreover, age, knee pain, anxiety about falling in daily life, and difficulty with simple tasks were identified as factors significantly associated with exacerbated locomotive organ impairment (p < 0.05). Appropriate interventions such as guidance or follow-up and recommendations for exercises are needed to prevent locomotive organ impairment and improve treatment. Full article
(This article belongs to the Special Issue Active and Healthy Ageing)
Article
Dosimetric Comparison of Exposure Pathways to Human Organs and Tissues in Radon Therapy
Int. J. Environ. Res. Public Health 2021, 18(20), 10870; https://doi.org/10.3390/ijerph182010870 (registering DOI) - 15 Oct 2021
Abstract
Three therapeutic applications are presently prescribed in the radon spas in Gastein, Austria: exposure to radon in a thermal bath, exposure to radon vapor in an exposure chamber (vapor bath), and exposure to radon in the thermal gallery, a former mine. The radiological [...] Read more.
Three therapeutic applications are presently prescribed in the radon spas in Gastein, Austria: exposure to radon in a thermal bath, exposure to radon vapor in an exposure chamber (vapor bath), and exposure to radon in the thermal gallery, a former mine. The radiological exposure pathways to human organs and tissues in these therapeutic radon applications are inhalation of radon and radon progeny via the lungs, radon transfer from water or air through the skin, and radon-progeny deposition on the skin in water or air. The objectives of the present study were to calculate radon and radon-progeny doses for selected organs and tissues for the different exposure pathways and therapeutic applications. Doses incurred in red bone marrow, liver, kidneys, and Langerhans cells in the skin may be correlated with potential therapeutic benefits, while doses to the lungs and the basal cells of the skin indicate potential carcinogenic effects. The highest organ doses among the three therapeutic applications were produced in the thermal gallery by radon progeny via inhalation, with lung doses of 5.0 mSv, and attachment to the skin, with skin doses of 4.4 mSv, while the radon contribution was less significant. For comparison, the primary exposure pathways in the thermal bath are the radon uptake through the skin, with lung doses of 334 μSv, and the radon-progeny attachment to the skin, with skin doses of 216 μSv, while the inhalation route can safely be neglected. Full article
Article
Effects of Anthropogenic Emissions from Different Sectors on PM2.5 Concentrations in Chinese Cities
Int. J. Environ. Res. Public Health 2021, 18(20), 10869; https://doi.org/10.3390/ijerph182010869 (registering DOI) - 15 Oct 2021
Abstract
PM2.5 pollution has gradually attracted people’s attention due to its important negative impact on public health in recent years. The influence of anthropogenic emission factors on PM2.5 concentrations is more complicated, but their relative individual impact on [...] Read more.
PM2.5 pollution has gradually attracted people’s attention due to its important negative impact on public health in recent years. The influence of anthropogenic emission factors on PM2.5 concentrations is more complicated, but their relative individual impact on different emission sectors remains unclear. With the aid of the geographic detector model (GeoDetector), this study evaluated the impacts of anthropogenic emissions from different sectors on the PM2.5 concentrations of major cities in China. The results indicated that the influence of anthropogenic emissions factors with different emission sectors on PM2.5 concentrations exhibited significant changes at different spatial and temporal scales. Residential emissions were the dominant driver at the national annual scale, and the NOX of residential emissions explained 20% (q = 0.2) of the PM2.5 concentrations. In addition, residential emissions played the leading role at the regional annual scale and during most of the seasons in northern China, and ammonia emissions from residents were the dominant factor. Traffic emissions play a leading role in the four seasons for MUYR and EC in southern China, MYR and NC in northern China, and on a national scale. Compared with primary particulate matter, secondary anthropogenic precursors have a more important effect on PM2.5 concentrations at the national or regional annual scale. The results can help to strengthen our understanding of PM2.5 pollution, improve PM2.5 forecasting models, and formulate more precise government control policy. Full article
(This article belongs to the Section Air)
Article
The Relationships between Character Strengths and Subjective Wellbeing: Evidence from Greece under Lockdown during COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(20), 10868; https://doi.org/10.3390/ijerph182010868 (registering DOI) - 15 Oct 2021
Abstract
COVID-19 was first identified in December 2019. As long as this type of coronavirus was new, the main way for governments to avoid the spread of the infection was enforced quarantine. Besides public health protection, quarantine can have a psychological impact on the [...] Read more.
COVID-19 was first identified in December 2019. As long as this type of coronavirus was new, the main way for governments to avoid the spread of the infection was enforced quarantine. Besides public health protection, quarantine can have a psychological impact on the residents, with main symptoms being angst, anxiety, depressive, and PTSD symptoms. As it has been found that character strengths can promote subjective wellbeing, the purpose of the study was to examine this relationship under the new situation of quarantine in the Greek population in adults who were in quarantine for at least two weeks. The total sample consisted of 354 participants who were aged 18–72-years-old. A total of 263 participants were women (74.3%), 91 were men (25.7%), and 94,6% of them were highly educated. The sample was a convenience sample. The tools used were PANAS) , PERMA) and finally VIA-114GR (). The data analysis was completed using SPSS software version 26.0 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp) and EQS 6.1 (Multivariate Software Inc.: Encino, CA, USA, 2006). The results showed that love, curiosity, persistence, hope, and zest are strongly associated with subjective wellbeing, even in conditions such as quarantine, and can support specific aspects of it. Full article
(This article belongs to the Collection COVID-19 Research)
Review
Immunological Mechanisms of Metal Allergies and the Nickel-Specific TCR-pMHC Interface
Int. J. Environ. Res. Public Health 2021, 18(20), 10867; https://doi.org/10.3390/ijerph182010867 (registering DOI) - 15 Oct 2021
Abstract
Besides having physiological functions and general toxic effects, many metal ions can cause allergic reactions in humans. We here review the immune events involved in the mediation of metal allergies. We focus on nickel (Ni), cobalt (Co) and palladium (Pd), because these allergens [...] Read more.
Besides having physiological functions and general toxic effects, many metal ions can cause allergic reactions in humans. We here review the immune events involved in the mediation of metal allergies. We focus on nickel (Ni), cobalt (Co) and palladium (Pd), because these allergens are among the most prevalent sensitizers (Ni, Co) and immediate neighbors in the periodic table of the chemical elements. Co-sensitization between Ni and the other two metals is frequent while the knowledge on a possible immunological cross-reactivity using in vivo and in vitro approaches remains limited. At the center of an allergic reaction lies the capability of a metal allergen to form T cell epitopes that are recognized by specific T cell receptors (TCR). Technological advances such as activation-induced marker assays and TCR high-throughput sequencing recently provided new insights into the interaction of Ni2+ with the αβ TCR-peptide-major histocompatibility complex (pMHC) interface. Ni2+ functionally binds to the TCR gene segment TRAV9-2 or a histidine in the complementarity determining region 3 (CDR3), the main antigen binding region. Thus, we overview known, newly identified and hypothesized mechanisms of metal-specific T cell activation and discuss current knowledge on cross-reactivity. Full article
(This article belongs to the Special Issue Current Insights into Immunotoxicology)
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Article
Is Self-Efficacy Related to the Quality of Life in Elite Athletes after Spinal Cord Injury?
Int. J. Environ. Res. Public Health 2021, 18(20), 10866; https://doi.org/10.3390/ijerph182010866 (registering DOI) - 15 Oct 2021
Abstract
Background: A spinal cord injury (SCI) is a traumatic event that affects every aspect of life: physical, mental, economic, and social. The main aim of this study was to investigate self-efficacy, quality of life, and their correlations among outstanding athletes who have suffered [...] Read more.
Background: A spinal cord injury (SCI) is a traumatic event that affects every aspect of life: physical, mental, economic, and social. The main aim of this study was to investigate self-efficacy, quality of life, and their correlations among outstanding athletes who have suffered spinal cord injuries, and to determine whether these individuals have specific psychological characteristics that contribute to a better quality of life. Methods: The study involved nine athletes with at least national-level achievements in sports prior to an SCI. Participation in the study consisted of an interview via an online communicator, followed by an online questionnaire consisting of a personal questionnaire and two scales: The World Health Organization Quality of Life Scale (WHOQoL-BREF), and the General Self-Efficacy Scale (GSES). Results: Spearman’s correlation showed a correlation between general self-efficacy, perception of quality of life, and satisfaction with own physical health, as well as psychological resources and environmental support. Conclusions: Involvement in an environment that was important to the injured person before the accident, in either a passive (in the absence of functional capacity) or active form, promotes a greater sense of self-efficacy and good QoL, regardless of the time that has passed since the accident, and despite high levels of pain or secondary health issues. To fill the gap in professional long-term healthcare services for athletes after SCIs, intervention programs should be considered that support self-efficacy, which is an important factor that can be subject to improvement. Full article
Article
Environmental, Social, Governance Risk and Corporate Sustainable Growth Nexus: Quantile Regression Approach
Int. J. Environ. Res. Public Health 2021, 18(20), 10865; https://doi.org/10.3390/ijerph182010865 (registering DOI) - 15 Oct 2021
Abstract
Despite a huge body of literature revealing that the effect of environmental, social and governance (ESG) scores on a firms' financial performance and value, it lacks the empirical research on the nexus between corporate sustainable growth and ESG risk in the existing research. [...] Read more.
Despite a huge body of literature revealing that the effect of environmental, social and governance (ESG) scores on a firms' financial performance and value, it lacks the empirical research on the nexus between corporate sustainable growth and ESG risk in the existing research. The paper aims to examine the nexus between ESG risk and corporate sustainable growth. This study utilizes a quantile regression approach to explore how ESG risk affects corporate sustainable growth (proxied by sustainable growth rate, SGR). The ordinary least squares estimation results confirm that ESG significantly negatively affects corporate sustainable growth. The quantile regression results reveal ESG risk has a significant negative effect on corporate sustainable growth in the upper quantiles of SGR, but not in the lower and median quantiles. The results show that the impact of ESG risk on the corporate sustainable growth is asymmetric and affected by the distribution of SGR. Furthermore, the research results identify that the negative relationship between ESG risk and corporate sustainable growth is particularly apparent for firms in environmentally sensitive industries. This study greatly contributes to existing literature, as with this detailed knowledge, managers can make decisions based on these associations and identify the most lucrative course of action. Full article
Review
Compliance of Healthcare Worker’s Toward Tuberculosis Preventive Measures in Workplace: A Systematic Literature Review
Int. J. Environ. Res. Public Health 2021, 18(20), 10864; https://doi.org/10.3390/ijerph182010864 (registering DOI) - 15 Oct 2021
Abstract
Despite several guidelines published by the World Health Organization (WHO) and national authorities, there is a general increase in the number of healthcare workers (HCWs) contracting tuberculosis. This review sought to evaluate the compliance of the HCWs toward tuberculosis preventive measures (TPMs) in [...] Read more.
Despite several guidelines published by the World Health Organization (WHO) and national authorities, there is a general increase in the number of healthcare workers (HCWs) contracting tuberculosis. This review sought to evaluate the compliance of the HCWs toward tuberculosis preventive measures (TPMs) in their workplace. Both electronic databases and manual searches were conducted to retrieve articles regarding the compliance of HCWs in the workplace published from 2010 onwards. Independent reviewers extracted, reviewed, and analyzed the data using the mixed methods appraisal tool (MMAT) 2018, comprising 15 studies, 1572 HCWs, and 249 health facilities. The results showed there was low compliance toward TPMs in the workplace among HCWs and health facilities from mostly high-burden tuberculosis countries. The failure to comply with control measures against tuberculosis was mainly reported at administrative levels, followed by engineering and personnel protective control measures. In addition, low managerial support and negative attitudes of the HCWs influenced the compliance. Further studies are needed to elucidate how to improve the compliance of HCWs toward the preventive measures against tuberculosis in order to reduce the disease burden among HCWs worldwide. Full article
Article
Recent Malignant Melanoma Epidemiology in Upper Silesia, Poland. A Decade-Long Study Focusing on the Agricultural Sector
Int. J. Environ. Res. Public Health 2021, 18(20), 10863; https://doi.org/10.3390/ijerph182010863 (registering DOI) - 15 Oct 2021
Abstract
The aim of the present study was to create spatial and spatio-temporal patterns of cutaneous malignant melanoma (MM) incidence in Upper Silesia, Poland, using the largest MM database (<4K cases) in Central Europe, focusing on the agricultural sector. The data comprised all the [...] Read more.
The aim of the present study was to create spatial and spatio-temporal patterns of cutaneous malignant melanoma (MM) incidence in Upper Silesia, Poland, using the largest MM database (<4K cases) in Central Europe, focusing on the agricultural sector. The data comprised all the registered cancer cases (C43, according to the International Classification of Diseases after the 10th Revision) between the years 2004–2013 by the Regional Cancer Registries (RCRs) in Opole and Gliwice. The standardized incidence ratios (SIRs), spatio-temporal growth rates (GRs), and disease cluster relative risks (RRs) were estimated. Based on the regression coefficients, we have indicated irregularities of spatial variance in cutaneous malignant melanoma, especially in older women (≥60), and a possible age-migrating effect of agricultural population density on the risk of malignant melanoma in Upper Silesia. All the estimates were illustrated in choropleth thematic maps. Full article
(This article belongs to the Section Skin Health)
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Article
Ethical Leadership and Followers’ Emotional Exhaustion: Exploring the Roles of Three Types of Emotional Labor toward Leaders in South Korea
Int. J. Environ. Res. Public Health 2021, 18(20), 10862; https://doi.org/10.3390/ijerph182010862 (registering DOI) - 15 Oct 2021
Abstract
Employees’ emotional exhaustion caused by their leaders has significant consequences for both individuals and organizations. Identifying the roles of intra-organizational emotional labor is important to prevent employees’ emotional exhaustion. This study examined the relationships between ethical leadership, followers’ emotional labor toward leaders, and [...] Read more.
Employees’ emotional exhaustion caused by their leaders has significant consequences for both individuals and organizations. Identifying the roles of intra-organizational emotional labor is important to prevent employees’ emotional exhaustion. This study examined the relationships between ethical leadership, followers’ emotional labor toward leaders, and emotional exhaustion using Hobfoll’s conservation of resources theory. Data collected from 259 employees working in South Korea were analyzed using regression and SEM. The results indicate that ethical leadership was negatively related to followers’ emotional exhaustion. It is demonstrated that ethical leadership has a significant indirect relationship with followers’ emotional exhaustion through three types of emotional labor strategies; genuine display, faked display, and suppressed display. Through genuine display and suppressed display, ethical leadership had an indirect and negative relationship with followers’ emotional exhaustion, whereas ethical leadership and followers’ emotional exhaustion showed a positive indirect relationship through faked display. We discuss the implications and limitations of this research and future research directions. Full article
(This article belongs to the Special Issue Occupational Stress and Health: Psychological Burden and Burnout)
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