Int. J. Environ. Res. Public Health, Volume 9, Issue 12 (December 2012) – 31 articles , Pages 4241-4781

The health impact attributable to climate change has been identified as one of the priority areas for impact assessment. The main goal of this paper is to estimate the monetary value of one key health effect, which is premature mortality. Specifically, our goal is to derive the value of a statistical life from people’s willingness to pay for avoiding the risk of dying in one post-transition country in Europe, i.e., the Czech Republic. We carried out a series of conjoint choice experiments in order to value mortality risk reductions. We found the responses to the conjoint choice questions to be reasonable and consistent with the economic paradigm. The VSL is about EUR 2.4 million, and our estimate is comparable with the value of preventing a fatality as used in one of the integrated assessment models. To investigate whether carrying out the survey through the internet may violate the welfare estimate, we administered our questionnaire to two independent samples of respondents using two different modes of survey administration. The results show that the VSLs for the two groups of respondents are €2.25 and €2.55 million, and these figures are statistically indistinguishable. However, the key parameters of indirect utility between the two modes of survey administration are statistically different when specific subgroups of population, such as older respondents, are concerned. Based on this evidence, we conclude that properly designed and administered on-line surveys are a reliable method for administering questionnaires, even when the latter are cognitively challenging. However, attention should be paid to sampling and choice regarding the mode of survey administration if the preference of specific segments of the population is elicited. Full article

More than half of all cancer patients receive radiotherapy as a part of their treatment. With the increasing number of long-term cancer survivors, there is a growing concern about the risk of radiation induced second malignant neoplasm [SMN]. This risk appears to be highest for survivors of childhood cancers. The exact mechanism and dose-response relationship for radiation induced malignancy is not well understood, however, there have been growing efforts to develop strategies for the prevention and mitigation of radiation induced cancers. This review article focuses on the incidence, etiology, and risk factors for SMN in various organs after radiotherapy. Full article

There is a growing concern about the serious harm of radioactive materials, which are widely used in energy production, scientific research, medicine, industry and other areas. In recent years, owing to the great side effects of anti-radiation drugs, research on the radiation protectants has gradually expanded from the previous chemicals to the use of natural anti-radiation drugs and functional foods. Some reports have confirmed that anthocyanins are good antioxidants, which can effectively eliminate free radicals, but studies on the immunoregulatory and anti-radiation effects of anthocyanins from lingonberry (ALB) are less reported. In this experiment, mice were given orally once daily for 14 consecutive days before exposure to 6 Gy of gamma-radiation and were sacrificed on the 7th day post-irradiation. The results showed that the selected dose of extract did not lead to acute toxicity in mice; while groups given anthocyanins orally were significantly better than radiation control group according to blood analysis; pretreatment of anthocyanins significantly (p < 0.05) enhanced the thymus and spleen indices and spleen cell survival compared to the irradiation control group. Pretreatment with anthocyanins before irradiation significantly reduced the numbers of micronuclei (MN) in bone marrow polychromatic erythrocytes (PCEs). These findings indicate that anthocyanins have immunostimulatory potential against immunosuppression induced by the radiation. Full article

Studies have revealed that relative poverty is associated with ill health, but the interpretations of this correlation vary. This article asks whether relative poverty among Norwegian adolescents is causally related to poor subjective health, i.e., self-reported somatic and mental symptoms. Data consist of interview responses from a sample of adolescents (N = 510) and their parents, combined with register data on the family’s economic situation. Relatively poor adolescents had significantly worse subjective health than non-poor adolescents. Relatively poor adolescents also experienced many other social disadvantages, such as parental unemployment and parental ill health. Comparisons between the relatively poor and the non-poor adolescents, using propensity score matching, indicated a negative impact of relative poverty on the subjective health among those adolescents who lived in families with relatively few economic resources. The results suggest that there is a causal component in the association between relative poverty and the symptom burden of disadvantaged adolescents. Relative poverty is only one of many determinants of adolescents’ subjective health, but its role should be acknowledged when policies for promoting adolescent health are designed. Full article

The magnitude of regional malaria risk is dependent primarily on the dynamics and distribution of the vector species, which are determined mainly by climate conditions. A coupled model with ecophysiological and climatological factors was developed to estimate the spatiotemporal distribution of the five species of dominant malaria vectors in monsoon Asia. Here, we examined how the potential distribution obtained from the model could explain trends in malaria incidence observed in India, which has the highest number of confirmed cases of malaria in Asia. Most notably, there was a significant positive correlation between annual malaria incidences and the maximum generation number of vectors for each state (p < 0.001). Malaria incidence tended to increase exponentially as vector generation number increased. In addition, the interannual variation in observed regional malaria incidences was synchronized with that of the potential number of vector generations. The observed seasonal peak of malaria incidences corresponded closely to the simulated appearance period of vector species, except for intensively irrigated areas that experience anthropogenic impacts on hydrologic conditions. Simulated vector distributions effectively expressed spatial and temporal prevalence of malaria in India. This novel approach to modeling based on vector ecology is an effective method for assessing malaria risk. Full article

The Janus series of radiation experiments, conducted from 1970 to 1992, explored the effects of gamma and neutron radiation on animal lifespan and disease development. Data from these experiments presents an opportunity to conduct a large scale analysis of both tumor and non-tumor disease development. This work was focused on a subset of animals from the Janus series of experiments, comparing acute or fractionated exposures of gamma or neutron radiation on the hazards associated with the development of tumor and non-tumor diseases of the liver, lung, kidney or vascular system. This study also examines how the co-occurrence of non-tumor diseases may affect tumor-associated hazards. While exposure to radiation increases the hazard of dying with tumor and non-tumor diseases, dose fractionation modulates these hazards, which varies across different organ systems. Finally, the effect that concurrent non-cancer diseases have on the hazard of dying with a tumor also differs by organ system. These results highlight the complexity in the effects of radiation on the liver, lung, kidney and vascular system. Full article

The aim of the present study was to evaluate the association between childhood dental experiences and dental fear in adulthood among dentistry, psychology and mathematics undergraduate students. A cross-sectional study of 1,256 students from the city of Belo Horizonte, Brazil, was performed. Students responded to the Brazilian version of the Dental Fear Survey (DFS) and a questionnaire regarding previous dental experiences. Both the DFS and the questionnaire were self-administered. Association was tested using descriptive, bivariate and multivariate linear regression analysis, with a 5% significance level. Dentistry undergraduates reported lower scores than psychology (p < 0.001) and mathematics undergraduates (p < 0.05) for all three dimensions of the DFS. Negative dental experiences in childhood was associated with dimensions of Avoidance (B = 2.70, p < 0.001), Physiological arousal (B = 1.42, p < 0.001) and Fears of specific stimuli/situations (B = 3.44, p < 0.001). The reason for first visit to dentist was associated with dimensions of Physiological arousal (B = 0.76, p < 0.01) and Fears of specific stimuli/situations (B = 1.29, p < 0.01). Dentists should be encouraged to evaluate the dental fear of their patients before treatment. The DFS has been found to be an effective instrument for this purpose. Full article

Vibrio parahaemolyticus and Vibrio vulnificus are the major pathogenic Vibrio species which contaminate ready-to-eat seafood. The purpose of this study was to evaluate the risk of human illness resulting from consumption of ready-to-eat seafood such as sashimi and raw oyster meat due to the presence of V. parahaemolyticus and V. vulnificus. We compared the growth kinetics of V. parahaemolyticus and V. vulnificus strains in broth and ready-to-eat seafood, including flounder and salmon sashimi, as a function of temperature. The growth kinetics of naturally occurring V. vulnificus in raw oyster meat was also evaluated. The minimum growth temperatures of V. parahaemolyticus and V. vulnificus in broth were 13 °C and 11 °C, respectively. Overall, significant differences in lag time (LT) and specific growth rate (SGR) values between flounder and salmon sashimi were observed at temperatures ranging from 13 °C to 30 °C (p < 0.05). The growth of naturally occurring V. vulnificus reached stationary phase at ~4 log CFU/g in oysters, regardless of the storage temperature. This data indicates that the population of V. vulnificus in oysters did not reach the maximum population density as observed in the broth, where growth of V. vulnificus and V. parahaemolyticus isolated from oysters grew up to >8 log CFU/mL. Full article

Air change rates (ACRs) and interzonal flows are key determinants of indoor air quality (IAQ) and building energy use. This paper characterizes ACRs and interzonal flows in 126 houses, and evaluates effects of these parameters on IAQ. ACRs measured using weeklong tracer measurements in several seasons averaged 0.73 ± 0.76 h⁻¹ (median = 0.57 h⁻¹, n = 263) in the general living area, and much higher, 1.66 ± 1.50 h⁻¹ (median = 1.23 h⁻¹, n = 253) in bedrooms. Living area ACRs were highest in winter and lowest in spring; bedroom ACRs were highest in summer and lowest in spring. Bedrooms received an average of 55 ± 18% of air from elsewhere in the house; the living area received only 26 ± 20% from the bedroom. Interzonal flows did not depend on season, indoor smoking or the presence of air conditioners. A two-zone IAQ model calibrated for the field study showed large differences in pollutant levels between the living area and bedroom, and the key parameters affecting IAQ were emission rates, emission source locations, air filter use, ACRs, interzonal flows, outdoor concentrations, and PM penetration factors. The single-zone models that are commonly used for residences have substantial limitations and may inadequately represent pollutant concentrations and exposures in bedrooms and potentially other environments other where people spend a substantial fraction of time. Full article

Pertussis continues to be a relevant public-health issue. The high coverage rates achieved have decreased the spread of the pathogen, but the waning of immunity implies a relevant role of adolescents and adults in the infective dynamics as they may represent a significant source of infection for unvaccinated or incompletely immunized newborns. The passive surveillance system is affected by many limitations. The underestimation of pertussis in adolescents, young adults and adults is mainly related to the atypical clinical characteristics of cases and the lack of lab confirmation. The real epidemiological impact of pertussis is not always perceived, anyway, the unavailability of comprehensive data should not hamper the adoption of active prophylactic interventions aimed at preventing the impact of waning immunity on pertussis. To avoid an increase of the mean age of acquisition of the infection, a booster dose of low-antigen content combined vaccine should be adopted in adolescents and adults. A decreased risk of infection in newborns can be achieved with the cocoon strategy, although the debate on this aspect is still open and enhanced surveillance and further studies are needed to fine-tune the pertussis prevention strategy. Full article

Physical activity (PA) provides health benefits in older adults. Research suggests that exposure to nature and time spent outdoors may also have effects on health. Older adults are the least active segment of our population, and are likely to spend less time outdoors than other age groups. The relationship between time spent in PA, outdoor time, and various health outcomes was assessed for 117 older adults living in retirement communities. Participants wore an accelerometer and GPS device for 7 days. They also completed assessments of physical, cognitive, and emotional functioning. Analyses of variance were employed with a main and interaction effect tested for ±30 min PA and outdoor time. Significant differences were found for those who spent >30 min in PA or outdoors for depressive symptoms, fear of falling, and self-reported functioning. Time to complete a 400 m walk was significantly different by PA time only. QoL and cognitive functioning scores were not significantly different. The interactions were also not significant. This study is one of the first to demonstrate the feasibility of using accelerometer and GPS data concurrently to assess PA location in older adults. Future analyses will shed light on potential causal relationships and could inform guidelines for outdoor activity. Full article

Asian dust events result from displacement of atmospheric pollutants from the Chinese and Mongolian deserts, causing associated health issues throughout Northeast Asia. We investigated the relationship between skin symptoms in Asian dust events and contact allergy to Asian dust and associated metals. Increases in atmospheric levels of heavy metals such as Ni, Al, and Fe occurred during the severe Asian dust event on March 21, 2010. We conducted a case–control study (n = 62) with patch testing to compare skin symptoms on an Asian dust day with metal allergic reactions. Skin symptoms were observed in 18/62 subjects. Nine subjects with skin symptoms (group A) and 11 without (group B) were patch tested for six metals and Asian dust particles. Metal and dust samples were applied to the subjects’ backs for 2 days and the reactions were scored according to the International Contact Dermatitis Research Group guidelines. Differences in the positive rates between the groups were analyzed. Skin reactions to ferric chloride (p = 0.015), aluminum chloride (p = 0.047), nickel sulfate (p = 0.008), and Asian dust particles (p = 0.047) were more common in group A than in group B. Skin symptoms during Asian dust events may be allergic reactions to Asian dust particle-bound metals. Full article

Wetlands are valuable habitats that provide important social, economic, and ecological services such as flood control, water quality improvement, carbon sequestration, pollutant removal, and primary/secondary production export to terrestrial and aquatic food chains. There is disagreement about the need for mosquito control in wetlands and about the techniques utilized for mosquito abatement and their impacts upon wetlands ecosystems. Mosquito control in wetlands is a complex issue influenced by numerous factors, including many hard to quantify elements such as human perceptions, cultural predispositions, and political climate. In spite of considerable progress during the last decades, habitat protection and environmentally sound habitat management still remain inextricably tied to politics and economics. Furthermore, the connections are often complex, and occur at several levels, ranging from local businesses and politicians, to national governments and multinational institutions. Education is the key to lasting wetlands conservation. Integrated mosquito abatement strategies incorporate many approaches and practicable options, as described herein, and need to be well-defined, effective, and ecologically and economically sound for the wetland type and for the mosquito species of concern. The approach will certainly differ in response to disease outbreaks caused by mosquito-vectored pathogens versus quality of life issues caused by nuisance-biting mosquitoes. In this contribution, we provide an overview of the ecological setting and context for mosquito control in wetlands, present pertinent information on wetlands mosquitoes, review the mosquito abatement options available for current wetlands managers and mosquito control professionals, and outline some necessary considerations when devising mosquito control strategies. Although the emphasis is on North American wetlands, most of the material is applicable to wetlands everywhere. Full article

Chronic arsenic exposure and its association with hypertension in adults are inconclusive and this cross-sectional study investigated the association. The study was conducted between January and July 2009 among 1,004 participants from 1,682 eligible women and men aged ≥30 years living in rural Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. Hypertension was defined as systolic blood pressure ≥140 mmHg (systolic hypertension) and diastolic blood pressure ≥90 mmHg (diastolic hypertension). Pulse pressure was calculated by deducting diastolic from systolic pressure and considered to be increased when the difference was ≥55 mmHg. The prevalence of hypertension was 6.6% (95% CI: 5.1–8.3%). After adjustment for other factors, no excess risk of hypertension was observed for arsenic exposure >50μg/L or to that of arsenic exposure as quartiles or as duration. Arsenic concentration as quartiles and >50 μg/L did show a strong relationship with increased pulse pressure (adjusted OR: 3.54, 95% CI: 1.46–8.57), as did arsenic exposure for ≥10 years (adjusted OR: 5.25, 95% CI: 1.41–19.51). Arsenic as quartiles showed a dose response relationship with increased pulse pressure. Our study suggests an association between higher drinking water arsenic or duration and pulse pressure, but not hypertension. Full article

In recent years, water quality degradation associated with rapid socio-economic development in the Taihu Lake Basin, China, has attracted increasing attention from both the public and the Chinese government. The primary sources of pollution in Taihu Lake are its inflow rivers and their tributaries. Effective water environmental management strategies need to be implemented in these rivers to improve the water quality of Taihu Lake, and to ensure sustainable development in the region. The aim of this study was to provide a basis for water environmental management decision-making. In this study, the QUAL2K model for river and stream water quality was applied to predict the water quality and environmental capacity of the Hongqi River, which is a polluted tributary in the Taihu Lake Basin. The model parameters were calibrated by trial and error until the simulated results agreed well with the observed data. The calibrated QUAL2K model was used to calculate the water environmental capacity of the Hongqi River, and the water environmental capacities of COD_Cr NH₃-N, TN, and TP were 17.51 t, 1.52 t, 2.74 t and 0.37 t, respectively. The results showed that the NH₃-N, TN, and TP pollution loads of the studied river need to be reduced by 50.96%, 44.11%, and 22.92%, respectively to satisfy the water quality objectives. Thus, additional water pollution control measures are needed to control and reduce the pollution loads in the Hongqi River watershed. The method applied in this study should provide a basis for water environmental management decision-making. Full article

Waste collectors have a theoretical risk of Hepatitis A virus infection. The aim of the study was to assess the prevalence and risk factors of hepatitis A virus infection (HAV) among municipal solid waste workers (MSWWs) in a municipality of central Greece. A seroprevalence study of HAV was conducted among 208 employees (100 waste collectors and 108 municipal gardeners) of a municipality in central Greece. Total antibodies against HAV were measured and information regarding potential risk factors was collected through a face to face interview. The prevalence of HAV infection among the municipal waste collectors was 61% vs. 27% among municipal gardeners. Logistic regression analysis showed that exposure to waste (OR = 2.87; 95% CI = 1.24–6.62) and age (OR = 22.57; 95% CI = 7.29–69.88) were independently associated with the anti-HAV positivity. Moreover, waste collectors who reported smoking/drinking/eating during waste collection were at higher risk of HAV infection (RR = 2.84; 95% CI = 1.73–4.63). Stratified analysis among municipal waste collectors indicated an independent association between eating/smoking/ drinking during waste collection and anti-HAV (+) (OR = 3.85; 95% CI = 1.34–11.06). Occupational exposure to waste is a potential risk factor for HAV infection. Smoking/eating/drinking during waste collection could be the mode of hepatitis A virus transmission among municipal waste collectors. Full article

Previous studies have found a higher body-burden of toxic metals, particularly mercury (Hg), among subjects diagnosed with an autism spectrum disorder (ASD) in comparison to neurotypical controls. Moreover, Hg body-burden was associated with ASD severity. This cross-sectional study examined the potential correlation between hair toxic metal concentrations and ASD severity in a prospective cohort of participants diagnosed with moderate to severe ASD. The Institutional Review Board at the University of Texas Southwestern Medical Center at Dallas (Dallas, TX) approved the present study. Qualifying study participants (n = 18) were evaluated for ASD severity using the Childhood Autism Rating Scale (CARS) and quantitatively for arsenic, Hg, cadmium, lead, chromium, cobalt, nickel, aluminum, tin, uranium, and manganese using hair toxic element testing by Doctor’s Data (a CLIA-approved laboratory). CARS scoring and hair toxic element testing were blinded to one another. Increasing hair Hg concentrations significantly correlated with increased ASD severity. In contrast, no significant correlations were observed between any other of the hair toxic metals examined and ASD severity. This study helps to provide additional mechanistic support for Hg in the etiology of ASD severity, and is supported by an increasing number of recent critical reviews that provide biological plausibility for the role of Hg exposure in the pathogenesis of ASDs. Full article

Little is known about genetic susceptibility to individual trihalomethanes (THM) in relation to adverse pregnancy outcomes. We conducted a nested case-control study of 682 pregnant women in Kaunas (Lithuania) and, using individual information on drinking water, ingestion, showering and bathing, and uptake factors of THMs in blood, estimated an internal THM dose. We used logistic regression to evaluate the relationship between internal THM dose, birth outcomes and individual and joint (modifying) effects of metabolic gene polymorphisms. THM exposure during entire pregnancy and specific trimesters slightly increased low birth weight (LBW) risk. When considering both THM exposure and maternal genotypes, the largest associations were found for third trimester among total THM (TTHM) and chloroform-exposed women with the GSTM1–0 genotype (OR: 4.37; 95% CI: 1.36–14.08 and OR: 5.06; 95% CI: 1.50–17.05, respectively). A test of interaction between internal THM dose and GSTM1–0 genotype suggested a modifying effect of exposure to chloroform and bromodichloromethane on LBW risk. However, the effect on small for gestational age (SGA) was not statistically significant. These data suggest that THM internal dose may affect foetal growth and that maternal GSTM1 genotype modifies the THM exposure effects on LBW. Full article

In this community based research initiative, we employed a survey instrument predominately developed and administered by Teen Educators to assess occupational health risks for Haitian, Salvadoran, and Brazilian immigrants (n = 405) in Somerville, MA, USA. We demonstrate that a combined analysis of ethnicity, years in the US, and English proficiency better characterized the occupational experience of immigrant workers than considering these variables individually. While years in the US (negatively) and English proficiency (positively) explained the occurrence of health risks, the country of origin identified the most vulnerable populations in the community. Brazilians, Salvadorans, and other Hispanic, all of whom who have been in the US varying length of time, with varying proficiency in English language had twice the odds of reporting injuries due to work compared to other immigrants. Although this observation was not significant it indicates that years in the US and English proficiency alone do not predict health risks among this population. We recommend the initiation of larger studies employing c community based participatory research methods to confirm these differences and to further explore work and health issues of immigrant populations. This study is one of the small number of research efforts to utilize a contemporaneous assessment of occupational health problems in three distinct immigrant populations at the community level within a specific Environmental Justice context and social milieu. Full article

This study aims at understanding the presence of regulated and emerging micropollutants, particularly pesticides and pharmaceuticals, in surface water, regarding spatial and temporal influences at a watershed scale. The study of relations between micropollutants and other water quality and hydroclimatic parameters was carried out from a statistical analysis on historical and experimental data of different sampling sites from the main watershed of Brittany, western France. The outcomes point out the influence of urban and rural areas of the watershed as well as the impact of seasons on contamination variations. This work contributes to health risk assessment related to surface water contamination by micropollutants. This approach is particularly interesting in the case of agricultural watersheds such as the one studied, where more than 80% of surface water is used to produce drinking water. Full article

This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants). Main health outcomes: any disability and six different types of disability: visual, hearing, learning, physical, psychiatric and speaking (binary outcomes). Sociodemographic variables: Demographic factors (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (SES: income, education, employment status, and an integrated indicator combining the SES measures through cluster analysis for the immigrant population), material factors (overcrowding, sanitation, housing quality) and migration related (country of origin and length of stay). Immigrants reported a significantly lower prevalence of any disability (3.55%), visual (1.00%) and physical disability (0.38%). Factors associated with any disability among immigrants were age, low SES or over 20 years duration of residence in Chile; while a range of sociodemographic factors were associated with disability in the Chilean-born. Conditional regression models by age group varied between populations, but SES remained significantly associated with disability across immigrants and the Chilean-born. However, there are no similar patterns of factors associated to different types of disability between the populations under study. Factors associated with disability varied between populations under study, but SES showed a consistent association with any disability in immigrants and the Chilean-born. Types of disability showed different patterns of factors associated to them between populations, which suggest the great complexity of underlying mechanisms related to disability in Chile. Full article

According to risk systems theory and the characteristics of the chemical industry, an index system was established for risk assessment of enterprises in chemical industrial parks (CIPs) based on the inherent risk of the source, effectiveness of the prevention and control mechanism, and vulnerability of the receptor. A comprehensive risk assessment method based on catastrophe theory was then proposed and used to analyze the risk levels of ten major chemical enterprises in the Songmu Island CIP, China. According to the principle of equal distribution function, the chemical enterprise risk level was divided into the following five levels: 1.0 (very safe), 0.8 (safe), 0.6 (generally recognized as safe, GRAS), 0.4 (unsafe), 0.2 (very unsafe). The results revealed five enterprises (50%) with an unsafe risk level, and another five enterprises (50%) at the generally recognized as safe risk level. This method solves the multi-objective evaluation and decision-making problem. Additionally, this method involves simple calculations and provides an effective technique for risk assessment and hierarchical risk management of enterprises in CIPs. Full article

This study examines race- and income-based disparities in cancer risks from air toxics in Cancer Alley, LA, USA. Risk estimates were obtained from the 2005 National Air Toxics Assessment and socioeconomic and race data from the 2005 American Community Survey, both at the census tract level. Disparities were assessed using spatially weighted ordinary least squares (OLS) regression and quantile regression (QR) for five major air toxics, each with cancer risk greater than 10⁻⁶. Spatial OLS results showed that disparities in cancer risks were significant: People in low-income tracts bore a cumulative risk 12% more than those in high-income tracts (p < 0.05), and those in black-dominant areas 16% more than in white-dominant areas (p < 0.01). Formaldehyde and benzene were the two largest contributors to the disparities. Contributions from emission sources to disparities varied by compound. Spatial QR analyses showed that magnitude of disparity became larger at the high end of exposure range, indicating worsened disparity in the poorest and most highly concentrated black areas. Cancer risk of air toxics not only disproportionately affects socioeconomically disadvantaged and racial minority communities, but there is a gradient effect within these groups with poorer and higher minority concentrated segments being more affected than their counterparts. Risk reduction strategies should target emission sources, risk driver chemicals, and especially the disadvantaged neighborhoods. Full article

The gravity models are commonly used spatial interaction models. They have been widely applied in a large set of domains dealing with interactions amongst spatial entities. The spread of vector-borne diseases is also related to the intensity of interaction between spatial entities, namely, the physical habitat of pathogens’ vectors and/or hosts, and urban areas, thus humans. This study implements the concept behind gravity models in the spatial spread of two vector-borne diseases, nephropathia epidemica and Lyme borreliosis, based on current knowledge on the transmission mechanism of these diseases. Two sources of information on vegetated systems were tested: the CORINE land cover map and MODIS NDVI. The size of vegetated areas near urban centers and a local indicator of occupation-related exposure were found significant predictors of disease risk. Both the land cover map and the space-borne dataset were suited yet not equivalent input sources to locate and measure vegetated areas of importance for disease spread. The overall results point at the compatibility of the gravity model concept and the spatial spread of vector-borne diseases. Full article

Irregular precipitation associated with global climate change had been causing various problems in urban regions. Besides the runoff due to rainfall in summer, the snowmelt runoff in early spring could also play an important role in deteriorating the water quality of the receiving waters. Due to global climate change, the snowfall has increased gradually in individual regions, and snowstorms occur more frequently, which leads to an enhancement of snowmelt runoff flow during the melting seasons. What is more, rivers just awaking from freezing cosntitute a frail ecosystem, with poor self-purification capacity, however, the urban snowmelt runoff could carry diverse pollutants accumulated during the winter, such as coal and/or gas combustion products, snowmelting agents, automotive exhaust and so on, which seriously threaten the receiving water quality. Nevertheless, most of the research focused on the rainfall runoff in rainy seasons, and the study on snowmelt runoff is still a neglected field in many countries and regions. In conclusion, due to the considerable water quantity and the worrisome water quality, snowmelt runoff in urban regions with large impervious surface areas should be listed among the important targets in urban nonpoint source pollution management and control. Full article

To facilitate the assessment of adverse effects of very low concentrations of air pollutants on general populations, we planned to establish a reliable biomarker that is also useful in identifying vulnerable populations. For this purpose we monitored several inflammation markers in blood samples from 2 year old Japanese children (N = 30), and found that those children living close to major highways (<50 m) show higher levels of mRNA expression IL-22 in their blood samples than those living further away (+50 m). This tendency was more pronounced among subjects showing positive IgE against egg and milk. We further examined association between IL-22 mRNA expression and PCB residues and found a number of significant positive correlations between each individual PCB congener and IL-22 expression. To identify the most vulnerable population among those children we selected asthma as a typical allergy-related disease, and could show that there are significant differences in the levels of IL-22 mRNA expression between IgE negative non-asthmatic subject and asthmatic children showing positive IgE reaction toward egg or milk, again. These observations support our main conclusion that IL-22 expression is a sensitive biomarker which is useful in identifying sub-populations of children who are especially vulnerable to air pollution. Full article

The aim of this study was to examine any differences in cardiovascular disease (CVD) risk in Portuguese children split by parental educational level. A cross-sectional school-based study was conducted in 2011 on 359 Portuguese children (202 girls and 157 boys) aged 10 to 17 years (mean age ± SD = 13.9 ± 1.98 years). Height and body mass were assessed to determine body mass index (BMI). Parental education level (PEL) was used as a surrogate for socioeconomic status (SES). Capillary blood sampling was used to determine: Total Cholesterol (TC), Triglycerides (TG), Fasting Glucos (GLUC), High and Low Density Lipoprotein (HDL/LDL). These measurements were combined with measures of systolic blood pressure and cardiorespiratory fitness as z-scores. CVD risk was constructed by summing the z-scores. Analysis of covariance, controlling for BMI, indicated that CVD risk was significantly different across PEL groups (p = 0.01), with CVD risk score being significantly lower in low (p = 0.04) and middle (p = 0.008) PEL groups, compared to high PEL. Moreover, the covariate, BMI was also significant (p = 0.0001, β = 0.023), evidencing a significant positive association between BMI and CVD risk, with higher BMI associated with greater CVD risk. In Portuguese children, significantly greater CVD risk was found for children of high PEL, while higher BMI was associated with greater CVD risk. Full article

This study provides additional evidence for the positive effect of the presence of a quiet façade at a dwelling and aims at unraveling potential mechanisms. Locations with dominant road traffic noise and high Lden-levels at the most exposed façade were selected. Dwellings both with and without a quiet façade were deliberately sought out. Face-to-face questionnaires (N = 100) were taken to study the influence of the presence of a quiet side in relation to noise annoyance and sleep disturbance. As a direct effect, the absence of a quiet façade in the dwelling (approached as a front-back façade noise level difference smaller than 10 dBA) leads to an important increase of at least moderately annoyed people (odds-ratio adjusted for noise sensitivity equals 3.3). In an indirect way, a bedroom located at the quiet side leads to an even stronger reduction of the self-reported noise annoyance (odds-ratio equal to 10.6 when adjusted for noise sensitivity and front façade Lden). The quiet side effect seems to be especially applicable for noise sensitive persons. A bedroom located at the quiet side also reduces noise-induced sleep disturbances. On a loud side, bedroom windows are more often closed, however, conflicting with the preference of dwellers. Full article

The aim of the present study was to test the association between social vulnerability and the prevalence of traumatic dental injury (TDI). A population-based cross-sectional study was carried out with 1,556 schoolchildren aged 11 to 14 years in the city of Belo Horizonte, Brazil. The participants were examined for TDI using Andreasen’s criteria and those diagnosed with TDI were interviewed to determine the history of the injury. The Social Vulnerability Index (SVI) was used for socioeconomic classification, which addresses environmental, cultural, economic, legal and security/survival dimensions. The Poisson regression model was used for the multivariate analysis, with the significance level set at 5%. The prevalence of TDI was 14.1%; 59.3% of the participants with TDI did not seek a dentist after the incident. Poorer environmental, economic and legal conditions were statistically associated with the occurrence of untreated TDI (p < 0.05) and all the five SVI dimensions were associated with seeking a dentist due to TDI (p < 0.006). The prevalence of untreated TDI was higher among boys (PR: 1.42; 95%CI: 1.11–1.81) and those in situations of greater social vulnerability (PR: 2.27; 95%CI: 1.11–4.61). In conclusion, the male gender and high social vulnerability proved to be associated with the occurrence of TDI. Full article

Researchers have increasingly focused on how social determinants of health (SDH) influence health outcomes and disparities. They have also explored strategies for raising public awareness and mobilizing support for policies to address SDH, with particular attention to narrative and image-based information. These efforts will need to overcome low public awareness and concern about SDH; few organized campaigns; and limited descriptions of existing message content. To begin addressing these challenges, we analyzed characteristics of 58 narratives and 135 visual images disseminated by two national SDH awareness initiatives: The Robert Wood Johnson Foundation’s Commission to Build a Healthier America and the PBS-produced documentary film Unnatural Causes. Certain types of SDH, including income/wealth and one’s home and workplace environment, were emphasized more heavily than others. Solutions for addressing SDH often involved combinations of self-driven motivation (such as changes in personal health behaviors) along with externally-driven factors such as government policy related to urban revitilization. Images, especially graphs and charts, drew connections among SDH, health outcomes, and other variables, such as the relationship between mother’s education and infant mortality as well as the link between heart disease and education levels within communities. We discuss implications of these findings for raising awareness of SDH and health disparities in the US through narrative and visual means. Full article