International Journal of Environmental Research and Public Health — Open Access Journal

: The Cold Weather Plan (CWP) in England was introduced to prevent the adverse health effects of cold weather; however, its impact is currently unknown. This study characterizes cold-related mortality and fuel poverty at STP (Sustainability and Transformation Partnership) level, and assesses changes in cold risk since the introduction of the CWP. Time series regression was used to estimate mortality risk for up to 28 days following exposure. Area level fuel poverty was used to indicate mitigation against cold exposure and mapped alongside area level risk. We found STP variations in mortality risk, ranging from 1.74, 1.44–2.09 (relative risk (RR), 95% CI) in Somerset, to 1.19, 1.01–1.40 in Cambridge and Peterborough.Following the introduction of the CWP, national-level mortality risk declined significantly in those aged 0–64 (1.34, 1.23–1.45, to 1.09, 1.00–1.19), but increased significantly among those aged 75+ (1.36, 1.28–1.44, to 1.58, 1.47–1.70) and for respiratory conditions (1.78, 1.56–2.02, to 2.4, 2.10–2.79). We show how spatial variation in cold mortality risk has increased since the introduction of the CWP, which may reflect differences in implementation of the plan. Combining risk with fuel poverty information identifies 14 STPs with the greatest need to address the cold effect, and that would gain most from enhanced CWP activity or additional intervention measures. Full article

An aquatic surface microlayer covers more than 70% of the world’s surface. Our knowledge about the biology of the surface microlayer of Lake Baikal, the most ancient lake on Earth with a surface area of 31,500 km², is still scarce. The total bacterial abundance, the number of cultured heterotrophic temporal bacteria, and the spatial distribution of bacteria in the surface microlayer and underlying waters of Lake Baikal were studied. For the first time, the chemical composition of the surface microlayer of Lake Baikal was determined. There were significant differences and a direct relationship between the total bacterial abundance in the surface microlayer and underlying waters of Lake Baikal, as well as between the number of cultured heterotrophic bacteria in studied water layers in the period of summer stratification. In the surface microlayer, the share of cultured heterotrophic bacteria was higher than in the underlying waters. The surface microlayer was characterized by enrichment with PO₄³⁻, total organic carbon and suspended particulate matter compared to underlying waters. A direct relationship was found between the number of bacteria in the surface microlayer and environmental factors, including temperature, total organic carbon and suspended particulate matter concentration. Full article

Objective: We examine obese and non-obese patients with respect to Helicobacter pylori (H. pylori) positive-infection (HPPI) and associated factors, specifically body mass index (BMI). Methods: This study took place in the Department of Endoscopy of a central hospital in the Najran region of Saudi Arabia (SA). A total of 340 obese Saudi patients (BMI ≥ 30 kg/m²) who had undergone diagnostic upper endoscopy before sleeve gastrectomy, were compared with 340 age and gender-matched control patients (BMI < 30 kg/m²) who had undergone diagnostic upper endoscopy for other reasons. Data collected included diagnosis of HPPI. Descriptive and multivariable binary logistic regression was conducted. Results: Mean patient age was 31.22 ± 8.10 years, and 65% were males. The total prevalence of HPPI was 58% (95% CI = 54–61%) with obese patients presenting significantly more HPPI than non-obese patients (66% vs. 50%, OR = 1.98, 95% CI = 1.45–2.70, p < 0.0005). Age and gender did not associate significantly with HPPI (p = 0.659, 0.200, respectively) and increases in BMI associated significantly with increases in HPPI (p < 0.0005). BMI remained a significant factor in HPPI when modelled with both age and gender (OR = 1.022, 95% CI = 1.01–1.03, p < 0.0005). Conclusions: Within the limitations of this study, the significance of HPPI in obese Saudi patients residing in the Najran region in SA was demonstrated alongside the significance role of BMI in HPPI. Full article

Achieving high efficiency of biological waste treatment in mechanical–biological treatment (MBT) plants requires reliable methods for measuring the degree of biodegradation of organic substances. For this purpose, several physical, chemical, and biological indices are used. This paper presents respirometric activity (AT4), biogas potential (GB21), total and dissolved organic carbon (TOC and DOC, respectively), and loss on ignition (LOI) values, as well as the correlations between the indices selected for stabilized waste produced in 18 MBT plants in Poland, which use various technologies for biological processing of the organic fraction of municipal solid waste. The study confirms that there is a linear relationship between AT4 and GB21 for stabilized waste produced in MBT plants, regardless of the waste treatment technology used. It has also been found that there is a linear relationship between AT4 and the concentration of dissolved carbon in water extract from stabilized waste. This indicates that DOC can be used for monitoring the organic matter stabilization process in mechanical–biological waste treatment plants. Its advantage is a shorter time needed for measurements in comparison to AT4 and GB21 tests. Full article

Inappropriate grazing management is one of the most common causes of grassland degradation, and thus, an assessment of soil properties under different grazing intensities is critical for understanding its effects on ecosystem nutrient cycling and for formulating appropriate management strategies. However, the responses of certain main elements, including soil carbon, nitrogen, and phosphorus, to grazing in alpine meadow ecosystems remain insufficiently clarified. Here, we measured carbon, nitrogen, and phosphorus contents in the topmost 30 cm of soil in an alpine meadow under three grazing intensities (light, moderate, and heavy) and found clear differences in soil physical and chemical properties among different grazing intensities and soil layers. As grazing intensity increased, soil water content, carbon and nitrogen contents and stocks, and carbon to phosphorus and nitrogen to phosphorus ratios decreased, whereas soil bulk density increased. However, soil phosphorus and carbon to nitrogen ratio remained stable. Our findings highlight the negative impacts of heavy grazing intensity, in terms of soil carbon and nitrogen loss and phosphorus mineralization. Moreover, we emphasize that further related studies are necessary to gain a more comprehensive understanding of the effects of grazing on grassland ecosystems, and thereby provide information for sustainable management practices and eco-compensation policies. Full article

This study analyzed the finger temperatures of poultry slaughterhouse workers and its association with personal and organizational variables, bodily discomfort perception, and cold thermal sensation. The study included 143 poultry slaughterhouse workers. A thermograph was used to measure finger temperature and an interview to collect worker data. There were two groups: workers who used a tool and those without. The binary logistic regression, Friedman and Wilcoxon tests were used (p ≤ 0.05). Most workers presented at least one finger with an average temperature ≤15 °C (66.4%) and ≤24 °C (99.3%), perceived their cold hands, and wore three overlapping gloves (57.3%). There were no associations between finger temperatures (≤15 °C) and the analyzed variables. The chance of feeling cold for a worker who used a tool was greater than for a worker who did not (OR = 3.19, 95% CI 1.46; 6.94). There was a difference between the finger temperatures of each hand on both surfaces and the analyzed groups (p < 0.01). The temperature of each finger with its respective contralateral was different in the little fingers (no tool), index, middle, ring, and little fingers (using a tool) (p < 0.05). The use of several overlapping gloves was not sufficient to promote thermal insulation of the hands. Full article

Water resources are fundamental for the social and economic development of a country and sustainability is the best approach to treat water-related problems. Therefore, sustainability studies of water resources are deemed urgent. Sustainability analysis methods should enable space-temporal monitoring, decision-making, and development of policies necessary for water governance. Furthermore, sustainability analysis methods should also integrate environment and socioeconomic variables into a single system. In this context, this study aimed to assess the water sustainability conditions of the River Grande Basin (BHRG), Brazil, before the implementation of the Integrated Water Resources Plan (IWRP), using the Barometer of Sustainability tool (BS). The River Grande basin was in an “almost unsustainable” condition and under high environmental stress. A significant imbalance between environmental and human well-being in the system was also observed. To achieve an acceptable sustainability condition, it is thus necessary to improve the environmental quality of the area. Among the priority thematic area, native vegetation recovery was the most urgent. Overall, the sustainability study based on the BS not only facilitates comprehension regarding environment and human interrelationships, but also provide references for policy formulations and water management. Full article

Previous research has found churches to be effective at delivering physical activity (PA) programs to their congregants. Mosques, however, have not been extensively studied. Therefore, we quantified U.S. Islamic centers’ advertisement of PA programming and examined their programming characteristics. We conducted a content analysis of the websites of 773 eligible Islamic centers of which 206 centers in 32 states advertised PA programming. We categorized PA by program type: camping, fitness classes, sports, youth programs, and irregular offerings. We calculated descriptive statistics by program type for specific activity, frequency/duration/volume, participant/instructor sex, and instructor religion. Youth group (44%) and sports (23%) programs were most and least frequently advertised, respectively. Most centers (66%) that posted information on PA programming advertised only one program type. Men and Muslims taught most activities. Most activities—except for fitness classes—were advertised to a male audience. Islamic centers should offer and advertise additional PA programming—especially for women—and better utilize their websites for promoting such programming. Individual Islamic centers and Islamic- and non-religion based public health agencies can utilize our findings to fashion future PA offerings. Full article

The role of carbon pool of biochar as a method of long-term C sequestration in global warming mitigation is unclear. A two-year field study was conducted to investigate the seasonal variations of CO₂ emissions from water-saving irrigation paddy fields in response to biochar amendment and irrigation patterns. Three biochar treatments under water-saving irrigation and one biochar treatment under flooding irrigation were studied, and the application rates were 0, 20, 40, and 40 t ha⁻¹ and labeled as CI + NB (controlled irrigation and none biochar added), CI + MB (controlled irrigation and medium biochar added), CI + HB (controlled irrigation and high biochar added), and FI + HB (flood irrigation and high biochar added), respectively. Results showed that biochar application at medium rates (20 t ha⁻¹) decreased CO₂ emissions by 1.64–8.83% in rice paddy fields under water-saving irrigation, compared with the non-amendment treatment. However, the CO₂ emissions from paddy fields increased by 4.39–5.43% in the CI + HB treatment, compared with CI + NB. Furthermore, the mean CO₂ emissions from paddy fields under water-saving irrigation decreased by 2.22% compared with flood irrigation under the same amount of biochar application (40 t ha⁻¹). Biochar amendment increased rice yield and water use efficiency by 9.35–36.30% and 15.1–42.5%, respectively, when combined with water-saving irrigation. The CO₂ emissions were reduced in the CI + MB treatment, which then increased rice yield. The CO₂ emissions from paddy fields were positively correlated with temperature. The highest value of the temperature sensitivity coefficient (Q₁₀) was derived for the CI + MB treatment. The Q₁₀ was higher under water-saving irrigation compared with flooding irrigation. Full article

As the main material in indoor furniture, southern yellow pine (Pinus spp.) releases volatile organic compounds (VOCs) into the environment during use. To better understand variations in the contents of VOCs in southern yellow pine before and after heat treatment, this study conducts dry heat treatment on southern yellow pine at 140 °C and 220 °C. Headspace solid phase micro-extraction was used to extract VOCs from southern yellow pine. The VOCs of southern yellow pine before and after heat treatment were identified via gas chromatography-mass spectrometry, and chemical component differences were characterized via Fourier transform infrared spectroscopy. Results reveal 86 VOCs in pure southern yellow pine, including alcohols, aromatics, acids, aldehydes, alkanes, alkenes, and some trace compounds (e.g., furans, ketones, phenols, and esters). With an increase in heat-treatment temperature, the contents of alkanes increased, whereas those of alcohols and alkenes decreased. The contents of aromatics, acids, and aldehydes were highest when heat treated at 140 °C. At 220 °C, the total contents of key VOCs in southern yellow pine were lowest. Full article

Worldwide, development agencies have increased their investments in water supply and sanitation as a “powerful preventive medicine” to address infectious diseases. These interventions have focused on on-site technical interventions or social engineering approaches, emulating the result-based targets of the development goals. Against this backdrop, the study examines the following research question: What is the role of socio-cultural backgrounds, housing characteristics, and environmental hygiene practices in addressing water-transmitted diseases in the Tashkent province of Uzbekistan. In a country where public statistics and official maps are rarely accessible, and research is restrictive, the study carried out a household survey using open data kit (ODK) between July and October 2015 in Olmalik, an industrial district, and the Kibray urbanizing district in the province. The findings reveal that demographic factors, poor sanitation practices, housing characteristics, and social behaviors are key predictors of water-transmitted diseases in the two districts. In the industrial township, poor housing, larger household size, and poor excreta disposal habits increased the occurrence of diseases, while in urbanizing districts, higher household size, frequently eating out, and access to public taps significantly increased the occurrence of water-transmitted diseases. The study, which was carried out in a challenging institutional environment, highlights the need for Uzbekistan to focus their policies on environmental hygiene, demographic factors and social behavior as key interventions rather than merely on on-site drinking water and sanitation interventions. Full article

Although school climate and self-efficacy have received some attention in the literature, as correlates of students’ willingness to intervene in bullying, to date, very little is known about the potential mediating role of self-efficacy in the relationship between classroom climate and students’ willingness to intervene in bullying. To this end, the present study analyzes whether the relationship between classroom cohesion (as one facet of classroom climate) and students’ willingness to intervene in bullying situations is mediated by self-efficacy in social conflicts. This study is based on a representative stratified random sample of two thousand and seventy-one students (51.3% male), between the ages of twelve and seventeen, from twenty-four schools in Germany. Results showed that between 43% and 48% of students reported that they would not intervene in bullying. A mediation test using the structural equation modeling framework revealed that classroom cohesion and self-efficacy in social conflicts were directly associated with students’ willingness to intervene in bullying situations. Furthermore, classroom cohesion was indirectly associated with higher levels of students’ willingness to intervene in bullying situations, due to self-efficacy in social conflicts. We thus conclude that: (1) It is crucial to increase students’ willingness to intervene in bullying; (2) efforts to increase students’ willingness to intervene in bullying should promote students’ confidence in dealing with social conflicts and interpersonal relationships; and (3) self-efficacy plays an important role in understanding the relationship between classroom cohesion and students’ willingness to intervene in bullying. Recommendations are provided to help increase adolescents’ willingness to intervene in bullying and for future research. Full article

Elevated stress levels in emotional laborers has been documented in a number of studies. To minimize the negative effects of stress, the need to examine potential protective factors has been highlighted. The primary purpose of this study was to investigate the differential moderating effect of ego-resiliency on the relationship between emotional labor and salivary cortisol level by comparing two groups of bank clerks deemed to experience different degree of emotional labor. Twenty-four bank clerks working in regional branch offices who provided face-to-face customer service (customer service group) and 33 administrative-duty bank clerks who work without face-to-face customer service (administrative work group) were recruited to participate in the study. Participants were asked to draw saliva into a specimen tube at an identical time during a work day and complete self-report scales measuring emotional labor and ego-resiliency. Hierarchical multiple regression analyses were conducted to examine the interaction effect of ego-resiliency on the relationship between emotional labor and salivary cortisol level by controlling for gender, age and education level as covariates. The results demonstrated that the degree of emotional labor reported by the customer service group was higher than that of the administrative work group. Furthermore, ego-resiliency moderated the relationship between emotional labor and cortisol levels in the customer service group but not in the administrative work group. The implications and limitations of this study are discussed along with suggestions for future research. Full article

The purpose of this study was to investigate the relationship between occupational dysfunction and metabolic syndrome (MetS) and its component factors in community-dwelling Japanese adults (N = 1,514). Self-reported lifestyle behaviors, Classification and Assessment of Occupational Dysfunction (CAOD) scores, and metabolic traits were measured. CAOD levels were divided into tertiles (low, moderate, and high), and their associations with MetS and its components were evaluated through logistic regression analysis. The association of MetS with CAOD was demonstrated in the total number of individuals [OR = 1.92 (95% CI 1.17–3.17)] and in older individuals [OR = 1.90 (95% CI 1.04–3.46)]. The association of dyslipidemia and CAOD was evident for overweight individuals [OR = 2.08 (95% CI 1.17–3.68)]. A higher association of high blood pressure with CAOD was evidenced in younger individuals [OR = 2.02 (95% CI 1.05–3.89)] who belonged to the highest-CAOD-score group in comparison to those who registered the lowest-CAOD-score group. The evaluation of MetS and interventions related to its prevention may be more effective if the viewpoint of occupational dysfunction is taken into account. Full article

Introduction: Perfluoro-octanesulfonate (PFOS) and perfluoro-octanoic acid (PFOA) are two toxic perfluorochemicals (PFCs) commonly used as surfactants. PFCs are difficult to be eliminated from the body. We investigated the influence of different dialysis membranes on the concentrations of PFCs in patients under hemodialysis. Method: We enrolled 98 patients. Of these, 58 patients used hydrophobic polysulfone (PS) dialysis membranes, and the other 40 had hydrophilic membranes made by poly-methyl methacrylate (PMMA) or cellulose triacetate (CTA). Liquid chromatography tandem mass spectrometry coupled was used with isotope dilution to quantify PFOA and PFOS. Results: The predialysis concentrations of PFOA and PFOS in patients with hydrophobic PS dialysis membranes were 0.50 and 15.77 ng/mL, respectively, lower than the concentrations of 0.81 and 22.70 ng/mL, respectively, in those who used hydrophilic membranes (such as CTA or PMMA). Older patients have higher PFOS and poorer body function, with lower Karnofsky Performance Status Scale (KPSS) scores. The demographic data of the two groups were similar. However, patients with hydrophobic PS dialysis membranes had lower predialysis aspartate transaminase (AST) (p = 0.036), lower glucose levels (p = 0.017), and better body function (nonsignificantly higher KPSS scores, p = 0.091) compared with patients who used other membranes. These differences may be associated with the effects of different membranes, because PFOA positively correlated with AST, while PFOS negatively correlated with body function. Conclusions: This is the first study comparing PFC levels in uremic patients with different dialysis membrane. PS membrane may provide better clearance of PFCs and may, therefore, be beneficial for patients. Full article

The number of onshore wind turbines in Europe has greatly increased over recent years, a trend which can be expected to continue. However, the effects of wind turbine noise on long-term health outcomes for residents living near wind farms is largely unknown, although sleep disturbance may be a cause for particular concern. Presented here are two pilot studies with the aim of examining the acoustical properties of wind turbine noise that might be of special relevance regarding effects on sleep. In both pilots, six participants spent five consecutive nights in a sound environment laboratory. During three of the nights, participants were exposed to wind turbine noise with variations in sound pressure level, amplitude modulation strength and frequency, spectral content, turbine rotational frequency and beating behaviour. The impact of noise on sleep was measured using polysomnography and questionnaires. During nights with wind turbine noise there was more frequent awakening, less deep sleep, less continuous N2 sleep and increased subjective disturbance compared to control nights. The findings indicated that amplitude modulation strength, spectral frequency and the presence of strong beats might be of particular importance for adverse sleep effects. The findings will be used in the development of experimental exposures for use in future, larger studies. Full article

Background: Intensive post-operative physiotherapy after cardiac surgery helps to reduce the number of complications, accelerating convalescence and decreasing peri-operative mortality. Cardiac rehabilitation is aimed at regaining lost function and sustaining the effect of cardiac surgery. The aim of this study was to compare the efficacy of inpatient and home-based phase II physiotherapy following coronary artery bypass grafting, and inpatient phase II post-operative physiotherapy based on the analysis of the spirometry results. Methods: A prospective observational study included 104 adult patients of both sexes undergoing planned coronary artery bypass grafting and were randomized to one of the two groups—inpatients (InPhysio) and home-based (HomePhysio) at a 1:1 ratio. All patients had undergone spirometry testing prior to surgery (S1) and on the fifth day after the operation (S2), i.e., on the day of completion of the first phase (PI) of physiotherapy. Both the study group (InPhysio) and the control group (HomePhysio) performed the same set of exercises in the second phase (PII) of cardiac physiotherapy, either in the hospital or at home, respectively, according to the program obtained in the hospital. Both groups have undergone spirometry testing (S3) at 30 days after the operation. Results: The demographic and peri-operative data for both groups were comparable and showed no statistically significant differences. An analysis of gradients between the results of spirometry tests before surgery and at 30 days after the surgery showed a smaller decrease in forced vital capacity (FVC) in the study group than in the control group (p < 0.001). The results at five and 30 days after the surgery showed a greater increase in FVC in the study group than in the control group (680 mL vs. 450 mL, p = 0.009). There were no statistically significant differences in other parameters studied. Conclusions: The advantage of inpatient over home-based physiotherapy was evidenced by much smaller decreases in FVC between the initial and final tests, and greater increases between the fifth day after surgery and the final test. Our analysis showed greater efficacy of inpatient physiotherapy as compared with home-based exercises and raises concerns about patient adherence. Full article

Hypertension and prehypertension are risk factors for cardiovascular diseases. However, the associations of both prehypertension and hypertension with anthropometry, blood parameters, and spirometry have not been investigated. The purpose of this study was to identify the risk factors for prehypertension and hypertension in middle-aged Korean adults and to study prediction models of prehypertension and hypertension combined with anthropometry, blood parameters, and spirometry. Binary logistic regression analysis was performed to assess the statistical significance of prehypertension and hypertension, and prediction models were developed using logistic regression, naïve Bayes, and decision trees. Among all risk factors for prehypertension, body mass index (BMI) was identified as the best indicator in both men [odds ratio (OR) = 1.429, 95% confidence interval (CI) = 1.304–1.462)] and women (OR = 1.428, 95% CI = 1.204–1.453). In contrast, among all risk factors for hypertension, BMI (OR = 1.993, 95% CI = 1.818–2.186) was found to be the best indicator in men, whereas the waist-to-height ratio (OR = 2.071, 95% CI = 1.884–2.276) was the best indicator in women. In the prehypertension prediction model, men exhibited an area under the receiver operating characteristic curve (AUC) of 0.635, and women exhibited a predictive power with an AUC of 0.777. In the hypertension prediction model, men exhibited an AUC of 0.700, and women exhibited an AUC of 0.845. This study proposes various risk factors for prehypertension and hypertension, and our findings can be used as a large-scale screening tool for controlling and managing hypertension. Full article

More and more countries employ the Carbon Cap and Trade mechanism (CCT-mechanism) to stimulate the manufacturer to produce much more eco-friendly products. In this paper, we study how the CCT-mechanism affects competitive manufacturers’ product design and pricing strategies. Assume that there are two competitive manufacturers; we give the optimal closed form solutions of the carbon emission reduction rates and retail prices in the Nash game model and the Stackelberg game model with CCT-mechanism, respectively. Additionally, we also discuss the impacts of CCT-mechanism, consumer environmental awareness (CEA), and the sensitivity of switchovers toward price on the optimal carbon emission reduction rates, retail prices, and manufacturers’ profits. We find that (i) when the carbon quota is not enough, there is a trade off between investing in producing much greener product and purchasing carbon quota; when the carbon price is not high, the manufacturer tends to purchase the carbon quota; and when the carbon price is much higher, the manufacturer is more willing to increase the environmental quality of the product; (ii) manufacturer’s size affects product’s emission reduction rate and manufacturer’s optimal profit; larger manufacturer tends to produce much greener product, but it does not mean that he could obtain much more money than the small manufacturer; and (iii) the decision sequence changes manufacturer’s strategies; the optimal emission reduction rate in Nash and Stackelberg game models are almost the same, but the differences of prices and profits between Nash and Stackelberg model’s are much bigger. Full article