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

A river water quality spatial profile has a diverse pattern of variation over different climatic regions. To comprehend this phenomenon, our study evaluated the spatial scale variation of the Water Quality Index (WQI). The study was carried out over four main climatic classes in Asia based on the Koppen-Geiger climate classification system: tropical, temperate, cold, and arid. The one-dimensional surface water quality model, QUAL2Kw was selected and compared for water quality simulations. Calibration and validation were separately performed for the model predictions over different climate classes. The accuracy of the water quality model was assessed using different statistical analyses. The spatial profile of WQI was calculated using model predictions based on dissolved oxygen (DO), biological oxygen demand (BOD), nitrate (NO3), and pH. The results showed that there is a smaller longitudinal variation of WQI in the cold climatic regions than other regions, which does not change the status of WQI. Streams from arid, temperate, and tropical climatic regions show a decreasing trend of DO with respect to the longitudinal profiles of main river flows. Since this study found that each climate zone has the different impact on DO dynamics such as reaeration rate, reoxygenation, and oxygen solubility. The outcomes obtained in this study are expected to provide the impetus for developing a strategy for the viable improvement of the water environment. Full article

Given its wide involvement in and recognition by international organizations, China has signed many international agreements and negotiations. This study verified how and the extent to which changes in exogenous factors (e.g., international agreements and negotiations) affect Chinese governmental air protection policy development. Previous studies on policy network theory have demonstrated that exogenous factors affected the development of domestic policies significantly, while in this study little evidence was found to demonstrate the influence of exogenous factors on changes in Chinese policy. Rather, internal factors have played an important role in both its development and transformation. These findings differ from study results on wealthy countries and other developing districts. This study then explores the causes of substandard policy outcomes. To probe this further, policy network theory is applied to explain the gap between the guiding principle of central government’s policies and local implementation in actual practice. By analyzing the strategies of policy actors and specific rules in current Chinese context, the associated limitations and obstacles in the process of policy‐making and implementation can be explained from the aspect of bureaucratic system, energy market running mechanism and others. This paper recommends alterations in the current policy and structure based on these findings. Full article

Alterations of gut microbiota, intestinal barrier and the gut-brain axis may be involved in pathophysiology of functional gastrointestinal disorders. Our aim was to assess the prevalence of digestive tract symptoms and identify common variables potentially disrupting the gut-brain axis among participants of the Woodstock Festival Poland, 2017. In total 428 people filled in a questionnaire assessing health of their digestive tract. The investigator collected answers on an electronic device, while the study participant responded using a paper version of the same questionnaire. Liver and gallbladder related symptoms were the most prevalent among our study group (n = 266, 62%), however symptoms related to altered intestinal permeability were found to be the most intensive complaints. In females the intensity of gastrointestinal complaints was higher compared to men (p < 0.05), as well as the incidence of factors with the potential to alter gut-brain axis (p < 0.0001). Chronic psychological distress, intake of non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics, were the most common associations with gastrointestinal symptoms, which were the most prevalent in females. Further attention should be focused on stress as one of the main factors negatively influencing public health. Full article

Endothall dipotassium salt and monoamine salt are herbicide formulations used for controlling submerged aquatic macrophytes and algae in aquatic ecosystems. Microbial activity is the primary degradation pathway for endothall. To better understand what influences endothall degradation, we conducted a mesocosm experiment to (1) evaluate the effects of different water and sediment sources on degradation, and (2) determine if degradation was faster in the presence of a microbial community previously exposed to endothall. Endothall residues were determined with LC-MS at intervals to 21 days after endothall application. Two endothall isomers were detected. Isomer-1 was abundant in both endothall formulations, while isomer-2 was only abundant in the monoamine endothall formulation and was more persistent. Degradation did not occur in the absence of sediment. In the presence of sediment, degradation of isomer-1 began after a lag phase of 5–11 days and was almost complete by 14 days. Onset of degradation occurred 2–4 days sooner when the microbial population was previously exposed to endothall. We provide direct evidence that the presence and characteristics of sediment are of key importance in the degradation of endothall in an aquatic environment, and that monoamine endothall has two separate isomers that have different degradation characteristics. Full article

With the recent fast economy development and rapid urbanization, the huge generation of construction waste has become a threat to sustainable development in China. Though efforts have been made to promote reuse and recycling of construction waste, landfilling of waste remains the most commonly adapted approach for construction waste disposal. As the space for landfills is limited and because of the negative issues in terms of environmental and social aspects that may be caused, the appropriate site selection of landfills is crucial. With this background, this paper aims to establish a framework for facilitating landfill selection for construction waste. To begin with, a total of sixteen factors that may influence landfill site selection were identified from a literature review. Then, based on the combined analytic hierarchy process (AHP) and entropy method, the weights and the final comprehensive scores of the identified factors were calculated. According to the derived results, potential sites for landfills were divided into three levels, namely the most appropriate (0.38%), appropriate (17.58%), and inappropriate (82.04%). The proposed decision-making methods in this paper can provide a valuable reference for the selection of construction waste landfill sites. Full article

Health has many dimensions, and intolerance and lack of compassion may contribute to the poor health and disparities in our nation. Tolerance can convey an inherent paradox or dissonance that can be associated with stress. However, tolerance has a dimension of acceptance, an acknowledgement and acceptance of what “is” at the present moment, that can relieve tension associated with differing beliefs and practices. Compassionate consideration of others can be combined with acceptance to create harmony within and across individuals. In this article, we explore how contemplative practices can cultivate tolerance and compassion and contribute to improvements in individual and population health. Full article

In the present work, the results are presented for the characterization of work risk prevention in the Guatemalan construction industry. This characterization has been carried out using a simple random sampling technique, employing a questionnaire that was structured into 3 groups of variables: 1. General company data; 2. Prevention and management activities regarding health and safety in the company and on the worksite; and 3. Health and safety in the contractor companies. Following the sampling phase, the data were introduced in a database format, and a preliminary analysis was performed on the studied variables, followed by a descriptive analysis and a multiple correspondence analysis. The main findings of the study emphasize that companies in the Guatemalan construction sector are characterized as dedicating most of their activity (52.0%) indistinctly between civil engineering work, building construction and other specialized construction, mainly working as contractors (47.5%). These are “medium-sized” companies, employing an average of 81.1 on-site workers, having an average of 6.8 on-site work crews, and grossing an average turnover of 1.29 million euros annually. Likewise, it found that the larger construction companies adopt better prevention and management measures for worksite health and safety the larger companies are correlated with a high awareness of experiencing worksite accidents, while medium-sized companies have medium-level awareness. Companies with fewer workers manage workplace risk prevention worse, with low accident risk awareness. This correlation between these indicative variables of company size and workplace risk management and prevention is clearly reflected in the four company “clusters” that have been identified as having homogenous characteristics using the multiple correspondence analysis technique. Companies in the Guatemalan construction sector should make a greater effort to improve manager and worker training regarding workplace risk prevention to increase the effectiveness of company prevention management. Full article

Long-term exposure to high radon concentration exerts pathological effects and elicits changes in respiratory function, increasing an individual’s risk of developing lung cancer. In health risk assessment of indoor radon, consideration of long-term exposure thereto is necessary to identify a relationship between indoor radon exposure and lung cancer. However, measuring long-term indoor radon concentration can be difficult, and a statistical model for predicting mean annual indoor radon concentrations may be readily applicable. We investigated the predictability of mean annual radon concentrations using national data on indoor radon concentrations throughout the spring, summer, fall, and winter seasons in Korea. Indoor radon concentrations in Korea were highest in the winter and lowest in the summer. We derived seasonal correction and seasonal adjustment factors for each season based on the method proposed by previous study. However, these factors may not be readily applicable unless measured in a specific season. In this paper, we separate seasonal correction factors for each month of the year (new correction factors) based on correlations between indoor radon and meteorological factors according to housing type. To evaluate the correction factors, we assessed differences between estimated and measured mean annual radon concentrations. Roughly 97% of the estimated values were within ±40 Bq/m³ of actual measured values in detached houses, and roughly 85–87% of the estimated values were within ±40 Bq/m³ of the measured values in other residences. In most cases, the seasonal correction factors and the new correction factors had slightly better agreement than the seasonal adjustment factor. For predicting mean annual radon concentrations, the seasonal correction factors or seasonal adjustment factors can be of use when actual measurements of indoor radon concentrations for a specific season are available. Otherwise, the new correction factors may be more readily applicable. Full article

High accident rates have been a complicated and persistent problem in the Hong Kong construction industry. This situation has stimulated this investigation into factors that influence the risk-taking propensity of construction workers. However, interviewing workers who had a bad experience is problematic because changes in attitude and perception may occur as a result of such an experience. Using quasi-expert interviews can reduce this problem. The objective of this study was to identify factors that influence the risk-taking propensity of construction workers. Semi-structured interviews were conducted with 16 safety professionals all with accident inspection experience and six super-safe workers with no incident record for the past five years. Seven factors that affect the risk-taking propensity of construction workers were successfully identified. Each factor is thoughtfully discussed, and this study shows that quasi-expert interview is a pragmatic approach for deepening the understanding of risk-taking propensity among construction workers. Findings of this study will hopefully help and encourage further quantitative research on the risk-taking propensity of construction workers with different perspectives. Full article

Background: To determine the effects of social capital on harmful drinking (HD) among Chinese community residents using a multilevel study. Methods: A cross-sectional study conducted from 2017–2018. In total, 13,610 participants were randomly interviewed from 29 districts of 3 cities in China with a multi-stage sampling procedure. Social capital, including social cohesion, membership in social organizations, and frequency of social participation, were assessed using validated scales. HD was assessed using the CAGE four-item questionnaire. Multilevel models were developed to determine whether social capital was related to HD when socioeconomic and demographic covariates were controlled. Results: In general, the prevalence of HD was 8.18%, and more specifically, 13.77% for men and 2.74% for women. After controlling for covariates and stratifying by gender, compared to residents in the low individual-level membership of social organizations, we found that the odds ratio (OR) for HD was 1.30 with a 95% confidence interval (CI) of 1.07–1.56 among men and 1.95 (95% CI: 1.29–2.97) among women. Compared to residents in the low individual-level frequency of social participation groups, the odds ratio of HD among women was 1.58 (95% CI: 1.10–2.26). There was no association between district-level social capital and HD. Conclusions: A high level of social capital may promote HD among the residents of Chinese neighborhoods. Intervention to modify social capital under the Chinese drinking culture may help reduce HD. Full article

Although there is an increasing awareness of the suitability of using compositional data methodology in public health research, classical methods of statistical analysis have been primarily used so far. The present study aims to illustrate the potential of robust statistics to model movement behaviour using Czech adolescent data. We investigated: (1) the inter-relationship between various physical activity (PA) intensities, extended to model relationships by age; and (2) the associations between adolescents’ PA and sedentary behavior (SB) structure and obesity. These research questions were addressed using three different types of compositional regression analysis—compositional covariates, compositional response, and regression between compositional parts. Robust counterparts of classical regression methods were used to lessen the influence of possible outliers. We outlined the differences in both classical and robust methods of compositional data analysis. There was a pattern in Czech adolescents’ movement/non-movement behavior—extensive SB was related to higher amounts of light-intensity PA, and vigorous PA ratios formed the main source of potential aberrant observations; aging is associated with more SB and vigorous PA at the expense of light-intensity PA and moderate-intensity PA. The robust counterparts indicated that they might provide more stable estimates in the presence of outlying observations. The findings suggested that replacing time spent in SB with vigorous PA may be a powerful tool against adolescents’ obesity. Full article

Outside of western countries, the study of the local food environment and evidence for its association with dietary behavior is limited. The aim of this paper was to examine the association between the local retail food environment and consumption of fruit and vegetables (FV) among adults in Hong Kong. Local retail food environment was measured by density of different types of retail food outlets (grocery stores, convenience stores, and fast food restaurants) within a 1000 m Euclidean buffer around individual’s homes using a geographic information system (GIS). The Retail Food Environment Index (RFEI) was calculated based on the relative density of fast-food restaurants and convenience stores to grocery stores. Logistic regressions were performed to examine associations using cross-sectional data of 1977 adults (18 years or older). Overall, people living in an area with the highest RFEI (Q4, >5.76) had significantly greater odds of infrequent FV consumption (<7 days/week) after covariates adjustment (infrequent fruit consumption: OR = 1.36, 95% CI 1.04–1.78; infrequent vegetable consumption: OR = 1.72, 95% CI 1.11–2.68) in comparison to the lowest RFEI (Q1, <2.25). Highest density of fast food restaurants (Q4, >53) was also significantly associated with greater odds of infrequent fruit consumption (<7 days/week) (unadjusted model: OR = 1.34, 95% CI 1.04–1.73), relative to lowest density of fast food restaurants (Q1, <13). No significant association of density of grocery stores or convenience stores was observed with infrequent FV consumption regardless of the covariates included in the model. Our results suggest that the ratio of fast-food restaurants and convenience stores to grocery stores near people’s home is an important environmental factor in meeting fruit and vegetable consumption guidelines. “Food swamps” (areas with an abundance of unhealthy foods) rather than “food deserts” (areas where there is limited access to healthy foods) seems to be more of a problem in Hong Kong’s urban areas. We advanced international literature by providing evidence in a non-western setting. Full article

Food safety management in short supply chains of fruit and vegetables, controlled by large retailers, has been widely studied in the literature. However, when it comes to traditional long supply chains, which include a greater number of intermediaries and wholesalers who, in some cases, play a dual role as resellers and producers, the mechanisms which promote the use of safety certifications have yet to be clearly defined. The present study intended to fill this gap in the literature and shed light on the food safety level that exists in this channel. In addition, this work attempted to identify the existence of differences between both sales systems. For this purpose, the empirical research studied the most important variables that influence the food safety level of some of the main European fruit and vegetable wholesalers. A survey was thus designed and later applied to Spanish and French intermediaries working in key wholesale markets and in the southeast of Spain, which is the leading commercialization area of these products in Europe. The results revealed the positive influence of specific customers (big retailers) on establishing stricter safety controls within wholesale companies. It was also observed that specific wholesalers also play an important role in the system, namely those dedicated to importing, but which are also responsible for quality and safety inspection of agri-food products exported from third countries into the European Union. Full article

Classification systems constitute an important contribution to nursing practice, as they provide standardized frameworks for communication between nurses and other healthcare professionals. International Classification of Functioning, Disability and Health (ICF) provides a unified and standardized language, as well as a working structure, for the description of health and health-related states. This paper aims to describe some of the available classifications used in nursing practice and to identify the potential value provided by the application of the World Health Organization (WHO) International Classification of Functioning, Disability and Health by all healthcare professionals. With this purpose, a concept analysis was conducted. The relevant nursing classifications were analyzed and related evidence on the use of ICF classification was reviewed to provide a discussion on the application of ICF in nursing practice. The use of ICF could be beneficial in different areas of nursing practice, as it provides a more comprehensive framework to classify nursing outcomes and interventions, improving areas such as interprofessional communication and optimization of care. Although there is published evidence on the use of ICF core sets, further research is needed on this area. Full article

The goal of this cross-sectional survey was to assess the level of knowledge on harmful effects of environmental tobacco smoke (ETS) exposure and active smoking among socially-disadvantaged people in Poland. The study was conducted among 1817 respondents aged 18–59 years, who used aid services from local social care institutions in Piotrkowski district. Majority of the participants were aware of the fact that smoking may cause serious diseases and lung cancer (92%). However, those percentages were lower for awareness of ETS and health risk (69.4%) and for awareness of smoking/ETS-associated risk of stroke and heart attack (57%, 68%). The male respondents and smokers had much higher odds of lacking knowledge that smoking causes serious diseases and lung cancer compared to the females (OR = 1.47 and OR = 1.86; p < 0.05) and non-smokers (OR = 2.35 and OR = 2.31; p < 0.001). In addition, those with temporary jobs and the unemployed had a higher risk of lack of knowledge on smoking and lung cancer risk (OR = 2.14 and OR = 1.66; p < 0.05) as well as ETS and the risk of stroke (OR = 1.52 and OR = 1.51; p < 0.05) as compared to those with permanent jobs. The smokers who were aware of four health consequences of smoking indicated an intention to quit smoking within the next month more frequently when compared to those who did not have the knowledge on all of the analyzed harmful effects of tobacco use (19.7% vs. 13.1%; p < 0.05). There is a need to improve knowledge on the dangers associated with active and passive smoking among socially disadvantaged populations. Full article

Background: Schools can play an important role in promoting children’s health behaviours. A Dutch initiative, ‘The Healthy Primary School of the Future’, aims to integrate health and well-being into the school system. We use a contextual action-oriented research approach (CARA) to study the implementation process. Properties of CARA are its focus on contextual differences and the use of monitoring and feedback to support and evaluate the process of change. The aim of this article is to describe the use of the approach. Methods: Four schools (each with 200–300 children, aged 4–12 years) were included; all located in low socio-economic status areas in the south of the Netherlands. Data collection methods include interviews, observations, questionnaires, and health and behavioural measurements. Research contributions include giving feedback and providing schools with a range of possibilities for additional changes. The contextual data we examine include schools’ health promoting elements, practices of teachers and parents, dominating organisational issues, and characteristics of the student population; process data include the presence of potential barriers to changes. Discussion: CARA is an adaptive research approach that generates knowledge and experiences on how to deal with health promotion in complex systems. We think this approach can set an example for research efforts in comparable initiatives. Full article

With the general degradation of environmental carrying capacity in recent years, many developing countries are facing with the dual task of economic development and environmental protection. To explore the issue of urban environmental governance, in this research, we establish a Data Envelopment Analysis (DEA) model to investigate the environmental governance regarding temporal and spatial efficiency. Further, we deconstruct environmental governance efficiency into comprehensive efficiency, pure technical efficiency, and scale efficiency and develop a Tobit model to analyze the influencing factors affecting urban environmental governance efficiency. In addition, the above DEA, Tobit model, and deconstruction of efficiency have been applied to study environmental governance efficiency for the Yangtze River urban agglomeration. Findings include: (1) The gap in environmental governance efficiency between cities is highly noticeable, as the highest efficiency index is 0.934, the lowest is only 0.246, and the comprehensive efficiency index has fallen sharply from 0.708 to 0.493 in the past 10 years; (2) Environmental governance efficiency is basically driven by technological progress, while the scale efficiency change index is the main driver of the technological progress change index; (3) For environmental governance efficiency, urbanization and capital openness are irrelevant factors, economic level and urban construction are unfavorable factors, and industrial structure and population density are favorable factors. These findings will help urban agglomerations to effectively avoid the adverse effects of environmental governance efficiency in economic development, and achieve a coordinated development of urban construction and environmental governance. Full article

Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D may also be important for fertility, pregnancy outcomes and lactation. Significant changes in vitamin D metabolism during pregnancy such as increased production of the “active vitamin D hormone” calcitriol support the important role of vitamin D in this setting. Observational studies show that vitamin D deficiency is a risk marker for reduced fertility and various adverse pregnancy outcomes and is associated with a low vitamin D content of breast milk. Meta-analyses of randomized controlled trials (RCTs) document that physiological vitamin D supplementation during pregnancy is safe and improves vitamin D and calcium status, thereby protecting skeletal health. Although certain RCTs and/or meta-analyses reported some other beneficial effects, it is still not clear whether vitamin D supplementation improves fertility or decreases the risk of adverse pregnancy outcomes such as low birth weight, pre-eclampsia and neonatal mortality, or reduces wheeze/asthma in the infants. Nevertheless, vitamin D supplementation in pregnant women is frequently required to achieve a sufficient vitamin D status as recommended by nutritional vitamin D guidelines. In this review, we provide an overview of systematic reviews, meta-analyses and large trials reporting clinical data on the role of vitamin D for fertility, pregnancy and lactation. Full article

This study examined the effect of habitat types and ontogenetic stages on the diet shift of Coreius guichenoti (Sauvage and Dabry de Thiersant, 1874), a critically endangered fish species. Based on the stable isotope analysis method, the following was explored: the variations in δ¹³C and δ¹⁵N values, isotopic niche width and four basal food sources (Mollusks, Macrocrustaceans, Aquatic insect larvae and particulate organic matters (POMs)) among three essential habitat types (the spawning ground, natural riverine feeding and nursery area, and Three Gorges Reservoir area) and between two ontogenetic stages (immature and fully mature stages). A diet shift associated with habitat type changes was observed, but there were no obvious differences in diet composition between the two ontogenetic stages. Dietary plasticity and a preference for specific foods were the important determinants of feeding behavior through the life history of this species. POM was important for the survival of this species in the resource-limited spawning ground, but this species fed more heavily on higher-order consumers in resource-abundant areas. This study highlights the importance of maintaining free connectivity among different habitats (particularly spawning grounds) to ensure the long-term sustainability of potamodromous fish species as well as the full investigation of all types of critical habitats for understanding the trophic ecology of a single fish species. Full article