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

The primary aim of this study was to describe the prevalence of childhood overweight and obesity in Liverpool between 2006 and 2012. A secondary aim was to examine the extent to which socioeconomic inequalities relating to childhood overweight and obesity in Liverpool changed during this six-year period. A sample of 50,125 children was created using data from the National Child Measurement Program (NCMP) in Liverpool. The prevalence of overweight and obesity was calculated for Reception and Year 6 aged children in Liverpool for each time period by gender and compared against published averages for England. Logistic regression analyses examined the likelihood of children in Liverpool being classified as overweight and obese based on deprivation level for each time period. Analyses were conducted separately for Reception and Year 6 aged children and were adjusted for gender. The prevalence of overweight and obesity among Reception and Year 6 aged children in Liverpool increased between 2006 and 2012. During the same period, socioeconomic disparities in overweight and obesity prevalence between children living in the most deprived communities in Liverpool and those living in less deprived communities in Liverpool, widened. This study evidences rising rates of overweight and obesity among Liverpool children and widening socioeconomic health inequalities within Liverpool, England’s most deprived city between 2006 and 2012. Full article

Depressive symptoms among individuals with hypertension may increase the risk of cardio-cerebrovascular disease, disease burden, and mortality. However, few studies have examined the relationships among physical activity, sleep duration, and depressive symptoms. Thus, this cross-sectional study examined the associations of physical activity and sleep duration with depressive symptoms in individuals with hypertension. We analyzed data collected as part of the 2014 Korea National Health and Nutrition Examination Survey, which included 846 patients with hypertension aged 19 or older. The prevalence rate of depressive symptoms was around 11.2%. A logistic regression analysis showed that moderate to vigorous physical activity (odds ratio (OR) = 4.42; 95% confidence interval (CI) = 2.19–8.89) and short (OR = 2.18; 95% CI = 1.11–4.28) and long sleep duration (OR = 4.09; 95% CI = 1.83–9.13) increased the risk of depressive symptoms after adjusting for confounding factors. Additionally, older age and low educational levels were associated with depressive symptoms. Our findings highlight that physical activity and sleep duration should be key components of lifestyle modification among hypertensive patients with depressive symptoms. Further investigation might benefit from validating these findings using a longitudinal design and examining the mediating effects of physical activity and/or sleep duration on the relationship between individual characteristics and depressive symptoms. Full article

The survival of wetland plants in iron, sulfur and heavy metals-rich mine tailing ponds has been commonly attributed to the iron plaque (IP) on the root surface that acts as a protective barrier. However, the contribution of bacteria potentially regulates the iron-sulfur cycle and heavy metal exclusion at the root surface has not been studied in depth, particularly from a microbial ecology perspective. In this study, a pot experiment using Typha latifolia, a typical wetland plant, in non-polluted soil (NP) and tailing soil (T) was conducted. Samples from four zones, comprising non-rhizosphere soil (NR), rhizosphere soil (R) and internal (I) and external (E) layers of iron plaque, were collected from the NP and T and analyzed by 16S rRNA sequencing. Simpson index of the genus level showed greater diversities of bacterial community in the NP and its I zone is the most important part of the rhizosphere. PICRUSt predicted that the I zones in both NP and T harbored most of the functional genes. Specifically, functional genes related to sulfur relay and metabolism occurred more in the I zone in the T, whereas those related to iron acquisition and carbon and nitrogen circulation occurred more in the I zone in the NP. Analysis of dominant bacterial communities at genus level showed highest abundance of heavy metal resistant genus Burkholderia in the E zones in both soils, indicating that heavy metal resistance of Typha latifolia driven by Burkholderia mainly occurred at the external layer of IP. Moreover, many bacterial genera, such as Acidithiobacillus, Ferritrophicum, Thiomonas, Metallibacterium and Sideroxydans, involved in iron and sulfur metabolisms were found in the T and most showed higher abundance in the I zone than in the other zones. This work, as the first endeavor to separate the iron plaque into external and internal layers and investigate the variations of the bacterial communities therein, can provide an insight for further understanding the survival strategy of wetland plants, e.g., Typha latifolia, in extreme environment. Full article

Ambient air pollution in terms of fine and coarse particulate matter (PM_2.5 and PM₁₀) has been shown to increase adult and infant mortalities. Most studies have estimated the risk of mortalities through attributable proportions and number of excess cases with no reference to the time lost due to premature mortalities. Disability adjusted life years (DALYs) are necessary to measure the health impact of Ambient particulate matter (PM) over time. In this study, we used life-tables for three years (2014–2016) to estimate the years of life lost (YLL), a main component of DALYs, for adult mortalities (age 30+ years) and postneonatal infant mortalities (age 28+ days–1 year) associated with PM_2.5 exposure and PM₁₀ exposure, respectively. The annual average of PM_2.5 and PM₁₀ concentrations were recorded as 87.9 μg/m³ and 167.5 μg/m³, which are 8 times greater than the World Health Organization (WHO) air quality guidelines of 10 μg/m³ and 20 μg/m³, respectively. Results indicated a total of 252.18 (95% CI: 170.69–322.92) YLL for all ages with an increase of 27,474.61 (95% CI: 18,483.02–35,370.58) YLL over 10 years. The expected life remaining (ELR) calculations showed that 30- and 65-year-old persons would gain 2.34 years and 1.93 years, respectively if the current PM_2.5 exposure levels were reduced to the WHO interim targets (IT-1 = 35 μg/m³). Newborns and 1-year old children may live 79.81 and 78.94 years, respectively with an increase in average life expectancy of 2.65 years if the WHO PM₁₀ interim targets were met (IT-1 = 70 μg/m³). Sensitivity analyses for YLL were carried out for the years 2015, 2025, and 2045 and showed that the years of life would increase significantly for age groups between 30 and 85. Life expectancy, especially for the elderly (≥60 years), would increase at higher rates if PM_2.5 levels were reduced further. This study can be helpful for the assessment of poor air quality represented by PM_2.5 and PM₁₀ exposures in causing premature adult mortalities and postneonatal infant mortalities in developing countries with high ambient air pollution. Information in this article adds insights to the sustainable development goals (SDG 3.9.1 and 11.6.2) related to the reduction of mortality rates attributed to ambient air levels of coarse and fine particulate matter. Full article

The aim of this study was to examine the relationship between main air pollutants and all cancer mortality by performing a meta-analysis. We searched PubMed, EMBASE (a biomedical and pharmacological bibliographic database of published literature produced by Elsevier), and the reference lists of other reviews until April 2018. A random-effects model was employed to analyze the meta-estimates of each pollutant. A total of 30 cohort studies were included in the final analysis. Overall risk estimates of cancer mortality for 10 µg/m³ per increase of particulate matter (PM)_2.5, PM₁₀, and NO₂ were 1.17 (95% confidence interval (CI): 1.11–1.24), 1.09 (95% CI: 1.04–1.14), and 1.06 (95% CI: 1.02–1.10), respectively. With respect to the type of cancer, significant hazardous influences of PM_2.5 were noticed for lung cancer mortality and non-lung cancer mortality including liver cancer, colorectal cancer, bladder cancer, and kidney cancer, respectively, while PM₁₀ had harmful effects on mortality from lung cancer, pancreas cancer, and larynx cancer. Our meta-analysis of cohort studies indicates that exposure to the main air pollutants is associated with increased mortality from all cancers. Full article

Background: The aim of this study was to estimate the prevalence of diabetes mellitus in the Roma population and compare it to the prevalence in the Caucasian population. Methods: Using the words “Roma”, “Gypsies”, “Romani”, and ”traveler” in combination with “diabetes, “metabolic syndrome”, “cardiovascular disease” and “health status” we searched the MEDLINE, Pubmed and Scopus databases for articles in English that focused on the prevalence of diabetes mellitus among Roma populations published until December 2017. Results: Five studies met the inclusion criteria. The results of four of them suggested a higher prevalence of diabetes among Romani compared to Caucasians but none of them reached the standards regarding representative samples and number of cases for a conclusive result. Conclusion: Although some of the existing studies suggest a substantial prevalence of diabetes among Roma populations and even a higher risk of developing diabetes for Roma persons compared to Caucasians, the number of published literature on this topic remains very low and insufficient in design and number of participants to draw any conclusions. Full article

An emerging issue in occupational health and safety (OHS) is that interventions increasingly have to demonstrate that they offer sufficient value for money. To this end, the last decennia have seen more and more economic evaluation methods being employed in this field. However, several recent publications have indicated that many of the published studies suffer from important shortcomings. This paper aims to highlight difficulties in assessing the value of OHS by use of current economic evaluation methods. First, a summary framework presents an overview of the costs and benefits relevant for OHS interventions. Next, three elements from this framework are selected that are at the same time crucial to OHS value, but also challenging to measure and monetise: Effects on worker productivity, ‘intangible’ benefits, such as reputation effects, and the influence of the broader legal–fiscal context in which an intervention takes place. The following sections then discuss the following research questions for each of these elements: Why is it difficult to exclude these factors from OHS economic evaluations? Why do they pose a challenge to the quality of economic evaluations in OHS? How can they be included, and what are the known advantages and disadvantages of the methods to measure these factors? Future work should investigate (and standardise) better methods to include these elements. Full article

Among available home and community-based services in Taiwan, there should be a focus on providing people with people-centered, value-based services. This study aims to follow up the people-centered health outcomes of care recipients and to examine the factors associated with to feedback for policy and practice in long-term care. A total of 9889 persons from the long-term care dataset were followed up for two years (T0–T4). The Cox Proportional Hazard Regression analyses to analyze mortality and the mixed effect models for health outcomes were used. Three classes among the care recipients were identified. Health profiles (HR = 1.46 and 2.56 for FI and FD compared with RI, p < 0.001), subsidy gap (HR = 1.01), and living status (HR = 0.88 for those living with spouse only) had a significant impact on mortality. The overall dropout rate was 52.3% at two years, and the health profiles at baseline significantly influenced the health outcome’s change. The health heterogeneity matters and influences subsequent outcomes. To reach the goal of the HCBS, regular and exact monitoring of care recipients is crucial, while feedback regarding health outcomes and a greater focus on providing person-centered and responsive services in the community are also required. Full article

The aims of this article are to characterize: the quantity of culturable bacterial aerosol (QCBA) and the quality of culturable bacterial aerosol (QlCBA) in an office building in Southern Poland during the spring. The average concentration of culturable bacterial aerosol (CCBA) in this building ranged from 424 CFU m⁻³ to 821 CFU m⁻³, below Polish proposals for threshold limit values. Size distributions were unimodal, with a peak of particle bacterial aerodynamic diameters less than 3.3 μm, increasing potentially adverse health effects due to their inhalation. The spring office exposure dose (SPED) of bacterial aerosol was estimated. The highest value of SPED was in April (218 CFU kg⁻¹), whereas the lowest was in June (113 CFU kg⁻¹). Analysis was undertaken to determine the antibiotic resistance of isolated strains and their ability to form biofilms, which may facilitate the spread of antibiotic resistance genes. In the course of the study, it was found that Staphylococcus xylosus had the greatest ability to form biofilms, while the strains with the highest antibiotic resistance were Micrococcus luteus D and Macrococcus equipercicus. Given that mainly antibiotic-sensitive bacteria from bioaerosol were isolated, which transfers resistance genes to their plasmids, this shows the need for increased monitoring of indoor air quality in workplaces. Full article

Based on frequently used internal partitions in offices, the effects of pollutant source characteristics and an internal partition on airflow and contaminant distribution under different ventilation modes are studied in this paper. The indoor flow field measurement is implemented in a 1:1 single environmental chamber under different ventilation patterns, and then the numerical model is established. The numerical method is verified and analyzed by comparing the measured and simulated results. According to the verification results, the numerical simulation is introduced to study the influence of different supply and return air mixes and pollutant source distributions on the flow field and diffusion performance with an internal partition. The indoor flow field and concentration distribution under different conditions are compared, and the discharge efficiency under different working conditions is analyzed. The results indicate that internal partitions have a greater influence on the down-supply up-return ventilation mode than the floor-supply up-return and top-supply down-return ventilation mode. Furthermore, if the room is zoned, the effect of source position is larger under the down-supply up-return ventilation mode than under the other two modes. Full article

Both periodontal disease (PD) and inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are important diseases of the alimentary tract. Microbiome and immune-mediated inflammatory processes play important roles in these diseases. An association between PD and IBD may exist. This study investigated the risk of IBD in patients with PD. This study used data from the National Health Insurance Research Database of Taiwan from 1996 to 2013. A total of 27,041 patients with PD were enrolled as a study group, and 108,149 patients without PD were selected as the control group after matching by gender, age, insured region, urbanization, and income with a 1:4 ratio. Cox proportional hazards regression was used to calculate the risk of IBD. Of the 135,190 participants enrolled in this study, 5392 (4%) with newly diagnosed IBD were identified. The overall incidence of subsequent IBD was similar in both groups (3.8% vs. 4%, adjusted hazard ratio (aHR) = 1.01, 95% confidence interval (CI): 0.94–1.08). However, an increased risk of UC in the PD group was found after adjusting confounding factors (aHR: 1.56, 95% CI: 1.13–2.15; p < 0.05). This study demonstrated that patients with PD had approximately one-half higher risk of subsequent UC. Further studies are warranted to elucidate the relationship between PD and UC. Full article

This study investigated the accumulation of As, Cd, and Pb in 16 wheat cultivars and the associated health risks for the inhabitants of Jiyuan, China. The results indicated that the concentrations of As, Cd, and Pb decreased in the order of root > leaf > stem > grain. The concentrations of As, Cd, and Pb in wheat grains varied from 0.13 for Pingan8 to 0.34 mg kg⁻¹ for Zhengmai7698, 0.10 for Luomai26 to 0.25 mg kg⁻¹ for Zhengmai7698, and 0.12 for Zhoumai207 to 0.42 mg kg⁻¹ for Zhengmai379, respectively. There were significant differences in the bioaccumulation factors of As, Cd, and Pb among the 16 wheat cultivars. Cd was more readily accumulated to higher levels than As and Pb in wheat. The Target Hazard Quotients (THQs) of Cd and Pb in the grains from 16 wheat cultivars were below 1, while As THQ exceeded 1. The lowest detrimental human health effects via wheat consumption were found in cultivar AY58 among the 16 wheat cultivars, with total THQs (TTHQs) of 1.82 for children and 1.60 for adults, suggesting that children absorb more heavy metals than adults and they are more vulnerable to the adverse effects of these metals. Full article

This work examined the oxidation of Piroxicam (PIR), a representative nonsteroidal anti-inflammatory drug using iron activated persulfate. The effect of persulfate dosing was vital for the efficiency of the process. The addition of 20 mg/L sodium persulfate (SPS) eliminated 500 μg/L of PIR in less than 20 min at natural pH. PIR decomposition followed pseudo-first-order kinetics, and the observed kinetic constant increased by 2.1 times when the initial concentration of PIR decreased from 2000 to 250 μg/L. Acidic pH favored the PIR destruction, while both sulfate and hydroxyl radicals are involved in PIR destruction at natural pH. The effect of inorganic ions like bicarbonate and chlorides was almost insignificant on PIR removal. The presence of humic acid reduced PIR removal from 100% to 67% after 20 min of treatment with 2 mg/L Fe²⁺ and 20 mg/L SPS. The experiment that was performed with bottled water showed similar efficiency with ultrapure water, while in the case of secondary effluent, PIR removal decreased by 26% after 30 min of treatment. The Fe²⁺/SPS/ultrasound hybrid process showed a low degree of synergy (18.3%). The ecotoxicity of aqueous solution using the Vibrio fischeri as an indicator was reduced during the treatment, although with a different trend from the removal of PIR, possibly due to byproducts derived from the oxidation of secondary effluent and PIR. Full article

In many European children, high levels of screen time can be found, which is associated with several adverse health outcomes. Therefore, there is a need for identifying effective intervention strategies that reduce screen time in children. A factor that may contribute to excessive screen time in children may be “co-TV viewing” (i.e., the time that parents and children spend on watching TV together), as parents often recognize the importance of limiting children’s (individual) screen time, but often encourage TV viewing as a family because of its perceived benefits (e.g., educational purposes). The primary aim of this study was to investigate the (sex-specific) association between co-TV viewing and both children’s and parents’ screen time, and these associations were investigated across and within six European countries. In total, 10,969 parents (Mean_age = 40.7 ± 5.3 years, Mean_BMI = 24.4 ± 4.6) of primary school children (Mean_age = 8.2 ± 1.0 years, 49.0% boys, Mean_BMI = 17.3 ± 2.8) completed a questionnaire assessing co-TV viewing and screen time. Multilevel regression analyses were conducted. Across countries, positive associations were found between co-TV viewing and both children’s (β = 11.85, SE = 3.69, p < 0.001) and parents’ screen time (β = 14.47, SE = 4.43, p = 0.001). Similar associations were found in most (but not all) countries. The results suggest that targeting co-TV viewing might be a promising intervention strategy because of its potential to limit screen time of both children and parents. Full article

Impacted by ongoing climate change and anthropogenic activities, large seasonal lakes experience water regime evolution, which raises challenges for the management of water resources and environment. The water regime evolution refers to the spatial and temporal alterations in the hydrological features of lakes. Characterizing the lake water regime and its alteration may help policymakers design effective adaption strategies. Therefore, total 47 hydrological indicators were proposed, considering intra-annual fluctuations, flood and drought features, and rate and frequency of water level variations. Combined with Mann-Kendall algorithm and Sen’s slope, the indicators were applied in Poyang Lake, a typically large seasonal lake in China, as a case study. The results revealed temporal and spatial variations in different hydrological indicators. The most dramatic alteration was the water level decline in October and November over the entire study phase, especially over the past 30 years. This was an urgent environmental problem that Poyang Lake faced, partially caused by the increased hydraulic gradient between southern and northern lake. It could trigger the drought occurring earlier, prolong the drought duration, and impair the wetland ecosystem. Environmental water requirements of both Poyang Lake and Yangtze River were suggested for regional sustainable development. The application in Poyang Lake showed the practicability and reliability of the indicators, which are applicable in international seasonal lakes. The series of indicators can be used in whole or in part, determined by the ecohydrological characters of a specific lake and the research objectives. Full article

Estuarine bank sediments have the potential to support the survival and growth of fecal indicator organisms, including Escherichia coli. However, survival of fecal pathogens in estuarine sediments is not well researched and therefore remains a significant knowledge gap regarding public health risks in estuaries. In this study, simultaneous survival of Escherichia coli and a fecal pathogen, Salmonella enterica serovar Typhimurium, was studied for 21 days in estuarine bank sediment microcosms. Observed growth patterns for both organisms were comparable under four simulated scenarios; for continuous-desiccation, extended-desiccation, periodic-inundation, and continuous-inundation systems, logarithmic decay coefficients were 1.54/day, 1.51/day, 0.14/day, and 0.20/day, respectively, for E. coli, and 1.72/day, 1.64/day, 0.21/day, and 0.24/day for S. Typhimurium. Re-wetting of continuous-desiccated systems resulted in potential re-growth, suggesting survival under moisture-limited conditions. Key findings from this study include: (i) Bank sediments can potentially support human pathogens (S. Typhimurium), (ii) inundation levels influence the survival of fecal bacteria in estuarine bank sediments, and (iii) comparable survival rates of S. Typhimurium and E. coli implies the latter could be a reliable fecal indicator in urban estuaries. The results from this study will help select suitable monitoring and management strategies for safer recreational activities in urban estuaries. Full article

Background: Gallbladder diseases are common in Jilin, China. However, there have been few previous studies on this disease. Our study used the chronic disease database in Jilin Province to study the factors correlated with gallbladder diseases. Methods: A total of 21,435 people were selected from the Jilin Province adult chronic disease survey conducted in 2012. Multistage stratified random cluster sampling was used in this cross-sectional study. Multiple logistic regression analysis was used to explore the independent associations of different factors with gallbladder diseases. Results: There were 1876 people with gallbladder diseases, and the prevalence of the diseases was 8.8% (males 4.4%, females 12.8%). Multivariate logistic regression analysis showed that female (prevalence odds ratio (POR) = 3.13, 95% confidence intervals (CIs): 2.76–3.55), older people (30–45 years (POR = 2.79, 95% CIs: 2.06–3.77), 45–60 years (POR = 4.26, 95% CIs: 3.17–5.73), 60–79 years (POR = 4.72, 95% CIs: 3.48–6.41)), people living in rural areas (POR = 1.65, 95% CIs: 1.49–1.82), smoking (current smoker (POR = 1.15, 95% CIs: 1.01–1.31), former smoker (POR = 1.37, 95% CIs: 1.13–1.66)), high frequency of eating seafood (POR = 0.77, 95% CIs: 0.63–0.93), and high frequency of eating soy products (POR = 0.50, 95% CIs: 0.44–0.58) were associated with gallbladder diseases. Conclusions: We found that there were some factors associated with gallbladder disease, and there needs to be further studies to confirm these associations. Full article

Most soil remediation studies investigated single contaminants or multiple contaminants of the same type. However, in field conditions, soils are often contaminated with potentially both toxic metals and organic pollutants, posing a serious technical challenge. Here, batch experiments were conducted to evaluate the performance of combining in situ solidification/stabilization (ISS) and in situ chemical oxidation (ISCO) for the simultaneous removal of aniline (1000 mg/kg) and Cd (10 mg/kg). All four tested ISS amendments, especially quick lime and Portland cement, promoted in situ chemical oxidation with activated persulfate in contaminated soil. Combined ISS/ISCO remediation effectively removed aniline and reduced the bioavailable Cd content at optimal initial persulfate and ISS amendment concentrations of 1.08 mol/kg and 30 wt% with a seven-day curing time, and significantly reduced leaching. Persulfate inhibited the reduction of the bioavailable Cd content, and ISS amendment with persulfate did not synergistically remediate Cd in co-contaminated soil. Strong alkalinity and high temperature were the main mechanisms driving rapid pollutant removal and immobilization. The reaction of CaO with water released heat, and Ca(OH)₂ formation increased the pH. The relative contributions of heat vs. alkaline activation, as well as the contaminant removal efficiency, increased with ISS amendment CaO content. Combined treatment altered the soil physicochemical properties, and significantly increased Ca and S contents. Activated persulfate-related reactions did not negatively impact unconfined compressive strength and hydraulic conductivity. This work improves the selection of persulfate activation methods for the treatment of soils co-contaminated with both potentially toxic metals and organic pollutants. Full article

This study sought to investigate the efficacy of standardized versus individualized exercise intensity prescription on metabolic syndrome (MetS) severity following a 12-week exercise intervention. A total of 38 experimental participants (47.8 ± 12.2 yr, 170.7 ± 8.0 cm, 82.6 ± 18.7 kg, 26.9 ± 6.7 mL·k⁻¹·min⁻¹) were randomized to one of two exercise interventions (exercise intensity prescribed using heart rate reserve or ventilatory threshold). Following the 12-week intervention, MetS z-score was significantly improved for the standardized (−2.0 ± 3.1 to −2.8 ± 2.8 [p = 0.01]) and individualized (−3.3 ± 2.3 to −3.9 ± 2.2 [p = 0.04]) groups. When separating participants based on prevalence of MetS at baseline and MetS z-score responsiveness, there were six and three participants in the standardized and individualized groups, respectively, with three or more MetS risk factors. Of the six participants in the standardized group, 83% (5/6) of the participants were considered responders, whereas 100% (3/3) of the individualized participants were responders. Furthermore, only 17% (1/6) of the participants with MetS at baseline in the standardized group no longer had symptoms of MetS following the intervention. In the individualized group, 67% (2/3) of participants with baseline MetS were not considered to have MetS at week 12. These findings suggest that an individualized approach to the exercise intensity prescription may ameliorate the severity of MetS. Full article