International Journal of Environmental Research and Public Health

Interpersonal relationships are a fundamental human need [...]

Although stroke prevalence remains one of the leading causes of death and morbidity in the United States, there is paucity of ecological studies at the census tract level that elucidate geospatial associations between predictors of stroke prevalence in states across U.S. Health and Human Services Region 3 (HHS Region 3: Delaware, Maryland, Pennsylvania, Virginia, West Virginia, and the District of Columbia). This study operationalized the Health Opportunity Index (HOI) by exploring the geospatial relationship between the 13 indicators of the HOI and stroke prevalence at the census tract level in HHS Region 3 using four HOI indicator profiles: (a) neighborhood and built environment profile, (b) social and community context profile, (c) resource profile, and (d) economic profile. The methodological approach was quantitative using secondary data. The sample size was 8021 census tracts. The HOI was estimated for each census tract in the study area. Geographic weighted regression model was run to examine the varying strengths and direction of geospatial relationship of 13 HOI indicators and stroke prevalence across census tracts in HHS Region 3. The results showed variation in the geographic weighted regression (GWR) local estimated coefficients for each indicator across the study area, reflecting variation in the strength and direction of the associations. The findings of our study can guide the identification of geographic priorities for resource allocation, design of quality improvement interventions, inform policy creation and targeted local strategies for stroke prevention services across neighborhoods, support grant applications, and inform future research on stroke prevalence in HHS Region 3.

Styrene is an aromatic compound widely used as a reactive monomer in polyester resins, which are among the most utilized resins in cured-in-place pipe (CIPP) technology, the most widely used trenchless pipe renewal method. Given that styrene is classified as a suspected human carcinogen, this study aims to evaluate styrene concentrations emitted into the air during sewer pipe rehabilitation using CIPP. This study included developing a comprehensive methodology to collect data from six different CIPP installations across the U.S. and document styrene emissions before, during, and after the curing process. The air samples were collected and analyzed using the USEPA method TO-15 and TO-17. Measured styrene emissions were then compared with exposure limits established by USEPA, NIOSH, and OSHA to assess potential occupational and worker health impacts. The result confirmed that high styrene concentrations, exceeding the established threshold, can be observed within the CIPP work zone. The result also indicated a considerable reduction in styrene concentration within five feet downwind of the work zone. In conclusion, while the health risk to the public appears to be low, there is a potential for health impact for the CIPP crew. Therefore, implementing real-time air quality monitoring during CIPP installation to mitigate these health risks is recommended. Additionally, the use of appropriate personal protective equipment (PPE) by the crew is essential.