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Authors = Monika Nitschke

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13 pages, 2181 KiB  
Article
Relative Health Risk Reduction from an Advanced Multi-Modal Air Purification System: Evaluation in a Post-Surgical Healthcare Setting
by Dino Pisaniello and Monika Nitschke
Int. J. Environ. Res. Public Health 2024, 21(8), 1089; https://doi.org/10.3390/ijerph21081089 - 17 Aug 2024
Viewed by 2021
Abstract
Advanced air treatment systems have the potential to reduce airborne infection risk, improve indoor air quality (IAQ) and reduce energy consumption, but few studies reported practical implementation and performance. PlasmaShield®, an advanced multi-modal HVAC-integrated system, was directly compared with a standard [...] Read more.
Advanced air treatment systems have the potential to reduce airborne infection risk, improve indoor air quality (IAQ) and reduce energy consumption, but few studies reported practical implementation and performance. PlasmaShield®, an advanced multi-modal HVAC-integrated system, was directly compared with a standard MERV-13 system in a post-surgical paediatric healthcare setting. The evaluation entailed monitoring of multi-size airborne particles, bioaerosols and key IAQ parameters. Measurements were taken for outside air, supply air and air in the occupied space for 3 days prior to, and after, the installation of the PlasmaShield system. Compared with the existing arrangement, very significant reductions in particle number concentrations were observed in the occupied space, especially with virus-like submicron particles. Significant reductions in airborne culturable bacteria and fungi were observed in the supply air, with more modest reductions in the occupied space. In the case of virus-like particles, there was an eight-fold improvement in equivalent clean air, suggesting a five-fold infection risk reduction for long-range exposure. The data suggest multiple benefits of airborne particle and bioaerosol reduction, with applications beyond healthcare. Long-term studies are recommended to confirm the combined IAQ, health and energy benefits. Full article
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16 pages, 1292 KiB  
Article
Hospitalization Costs of Respiratory Diseases Attributable to Temperature in Australia and Projections for Future Costs in the 2030s and 2050s under Climate Change
by Michael Tong, Berhanu Wondmagegn, Jianjun Xiang, Alana Hansen, Keith Dear, Dino Pisaniello, Blesson Varghese, Jianguo Xiao, Le Jian, Benjamin Scalley, Monika Nitschke, John Nairn, Hilary Bambrick, Jonathan Karnon and Peng Bi
Int. J. Environ. Res. Public Health 2022, 19(15), 9706; https://doi.org/10.3390/ijerph19159706 - 6 Aug 2022
Cited by 16 | Viewed by 3759
Abstract
This study aimed to estimate respiratory disease hospitalization costs attributable to ambient temperatures and to estimate the future hospitalization costs in Australia. The associations between daily hospitalization costs for respiratory diseases and temperatures in Sydney and Perth over the study period of 2010–2016 [...] Read more.
This study aimed to estimate respiratory disease hospitalization costs attributable to ambient temperatures and to estimate the future hospitalization costs in Australia. The associations between daily hospitalization costs for respiratory diseases and temperatures in Sydney and Perth over the study period of 2010–2016 were analyzed using distributed non-linear lag models. Future hospitalization costs were estimated based on three predicted climate change scenarios-RCP2.6, RCP4.5 and RCP8.5. The estimated respiratory disease hospitalization costs attributable to ambient temperatures increased from 493.2 million Australian dollars (AUD) in the 2010s to more than AUD 700 million in 2050s in Sydney and from AUD 98.0 million to about AUD 150 million in Perth. The current cold attributable fraction in Sydney (23.7%) and Perth (11.2%) is estimated to decline by the middle of this century to (18.1–20.1%) and (5.1–6.6%), respectively, while the heat-attributable fraction for respiratory disease is expected to gradually increase from 2.6% up to 5.5% in Perth. Limitations of this study should be noted, such as lacking information on individual-level exposures, local air pollution levels, and other behavioral risks, which is common in such ecological studies. Nonetheless, this study found both cold and hot temperatures increased the overall hospitalization costs for respiratory diseases, although the attributable fractions varied. The largest contributor was cold temperatures. While respiratory disease hospitalization costs will increase in the future, climate change may result in a decrease in the cold attributable fraction and an increase in the heat attributable fraction, depending on the location. Full article
(This article belongs to the Special Issue Environment and Respiratory Health)
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13 pages, 1273 KiB  
Article
Pollen Exposure and Cardiopulmonary Health Impacts in Adelaide, South Australia
by Monika Nitschke, David Simon, Keith Dear, Kamalesh Venugopal, Hubertus Jersmann and Katrina Lyne
Int. J. Environ. Res. Public Health 2022, 19(15), 9093; https://doi.org/10.3390/ijerph19159093 - 26 Jul 2022
Cited by 6 | Viewed by 2164
Abstract
(1) Background: Limited research has suggested that cardiopulmonary health outcomes should be considered in relation to pollen exposure. This study sets out to test the relationship between pollen types (grasses, trees, weeds) and cardiovascular, lower respiratory and COPD health outcomes using 15 years [...] Read more.
(1) Background: Limited research has suggested that cardiopulmonary health outcomes should be considered in relation to pollen exposure. This study sets out to test the relationship between pollen types (grasses, trees, weeds) and cardiovascular, lower respiratory and COPD health outcomes using 15 years (2003–2017) of data gathered in Adelaide, South Australia; (2) Methods: A time-series analysis by months was conducted using cardiopulmonary data from hospital admissions, emergency presentations and ambulance callouts in relation to daily pollen concentrations in children (0–17) for lower respiratory outcomes and for adults (18+). Incidence rate ratios (IRR) were calculated over lags from 0 to 7 days; (3) Results: IRR increases in cardiovascular outcomes in March, May, and October were related to grass pollen, while increases in July, November, and December were related to tree pollen. IRRs ranged from IRR 1.05 (95% confidence interval (CI) 1.00–1.10) to 1.25 (95% CI 1.12–1.40). COPD increases related to grass pollen occurred only in May. Pollen-related increases were observed for lower respiratory outcomes in adults and in children; (4) Conclusion: Notable increases in pollen-related associations with cardiopulmonary outcomes were not restricted to any one season. Prevention measures for pollen-related health effects should be widened to consider cardiopulmonary outcomes. Full article
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16 pages, 368 KiB  
Article
Using a Qualitative Phenomenological Approach to Inform the Etiology and Prevention of Occupational Heat-Related Injuries in Australia
by Alana L Hansen, Susan Williams, Scott Hanson-Easey, Blesson M Varghese, Peng Bi, Jane Heyworth, Monika Nitschke, Shelley Rowett, Malcolm R Sim and Dino L Pisaniello
Int. J. Environ. Res. Public Health 2020, 17(3), 846; https://doi.org/10.3390/ijerph17030846 - 29 Jan 2020
Cited by 12 | Viewed by 4041
Abstract
Epidemiological evidence has shown an association between exposure to high temperatures and occupational injuries, an issue gaining importance with environmental change. The aim of this study was to better understand contributing risk factors and preventive actions based on personal experiences. Interviews were conducted [...] Read more.
Epidemiological evidence has shown an association between exposure to high temperatures and occupational injuries, an issue gaining importance with environmental change. The aim of this study was to better understand contributing risk factors and preventive actions based on personal experiences. Interviews were conducted with 21 workers from five Australian states using a critical phenomenological approach to capture the lived experiences of participants, whilst exploring contextual factors that surround these experiences. Two case studies are presented: a cerebrovascular injury and injuries among seasonal horticulture workers. Other accounts of heat-related injuries and heat stress are also presented. Risk factors were classified as individual, interpersonal and organizational. In terms of prevention, participants recommended greater awareness of heat risks and peer-support for co-workers. Adding value to current evidence, we have provided new insights into the etiology of the health consequences of workplace heat exposure with workers identifying a range of influencing factors, prevention measures and adaptation strategies. Underpinning the importance of these are future climate change scenarios, suggesting that extended hot seasons will lead to increasing numbers of workers at risk of heat-stress and associated occupational injuries. Full article
9 pages, 433 KiB  
Article
What Can We Learn about Workplace Heat Stress Management from a Safety Regulator Complaints Database?
by Alana Hansen, Dino Pisaniello, Blesson Varghese, Shelley Rowett, Scott Hanson-Easey, Peng Bi and Monika Nitschke
Int. J. Environ. Res. Public Health 2018, 15(3), 459; https://doi.org/10.3390/ijerph15030459 - 6 Mar 2018
Cited by 13 | Viewed by 6004
Abstract
Heat exposure can be a health hazard for many Australian workers in both outdoor and indoor situations. With many heat-related incidents left unreported, it is often difficult to determine the underlying causal factors. This study aims to provide insights into perceptions of potentially [...] Read more.
Heat exposure can be a health hazard for many Australian workers in both outdoor and indoor situations. With many heat-related incidents left unreported, it is often difficult to determine the underlying causal factors. This study aims to provide insights into perceptions of potentially unsafe or uncomfortably hot working conditions that can affect occupational health and safety using information provided by the public and workers to the safety regulator in South Australia (SafeWork SA). Details of complaints regarding heat exposure to the regulator’s “Help Centre” were assembled in a dataset and the textual data analysed thematically. The findings showed that the majority of calls relate to indoor work environments such as kitchens, factories, and warehouses. The main themes identified were work environment, health effects, and organisational issues. Impacts of hot working conditions ranged from discomfort to serious heat-related illnesses. Poor management practices and inflexibility of supervisors featured strongly amongst callers’ concerns. With temperatures predicted to increase and energy prices escalating, this timely study, using naturalistic data, highlights accounts of hot working conditions that can compromise workers’ health and safety and the need for suitable measures to prevent heat stress. These could include risk assessments to assess the likelihood of heat stress in workplaces where excessively hot conditions prevail. Full article
(This article belongs to the Special Issue Emerging Issues in Occupational Safety and Health)
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10 pages, 690 KiB  
Article
Heat Health Messages: A Randomized Controlled Trial of a Preventative Messages Tool in the Older Population of South Australia
by Monika Nitschke, Antoinette Krackowizer, Alana L. Hansen, Peng Bi and Graeme R. Tucker
Int. J. Environ. Res. Public Health 2017, 14(9), 992; https://doi.org/10.3390/ijerph14090992 - 31 Aug 2017
Cited by 29 | Viewed by 7122
Abstract
This study explores the efficacy of providing targeted information to older individuals to prevent adverse health outcomes during extreme heat. Participants ≥65 years of age (n = 637) were recruited from previous population-based studies and randomized into intervention and control groups. The [...] Read more.
This study explores the efficacy of providing targeted information to older individuals to prevent adverse health outcomes during extreme heat. Participants ≥65 years of age (n = 637) were recruited from previous population-based studies and randomized into intervention and control groups. The intervention group received evidence-based information leaflets and summarised “Beat the Heat” tips. Post summer 2013–2014, participants responded to questions about their behaviours and their health experiences. Chi square analysis and risk ratios (RR) were used to determine the difference in effects. Responses were received from 216 intervention subjects and 218 controls. Behaviour modification during extreme heat was similar in both groups except for significant increases in the use of cooling systems and the use of a wet cloth to cool the skin in the intervention group. Both actions were recommended in the information package. More people in the intervention group also claimed to have had adequate heat health information. After adjusting for confounders, the RR for self-reported heat stress experienced during summer 2014 indicated a 63% (RR 0.37; 95% CI: 0.22–0.63) reduction in the intervention group compared to the control group. Access to intensive prevention information may have contributed to this positive outcome, indicating the potential usefulness of targeted heat-health information for seniors. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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14 pages, 297 KiB  
Article
Developing Health-Related Indicators of Climate Change: Australian Stakeholder Perspectives
by Maryam Navi, Alana Hansen, Monika Nitschke, Scott Hanson-Easey and Dino Pisaniello
Int. J. Environ. Res. Public Health 2017, 14(5), 552; https://doi.org/10.3390/ijerph14050552 - 22 May 2017
Cited by 13 | Viewed by 7101
Abstract
Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders’ perspectives on the identification, development, and utility of such indicators. A [...] Read more.
Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders’ perspectives on the identification, development, and utility of such indicators. A qualitative approach was used, comprising semi-structured interviews with key informants and service providers from government and non-government stakeholder organizations in South Australia. Stakeholders saw a need for indicators that could enable the monitoring of health impacts and time trends, vulnerability to climate change, and those which could also be used as communication tools. Four key criteria for utility were identified, namely robust and credible indicators, specificity, data availability, and being able to be spatially represented. The variability of risk factors in different regions, lack of resources, and data and methodological issues were identified as the main barriers to indicator development. This study demonstrates a high level of stakeholder awareness of the health impacts of climate change, and the need for indicators that can inform policy makers regarding interventions. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
13 pages, 198 KiB  
Article
Risk Factors, Health Effects and Behaviour in Older People during Extreme Heat: A Survey in South Australia
by Monika Nitschke, Alana Hansen, Peng Bi, Dino Pisaniello, Jonathan Newbury, Alison Kitson, Graeme Tucker, Jodie Avery and Eleonora Dal Grande
Int. J. Environ. Res. Public Health 2013, 10(12), 6721-6733; https://doi.org/10.3390/ijerph10126721 - 3 Dec 2013
Cited by 71 | Viewed by 12737
Abstract
Older people had a high incidence of hospitalisation during the 2009 heat wave in South Australia. We sought to explore resilience, behaviours, health risk factors and health outcomes during recent heat waves for a representative sample of independently living residents. A telephone survey [...] Read more.
Older people had a high incidence of hospitalisation during the 2009 heat wave in South Australia. We sought to explore resilience, behaviours, health risk factors and health outcomes during recent heat waves for a representative sample of independently living residents. A telephone survey of 499 people aged 65 years and over was conducted, and included both metropolitan and rural residences. A variety of adaptive strategies were reported, with 75% maintaining regular appointments and activities during the heat. However, 74% took medication for chronic disease and 25% assessed their health status to be fair to poor. In a multivariate model, factors associated with heat health outcomes included medication for mental health, heart failure, diabetes or respiratory health, reporting a reduced health status, use of mobility aids and being female. Compared with younger participants, those over 75 had more check-up calls and visits by family, friends and neighbours. However, confidence to call on support was associated with indicators of social isolation. The study indicates that older people are generally resilient, but interventions addressing multi-morbidity and medication interactions and social isolation should be developed. Full article
(This article belongs to the Special Issue Climate Change and Human Health)
31 pages, 1514 KiB  
Review
Tissue Engineering of the Corneal Endothelium: A Review of Carrier Materials
by Juliane Teichmann, Monika Valtink, Mirko Nitschke, Stefan Gramm, Richard H.W. Funk, Katrin Engelmann and Carsten Werner
J. Funct. Biomater. 2013, 4(4), 178-208; https://doi.org/10.3390/jfb4040178 - 22 Oct 2013
Cited by 28 | Viewed by 12213
Abstract
Functional impairment of the human corneal endothelium can lead to corneal blindness. In order to meet the high demand for transplants with an appropriate human corneal endothelial cell density as a prerequisite for corneal function, several tissue engineering techniques have been developed to [...] Read more.
Functional impairment of the human corneal endothelium can lead to corneal blindness. In order to meet the high demand for transplants with an appropriate human corneal endothelial cell density as a prerequisite for corneal function, several tissue engineering techniques have been developed to generate transplantable endothelial cell sheets. These approaches range from the use of natural membranes, biological polymers and biosynthetic material compositions, to completely synthetic materials as matrices for corneal endothelial cell sheet generation. This review gives an overview about currently used materials for the generation of transplantable corneal endothelial cell sheets with a special focus on thermo-responsive polymer coatings. Full article
(This article belongs to the Special Issue Advances in Ophthalmic Biomaterials)
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15 pages, 308 KiB  
Article
Perceptions of Heat-Susceptibility in Older Persons: Barriers to Adaptation
by Alana Hansen, Peng Bi, Monika Nitschke, Dino Pisaniello, Jonathan Newbury and Alison Kitson
Int. J. Environ. Res. Public Health 2011, 8(12), 4714-4728; https://doi.org/10.3390/ijerph8124714 - 19 Dec 2011
Cited by 99 | Viewed by 12613
Abstract
The increase in the frequency of very hot weather that is a predicted consequence of climate change poses an emerging threat to public health. Extreme heat can be harmful to the health of older persons who are known to be amongst the most [...] Read more.
The increase in the frequency of very hot weather that is a predicted consequence of climate change poses an emerging threat to public health. Extreme heat can be harmful to the health of older persons who are known to be amongst the most vulnerable in the community. This study aimed to investigate factors influencing the ability of older persons to adapt to hot conditions, and barriers to adaptation. A qualitative study was conducted in Adelaide, Australia, involving focus groups and interviews with stakeholders including key personnel involved in aged care, community services, government sectors, emergency services and policy making. Findings revealed a broad range of factors that underpin the heat-susceptibility of the aged. These were categorized into four broad themes relating to: physiology and an age-related decline in health; socioeconomic factors, particularly those influencing air conditioning use; psychological issues including fears and anxieties about extreme heat; and adaptive strategies that could be identified as both enablers and barriers. As a consequence, the ability and willingness to undertake behavior change during heatwaves can therefore be affected in older persons. Additionally, understanding the control panels on modern air conditioners can present challenges for the aged. Improving heat-health knowledge and addressing the social and economic concerns of the older population will assist in minimizing heat-related morbidity and mortality in a warming climate. Full article
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