International Journal of Environmental Research and Public Health

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Open AccessComment

Comments on: Chari, R.; Burke, T.A.; White, R.H.; Fox, M.A. Integrating Susceptibility into Environmental Policy: An Analysis of the National Ambient Air Quality Standard for Lead. Int. J. Environ. Res. Public Health 2012, 9, 1077–1096

by Teresa S. Bowers

Int. J. Environ. Res. Public Health 2013, 10(2), 742-746; https://doi.org/10.3390/ijerph10020742 - 21 Feb 2013

Viewed by 5234

Abstract

A recent publication in International Journal of Environmental Research and Public Health by Chari et al. [1] provides no basis for changing the National Ambient Air Quality Standard (NAAQS) for lead in the U.S. to protect children in low socio-economic (SES) populations. The [...] Read more.

A recent publication in International Journal of Environmental Research and Public Health by Chari et al. [1] provides no basis for changing the National Ambient Air Quality Standard (NAAQS) for lead in the U.S. to protect children in low socio-economic (SES) populations. The studies selected by Chari et al. for analysis do not provide comparable information on regression coefficients for the blood lead level-IQ relationship. The coefficients differ from one another more on the basis of unequal blood lead metrics, ages of blood lead measurement, and differences in covariate adjustments and standardization, than the difference postulated by Chari et al. to correspond to low vs. high SES populations. Full article

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Open AccessArticle

Changes in Tobacco Use, Susceptibility to Future Smoking, and Quit Attempts among Canadian Youth over Time: A Comparison of Off-Reserve Aboriginal and Non-Aboriginal Youth

by Tara Elton-Marshall, Scott T. Leatherdale, Robin Burkhalter and K. Stephen Brown

Int. J. Environ. Res. Public Health 2013, 10(2), 729-741; https://doi.org/10.3390/ijerph10020729 - 21 Feb 2013

Cited by 13 | Viewed by 7268

Abstract

The purpose of this study was to determine whether there is a growing inequity in tobacco use, susceptibility to future smoking, and quit attempts among Off-Reserve Aboriginal (ORA) youth in Canada relative to Non-Aboriginal youth. Current smoking, susceptibility to future smoking and quit [...] Read more.

The purpose of this study was to determine whether there is a growing inequity in tobacco use, susceptibility to future smoking, and quit attempts among Off-Reserve Aboriginal (ORA) youth in Canada relative to Non-Aboriginal youth. Current smoking, susceptibility to future smoking and quit attempts were examined among a nationally representative sample of ORA and Non-Aboriginal Canadian youth. Data are from cross-sectional surveys of 88,661 respondents in Grades 6 to 9 across the 2004, 2006 and 2008 survey waves of the Youth Smoking Survey (YSS). At each wave, ORA youth were more likely to be current smokers (overall OR = 3.91, 95% CI 3.47 to 4.41), to be susceptible to future smoking (overall OR = 1.37, 95% CI 1.27 to 1.48), and less likely to have ever made a quit attempt compared to Non-Aboriginal youth (overall OR = 0.74, 95% CI 0.57 to 0.96). Although susceptibility to future smoking declined for Non-Aboriginal youth, the prevalence of susceptibility remained stable among ORA youth. The percentage of ORA youth reporting making a quit attempt increased, however, current smoking rates among ORA youth did not decline. These findings suggest that the disparity in susceptibility to future tobacco use among ORA and Non-Aboriginal youth has increased over time. Despite increased rates of quit attempts, current smoking rates remain significantly higher among ORA youth. Tobacco control programs for Aboriginal youth should be a public health priority. Full article

(This article belongs to the Special Issue Tobacco Control in Vulnerable Population Groups)

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Open AccessArticle

Assessing Organ Doses from Paediatric CT Scans—A Novel Approach for an Epidemiology Study (the EPI-CT Study)

by Isabelle Thierry-Chef, Jérémie Dabin, Eva G. Friberg, Johannes Hermen, Tore S. Istad, Andreas Jahnen, Lucian Krille, Choonsik Lee, Carlo Maccia, Arvid Nordenskjöld, Hilde M. Olerud, Kaddour Rani, Jean-Luc Rehel, Steven L. Simon, Lara Struelens and Ausrele Kesminiene

Int. J. Environ. Res. Public Health 2013, 10(2), 717-728; https://doi.org/10.3390/ijerph10020717 - 18 Feb 2013

Cited by 29 | Viewed by 6802

Abstract

The increasing worldwide use of paediatric computed tomography (CT) has led to increasing concerns regarding the subsequent effects of exposure to radiation. In response to this concern, the international EPI-CT project was developed to study the risk of cancer in a large multi-country [...] Read more.

The increasing worldwide use of paediatric computed tomography (CT) has led to increasing concerns regarding the subsequent effects of exposure to radiation. In response to this concern, the international EPI-CT project was developed to study the risk of cancer in a large multi-country cohort. In radiation epidemiology, accurate estimates of organ-specific doses are essential. In EPI-CT, data collection is split into two time periods—before and after introduction of the Picture Archiving Communication System (PACS) introduced in the 1990s. Prior to PACS, only sparse information about scanner settings is available from radiology departments. Hence, a multi-level approach was developed to retrieve information from a questionnaire, surveys, scientific publications, and expert interviews. For the years after PACS was introduced, scanner settings will be extracted from Digital Imaging and Communications in Medicine (DICOM) headers, a protocol for storing medical imaging data. Radiation fields and X-ray interactions within the body will be simulated using phantoms of various ages and Monte-Carlo-based radiation transport calculations. Individual organ doses will be estimated for each child using an accepted calculation strategy, scanner settings, and the radiation transport calculations. Comprehensive analyses of missing and uncertain dosimetry data will be conducted to provide uncertainty distributions of doses. Full article

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139 KiB

Open AccessComment

Comments on: Chari, R.; Burke, T.A.; White, R.H.; Fox, M.A. Integrating Susceptibility into Environmental Policy: An Analysis of the National Ambient Air Quality Standard for Lead. Int. J. Environ. Res. Public Health 2012, 9, 1077-1096

by Deirdre L. Murphy, Molini Patel, Ellen Kirrane and Lisa Vinikoor-Imler

Int. J. Environ. Res. Public Health 2013, 10(2), 712-716; https://doi.org/10.3390/ijerph10020712 - 8 Feb 2013

Viewed by 4694

Abstract

In their recent article [1], Chari et al. call attention to the important subject of setting National Ambient Air Quality Standards (NAAQS) to provide requisite protection for public health, including the health of sensitive groups, as specified under the Clean Air Act (73 [...] Read more.

In their recent article [1], Chari et al. call attention to the important subject of setting National Ambient Air Quality Standards (NAAQS) to provide requisite protection for public health, including the health of sensitive groups, as specified under the Clean Air Act (73 FR 66965) [2]. The authors focus on consideration of susceptibility to inform policy choices, using lead (Pb)-related neurocognitive effects and children from low socioeconomic status (SES) families in the context of alternative Pb standard levels. Our comments focus on the authors’ analysis of the scientific evidence and not on policy. We agree with the authors that the health effects evidence for Pb indicates a role (or roles) for SES-related factors in influencing childhood Pb exposure and associated health effects. We disagree, however, with the authors’ interpretation of the literature on SES influence on the shape of the concentration-response (C-R) relationship between children’s blood Pb and IQ (e.g., steepness of the slope). We further address aspects of the scientific evidence that are important to the consideration of sensitive populations in the context of the Pb NAAQS, and how the U.S. Environmental Protection Agency (EPA) considered this evidence in setting the Pb NAAQS in 2008. Full article

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Open AccessArticle

Placental Transfer of Persistent Organic Pollutants: A Preliminary Study on Mother-Newborn Pairs

by Maria Grazia Porpora, Renato Lucchini, Annalisa Abballe, Anna Maria Ingelido, Silvia Valentini, Eliana Fuggetta, Veronica Cardi, Adele Ticino, Valentina Marra, Anna Rita Fulgenzi and Elena De Felip

Int. J. Environ. Res. Public Health 2013, 10(2), 699-711; https://doi.org/10.3390/ijerph10020699 - 7 Feb 2013

Cited by 76 | Viewed by 6859

Abstract

The aim of this study was to characterize the placental transfer of some environmental pollutants, and to explore the possibility of quantitatively predicting in utero exposure to these contaminants from concentrations assessed in maternal blood. Levels of toxic substances such as pesticides ( [...] Read more.

The aim of this study was to characterize the placental transfer of some environmental pollutants, and to explore the possibility of quantitatively predicting in utero exposure to these contaminants from concentrations assessed in maternal blood. Levels of toxic substances such as pesticides (p,p’-DDE, β-HCH, and HCB), polychlorinated biphenyls (PCBs), perfluorooctane sulfonate (PFOS), and perfluorooctanoic acid (PFOA) were determined in serum samples of 38 pregnant women living in Rome and in samples of cord blood from their respective newborns. The study was carried out in the years 2008–2009. PCB mean concentrations in maternal serum and cord serum ranged from 0.058 to 0.30, and from 0.018 to 0.064 ng/g·fw respectively. Arithmetic means of PFOS and PFOA concentrations in mothers and newborns were 3.2 and 1.4 ng/g·fw, and 2.9 and 1.6 ng/g·fw. A strong correlation was observed between concentrations in the maternal and the foetal compartment for PFOS (Spearman r = 0.74, p < 0.001), PFOA (Spearman r = 0.70, p < 0.001), PCB 153 (Spearman r = 0.60, p < 0.001), HCB (Spearman r = 0.68, p < 0.001), PCB 180 (Spearman r = 0.55, p = 0.0012), and p,p’-DDE (Spearman r = 0.53, p = 0.0099). A weak correlation (p < 0.1) was observed for PCBs 118 and 138. Full article

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Open AccessArticle

Developing an Exploratory Framework Linking Australian Aboriginal Peoples’ Connection to Country and Concepts of Wellbeing

by Jonathan Kingsley, Mardie Townsend, Claire Henderson-Wilson and Bruce Bolam

Int. J. Environ. Res. Public Health 2013, 10(2), 678-698; https://doi.org/10.3390/ijerph10020678 - 7 Feb 2013

Cited by 121 | Viewed by 59027

Abstract

Aboriginal people across Australia suffer significant health inequalities compared with the non-Indigenous population. Evidence indicates that inroads can be made to reduce these inequalities by better understanding social and cultural determinants of health, applying holistic notions of health and developing less rigid definitions [...] Read more.

Aboriginal people across Australia suffer significant health inequalities compared with the non-Indigenous population. Evidence indicates that inroads can be made to reduce these inequalities by better understanding social and cultural determinants of health, applying holistic notions of health and developing less rigid definitions of wellbeing. The following article draws on qualitative research on Victorian Aboriginal peoples’ relationship to their traditional land (known as Country) and its link to wellbeing, in an attempt to tackle this. Concepts of wellbeing, Country and nature have also been reviewed to gain an understanding of this relationship. An exploratory framework has been developed to understand this phenomenon focusing on positive (e.g., ancestry and partnerships) and negative (e.g., destruction of Country and racism) factors contributing to Aboriginal peoples’ health. The outcome is an explanation of how Country is a fundamental component of Aboriginal Victorian peoples’ wellbeing and the framework articulates the forces that impact positively and negatively on this duality. This review is critical to improving not only Aboriginal peoples’ health but also the capacity of all humanity to deal with environmental issues like disconnection from nature and urbanisation. Full article

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Open AccessArticle

The Long-Term Relationship between Population Growth and Vegetation Cover: An Empirical Analysis Based on the Panel Data of 21 Cities in Guangdong Province, China

by Chao Li, Yaoqiu Kuang, Ningsheng Huang and Chao Zhang

Int. J. Environ. Res. Public Health 2013, 10(2), 660-677; https://doi.org/10.3390/ijerph10020660 - 7 Feb 2013

Cited by 32 | Viewed by 8102

Abstract

It is generally believed that there is an inverse relationship between population growth and vegetation cover. However, reports about vegetation protection and reforestation around the World have been continuously increasing in recent decades, which seems to indicate that this relationship may not be [...] Read more.

It is generally believed that there is an inverse relationship between population growth and vegetation cover. However, reports about vegetation protection and reforestation around the World have been continuously increasing in recent decades, which seems to indicate that this relationship may not be true. In this paper, we have taken 21 cities in Guangdong Province, China as the study area to test the long-term relationship between population growth and vegetation cover, using an AVHRR NDVI data set and the panel cointegrated regression method. The results show that there is a long-term inverted N-shaped curve relationship between population growth and vegetation cover in the region where there are frequent human activities and the influence of climate change on vegetation cover changes is relatively small. The two turning points of the inverted N-shaped curve for the case of Guangdong Province correspond to 2,200 persons·km⁻² and 3,820 persons·km⁻², and they can provide a reference range for similar regions of the World. It also states that the population urbanization may have a negative impact on the vegetation cover at the early stage, but have a positive impact at the later stage. In addition, the Panel Error Correction Model (PECM) is used to investigate the causality direction between population growth and vegetation cover. The results show that not only will the consuming destruction effect and planting construction effect induced by the population growth have a great impact on vegetation cover changes, but vegetation cover changes in turn will also affect the population growth in the long term. Full article

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Open AccessArticle

The Influence of Fish Length on Tissue Mercury Dynamics: Implications for Natural Resource Management and Human Health Risk

by Dana K. Sackett, W. Gregory Cope, James A. Rice and D. Derek Aday

Int. J. Environ. Res. Public Health 2013, 10(2), 638-659; https://doi.org/10.3390/ijerph10020638 - 6 Feb 2013

Cited by 50 | Viewed by 6758

Abstract

Consumption of fish has well-known human health benefits, though some fish may contain elevated levels of mercury (Hg) that are especially harmful to developing children. Fish length is most often the basis for establishing fishery harvest regulations that determine which fish will ultimately [...] Read more.

Consumption of fish has well-known human health benefits, though some fish may contain elevated levels of mercury (Hg) that are especially harmful to developing children. Fish length is most often the basis for establishing fishery harvest regulations that determine which fish will ultimately be consumed by humans. It is, therefore, essential to quantify the relationship between fish length and Hg accumulation in regard to harvest regulations for effective fishery and public health policy. We examined this relationship for three sportfish from six lakes across North Carolina, USA. Bluegill (Lepomis macrochirus) had the lowest Hg levels and only the very largest fish in the most contaminated site exceeded the US Environmental Protection Agency (USEPA) Hg screening level. Black crappie (Pomoxis nigromaculatus) had an intermediate level of Hg and larger individuals exceeded the USEPA screening level; however, they tended not to exceed this level before reaching the harvest length limit. Largemouth bass (Micropterus salmoides) exceeded the USEPA screening level at sizes below the fishery length limit in two lakes, leaving only higher risk fish for anglers to harvest and consume. Removing the effects of fish age and trophic position, we found strong positive correlations between Hg and fish length for largemouth bass and black crappie. We suggest public health officials and wildlife managers collaborate to structure fishery regulations and length-based fish consumption advisories that protect consumers from Hg exposure and communicate the relative risk of fish consumption. Full article

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Open AccessArticle

“Hike up yer Skirt, and Quit.” What Motivates and Supports Smoking Cessation in Builders and Renovators

by Susan J. Bondy and Kim L. Bercovitz

Int. J. Environ. Res. Public Health 2013, 10(2), 623-637; https://doi.org/10.3390/ijerph10020623 - 4 Feb 2013

Cited by 7 | Viewed by 6822

Abstract

Construction-related occupations have very high smoking prevalence rates and are an identified priority population for efforts to promote cessation. This study sought to identify the smoking cessation supports and services which best suited this workforce group, and to identify gaps in reach of [...] Read more.

Construction-related occupations have very high smoking prevalence rates and are an identified priority population for efforts to promote cessation. This study sought to identify the smoking cessation supports and services which best suited this workforce group, and to identify gaps in reach of preventive health services. We performed qualitative text analysis on pre-existing conversations about smoking cessation among workers in this sector. The material appeared on a discussion forum about residential construction from 1998 and 2011. Roughly 250 unique user names appeared in these discussions. The qualitative analysis addressed knowledge, motivation, environmental influences, and positive and negative experiences with supports for cessation. Self-identified smokers tended to want to quit and described little social value in smoking. Actual quit attempts were attributed to aging and tangible changes in health and fitness. Peer-to-peer social support for cessation was evident. Advice given was to avoid cigarettes and smokers, to focus on personal skills, personal commitment, and the benefits of cessation (beyond the harms from smoking). Many discussants had received medical support for cessation, but behavioural counselling services appeared underutilized. Our findings support efforts toward more complete bans on workplace smoking and increased promotion of available behavioural support services among dispersed blue-collar workers. Full article

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Open AccessArticle

Comparison of Health Status and Health Care Services Utilization between Migrants and Natives of the Same Ethnic Origin—The Case of Hong Kong

by Su Liu, Catherine X. J. Hu and Selene Mak

Int. J. Environ. Res. Public Health 2013, 10(2), 606-622; https://doi.org/10.3390/ijerph10020606 - 4 Feb 2013

Cited by 20 | Viewed by 6651

Abstract

Based on the 2009 Thematic Household Survey in Hong Kong, this study compared health status and utilization of health care services in Hong Kong between migrants from Mainland China and natives. Overall, Mainland migrants reported lower socioeconomic conditions, worse health status, and less [...] Read more.

Based on the 2009 Thematic Household Survey in Hong Kong, this study compared health status and utilization of health care services in Hong Kong between migrants from Mainland China and natives. Overall, Mainland migrants reported lower socioeconomic conditions, worse health status, and less health care services utilization than the natives. After controlling for socio-demographic factors, we found that the migrants were 1.2 times more likely to report fair or poor health and 0.78 times less likely to report having a usual source of care, compared with the natives. Mainland migrants also had fewer physician visits and relied more on the public sector. Within the migrant group, those who had language advantage had more visits, and the recent arrivals who stayed in Hong Kong for three years or less had fewer visits and were far less likely to have a usual source of care. The findings underscore migration as an important social determinant of health in Hong Kong. A combination of targeted social and health policies is needed to help Mainland migrants better integrate into society and to improve their access to care. Programs should be tailored to address varying needs from different subgroups among migrants. Full article

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Open AccessArticle

High Dosage Folic Acid Supplementation, Oral Cleft Recurrence and Fetal Growth

by George L. Wehby, Têmis Maria Félix, Norman Goco, Antonio Richieri-Costa, Hrishikesh Chakraborty, Josiane Souza, Rui Pereira, Carla Padovani, Danilo Moretti-Ferreira and Jeffrey C. Murray

Int. J. Environ. Res. Public Health 2013, 10(2), 590-605; https://doi.org/10.3390/ijerph10020590 - 4 Feb 2013

Cited by 30 | Viewed by 11341

Abstract

Objectives: To evaluate the effects of folic acid supplementation on isolated oral cleft recurrence and fetal growth. Patients and Methods: The study included 2,508 women who were at-risk for oral cleft recurrence and randomized into two folic acid supplementation groups: 0.4 [...] Read more.

Objectives: To evaluate the effects of folic acid supplementation on isolated oral cleft recurrence and fetal growth. Patients and Methods: The study included 2,508 women who were at-risk for oral cleft recurrence and randomized into two folic acid supplementation groups: 0.4 and 4 mg per day before pregnancy and throughout the first trimester. The infant outcome data were based on 234 live births. In addition to oral cleft recurrence, several secondary outcomes were compared between the two folic acid groups. Cleft recurrence rates were also compared to historic recurrence rates. Results: The oral cleft recurrence rates were 2.9% and 2.5% in the 0.4 and 4 mg groups, respectively. The recurrence rates in the two folic acid groups both separately and combined were significantly different from the 6.3% historic recurrence rate post the folic acid fortification program for this population (p = 0.0009 when combining the two folic acid groups). The rate of cleft lip with palate recurrence was 2.9% in the 0.4 mg group and 0.8% in the 4 mg group. There were no elevated fetal growth complications in the 4 mg group compared to the 0.4 mg group. Conclusions: The study is the first double-blinded randomized clinical trial (RCT) to study the effect of high dosage folic acid supplementation on isolated oral cleft recurrence. The recurrence rates were similar between the two folic acid groups. However, the results are suggestive of a decrease in oral cleft recurrence compared to the historic recurrence rate. A RCT is still needed to identify the effect of folic acid on oral cleft recurrence given these suggestive results and the supportive results from previous interventional and observational studies, and the study offers suggestions for such future studies. The results also suggest that high dosage folic acid does not compromise fetal growth. Full article

(This article belongs to the Special Issue Birth Defect Prevention)

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Open AccessArticle

Investigating Individual- and Area-Level Socioeconomic Gradients of Pulse Pressure among Normotensive and Hypertensive Participants

by Lisa A. Matricciani, Catherine Paquet, Natasha J. Howard, Robert Adams, Neil T. Coffee, Anne W. Taylor and Mark Daniel

Int. J. Environ. Res. Public Health 2013, 10(2), 571-589; https://doi.org/10.3390/ijerph10020571 - 4 Feb 2013

Cited by 6 | Viewed by 6621

Abstract

Socioeconomic status is a strong predictor of cardiovascular disease. Pulse pressure, the difference between systolic and diastolic blood pressure, has been identified as an important predictor of cardiovascular risk even after accounting for absolute measures of blood pressure. However, little is known about [...] Read more.

Socioeconomic status is a strong predictor of cardiovascular disease. Pulse pressure, the difference between systolic and diastolic blood pressure, has been identified as an important predictor of cardiovascular risk even after accounting for absolute measures of blood pressure. However, little is known about the social determinants of pulse pressure. The aim of this study was to examine individual- and area-level socioeconomic gradients of pulse pressure in a sample of 2,789 Australian adults. Using data from the North West Adelaide Health Study we estimated the association between pulse pressure and three indices of socioeconomic status (education, income and employment status) at the area and individual level for hypertensive and normotensive participants, using Generalized Estimating Equations. In normotensive individuals, area-level education (estimate: −0.106; 95% CI: −0.172, −0.041) and individual-level income (estimate: −1.204; 95% CI: −2.357, −0.050) and employment status (estimate: −1.971; 95% CI: −2.894, −1.048) were significant predictors of pulse pressure, even after accounting for the use of medication and lifestyle behaviors. In hypertensive individuals, only individual-level measures of socioeconomic status were significant predictors of pulse pressure (education estimate: −2.618; 95% CI: −4.878, −0.357; income estimate: −1.683, 95% CI: −3.743, 0.377; employment estimate: −2.023; 95% CI: −3.721, −0.326). Further research is needed to better understand how individual- and area-level socioeconomic status influences pulse pressure in normotensive and hypertensive individuals. Full article

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Open AccessEditorial

Child Injury Prevention: An Overlooked Challenge for Child Survival

by David Meddings

Int. J. Environ. Res. Public Health 2013, 10(2), 568-570; https://doi.org/10.3390/ijerph10020568 - 1 Feb 2013

Cited by 4 | Viewed by 4866

Abstract

Those interested in child survival frequently cite and follow the under-five mortality rate. While a useful measure, the under-five mortality rate lumps together neonatal and post-neonatal mortality with deaths in the 1–4 year period. Unfortunately, this hampers public health decision making about the [...] Read more.

Those interested in child survival frequently cite and follow the under-five mortality rate. While a useful measure, the under-five mortality rate lumps together neonatal and post-neonatal mortality with deaths in the 1–4 year period. Unfortunately, this hampers public health decision making about the most appropriate child survival strategies as children survive beyond their first year of life. [...] Full article

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Open AccessArticle

Infectious Risk Assessment of Unsafe Handling Practices and Management of Clinical Solid Waste

by Md. Sohrab Hossain, Nik Norulaini Nik Ab Rahman, Venugopal Balakrishnan, Vignesh R. Puvanesuaran, Md. Zaidul Islam Sarker and Mohd Omar Ab Kadir

Int. J. Environ. Res. Public Health 2013, 10(2), 556-567; https://doi.org/10.3390/ijerph10020556 - 31 Jan 2013

Cited by 32 | Viewed by 14527

Abstract

The present study was undertaken to determine the bacterial agents present in various clinical solid wastes, general waste and clinical sharp waste. The waste was collected from different wards/units in a healthcare facility in Penang Island, Malaysia. The presence of bacterial agents in [...] Read more.

The present study was undertaken to determine the bacterial agents present in various clinical solid wastes, general waste and clinical sharp waste. The waste was collected from different wards/units in a healthcare facility in Penang Island, Malaysia. The presence of bacterial agents in clinical and general waste was determined using the conventional bacteria identification methods. Several pathogenic bacteria including opportunistic bacterial agent such as Pseudomonas aeruginosa, Salmonella spp., Klebsiella pneumoniae, Serratia marcescens, Acinetobacter baumannii, Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus pyogenes were detected in clinical solid wastes. The presence of specific pathogenic bacterial strains in clinical sharp waste was determined using 16s rDNA analysis. In this study, several nosocomial pathogenic bacteria strains of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Lysinibacillus sphaericus, Serratia marcescens, and Staphylococcus aureus were detected in clinical sharp waste. The present study suggests that waste generated from healthcare facilities should be sterilized at the point of generation in order to eliminate nosocomial infections from the general waste or either of the clinical wastes. Full article

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Open AccessArticle

Assessment of the Levels of Airborne Bacteria, Gram-Negative Bacteria, and Fungi in Hospital Lobbies

by Dong-Uk Park, Jeong-Kwan Yeom, Won Jae Lee and Kyeong-Min Lee

Int. J. Environ. Res. Public Health 2013, 10(2), 541-555; https://doi.org/10.3390/ijerph10020541 - 31 Jan 2013

Cited by 104 | Viewed by 10232

Abstract

Aims: We assessed the levels of airborne bacteria, Gram-negative bacteria (GNB), and fungi in six hospital lobbies, and investigated the environmental and hospital characteristics that affected the airborne microorganism levels. Methods: An Andersen single-stage sampler equipped with appropriate nutrition plate agar was used [...] Read more.

Aims: We assessed the levels of airborne bacteria, Gram-negative bacteria (GNB), and fungi in six hospital lobbies, and investigated the environmental and hospital characteristics that affected the airborne microorganism levels. Methods: An Andersen single-stage sampler equipped with appropriate nutrition plate agar was used to collect the samples. The three types of microorganisms were repeatedly collected at a fixed location in each hospital (assumed to be representative of the entire hospital lobby) from 08:00 through 24:00, with a sampling time of less than 5 min. Temperature and relative humidity were simultaneously monitored. Results: Multiple regression analysis was used to identify the major factors affecting microorganism levels. The average levels of bacteria (7.2 × 10² CFU/m³), GNB (1.7 × 10 CFU/m³), and fungi (7.7 × 10 CFU/m³) indicated that all hospital lobbies were generally contaminated. Season was the only factor that significantly affected the levels of all microorganisms (p < 0.0001), where contamination was the highest during the summer, significantly higher than during the winter. Other significant factors varied by microorganism, as follows: airborne bacteria (number of people in the lobby, sampling time), GNB (scale of hospital), and fungi (humidity and air temperature). Conclusions: Hospital lobby air was generally contaminated with microorganisms, including bacteria, GNB, and fungi. Environmental factors that may significantly influence the airborne concentrations of these agents should be managed to minimize airborne levels. Full article

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Open AccessArticle

Childhood Mortality Due to Unintentional Injuries in Japan, 2000–2009

by Hideaki Sekii, Tadahiro Ohtsu, Takako Shirasawa, Hirotaka Ochiai, Takaya Shimizu and Akatsuki Kokaze

Int. J. Environ. Res. Public Health 2013, 10(2), 528-540; https://doi.org/10.3390/ijerph10020528 - 30 Jan 2013

Cited by 28 | Viewed by 6128

Abstract

This study examined deaths due to unintentional injuries among children in Japan to identify the age groups and sexes at most risk, and the types of injuries, so that effective forms of targeted intervention can be devised. Among children aged 0–14 years, deaths [...] Read more.

This study examined deaths due to unintentional injuries among children in Japan to identify the age groups and sexes at most risk, and the types of injuries, so that effective forms of targeted intervention can be devised. Among children aged 0–14 years, deaths whose underlying causes had been classified under code V01-X59 of the ICD-10 were defined as deaths of children caused by unintentional injuries. Using data from the Vital Statistics 2000–2009 for analysis, we examined the changes in mortality and trends in terms of sex, age, and cause of death. Mortality decreased by 46.2%, from 933 in 2000 to 502 in 2009. The mortality rate among children aged 1–4 years decreased by almost half. The total number of deaths during this decade was 7,362 (boys: 4,690, girls: 2,672). Among the causes of death, the majority were due to “transport accidents”, followed by “other accidental threats to breathing”, and “accidental drowning and submersion”. The characteristics observed in terms of sex, age, and cause of death—that is, deaths from suffocation among infants aged less than 1 year, drowning deaths among boys, and transport accidents involving pedestrians and cyclists—must be addressed as targets for future intervention. Full article

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Open AccessArticle

The Influence of Monitoring Interval on Data Measurement: An Analysis of Step Counts of University Students

by Dagmar Sigmundová, Jana Vašíčková, Jiří Stelzer and Emil Řepka

Int. J. Environ. Res. Public Health 2013, 10(2), 515-527; https://doi.org/10.3390/ijerph10020515 - 28 Jan 2013

Cited by 9 | Viewed by 6544

Abstract

The pedometer is a widely used research tool for measuring the level and extent of physical activity (PA) within population subgroups. The sample used in this study was drawn from a population of university students to examine the influence of the monitoring interval [...] Read more.

The pedometer is a widely used research tool for measuring the level and extent of physical activity (PA) within population subgroups. The sample used in this study was drawn from a population of university students to examine the influence of the monitoring interval and alternate starting days on step-count activity patterns. The study was part of a national project during 2008–2010. Eligible subjects (641) were selected from a sample of 906 university students. The students wore pedometers continuously for 7 days excluding time for sleep and personal hygiene. Steps per day were logged on record sheets by each student. Data gathering spanned an entire week, and the results were sorted by alternate starting days, by activity for an entire week, by activity for only the weekdays of the one-week monitoring interval and for the two-day weekend. The statistical analysis included ANOVA, intra-class correlation (ICC) analysis, and regression analysis. The ICC analysis suggested that monitoring starting on Monday (ICC = 0.71; 95%CI (0.61–0.79)), Tuesday (ICC = 0.67; 95%CI (0.59–0.75)) or Thursday (ICC = 0.68; 95%CI (0.55–0.79)) improved reliability. The results of regression analysis also indicated that any starting day except Sunday is satisfactory as long as a minimum of four days of monitoring are used. Full article

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Open AccessArticle

Ecological Niche Modelling of Bank Voles in Western Europe

by Sara Amirpour Haredasht, Miguel Barrios, Jamshid Farifteh, Piet Maes, Jan Clement, Willem W. Verstraeten, Katrien Tersago, Marc Van Ranst, Pol Coppin, Daniel Berckmans and Jean-Marie Aerts

Int. J. Environ. Res. Public Health 2013, 10(2), 499-514; https://doi.org/10.3390/ijerph10020499 - 28 Jan 2013

Cited by 13 | Viewed by 7715

Abstract

The bank vole (Myodes glareolus) is the natural host of Puumala virus (PUUV) in vast areas of Europe. PUUV is one of the hantaviruses which are transmitted to humans by infected rodents. PUUV causes a general mild form of hemorrhagic fever with renal [...] Read more.

The bank vole (Myodes glareolus) is the natural host of Puumala virus (PUUV) in vast areas of Europe. PUUV is one of the hantaviruses which are transmitted to humans by infected rodents. PUUV causes a general mild form of hemorrhagic fever with renal syndrome (HFRS) called nephropathia epidemica (NE). Vector-borne and zoonotic diseases generally display clear spatial patterns due to different space-dependent factors. Land cover influences disease transmission by controlling both the spatial distribution of vectors or hosts, as well as by facilitating the human contact with them. In this study the use of ecological niche modelling (ENM) for predicting the geographical distribution of bank vole population on the basis of spatial climate information is tested. The Genetic Algorithm for Rule-set Prediction (GARP) is used to model the ecological niche of bank voles in Western Europe. The meteorological data, land cover types and geo-referenced points representing the locations of the bank voles (latitude/longitude) in the study area are used as the primary model input value. The predictive accuracy of the bank vole ecologic niche model was significant (training accuracy of 86%). The output of the GARP models based on the 50% subsets of points used for testing the model showed an accuracy of 75%. Compared with random models, the probability of such high predictivity was low (χ² tests, p < 10⁻⁶). As such, the GARP models were predictive and the used ecologic niche model indeed indicates the ecologic requirements of bank voles. This approach successfully identified the areas of infection risk across the study area. The result suggests that the niche modelling approach can be implemented in a next step towards the development of new tools for monitoring the bank vole’s population. Full article

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Open AccessCommunication

Urban Public Health: Is There a Pyramid?

by Meirong Su, Bin Chen, Zhifeng Yang, Yanpeng Cai and Jiao Wang

Int. J. Environ. Res. Public Health 2013, 10(2), 490-498; https://doi.org/10.3390/ijerph10020490 - 28 Jan 2013

Cited by 2 | Viewed by 6052

Abstract

Early ecologists identified a pyramidal trophic structure in terms of number, biomass and energy transfer. In 1943, the psychologist Maslow put forward a pyramid model to describe layers of human needs. It is indicated that the pyramid principle is universally applicable in natural, [...] Read more.

Early ecologists identified a pyramidal trophic structure in terms of number, biomass and energy transfer. In 1943, the psychologist Maslow put forward a pyramid model to describe layers of human needs. It is indicated that the pyramid principle is universally applicable in natural, humanistic and social disciplines. Here, we report that a pyramid structure also exists in urban public health (UPH). Based on 18 indicators, the UPH states of four cities (Beijing, Tokyo, New York, and London) are compared from the point of view of five aspects, namely physical health, living conditions, social security, environmental quality, and education and culture. A pyramid structure was found in each city when focusing on 2000–2009 data. The pyramid of Beijing is relatively similar to that of Tokyo, and the pyramids of New York and London are similar to each other. A general development trend in UPH is proposed and represented by different pyramid modes. As a basic conjecture, the UPH pyramid model can be verified and developed with data of more cities over a longer period, and be used to promote healthy urban development. Full article

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Open AccessArticle

Identifying the Relationships between Water Quality and Land Cover Changes in the Tseng-Wen Reservoir Watershed of Taiwan

by Hone-Jay Chu, Chun-Yu Liu and Chi-Kuei Wang

Int. J. Environ. Res. Public Health 2013, 10(2), 478-489; https://doi.org/10.3390/ijerph10020478 - 28 Jan 2013

Cited by 36 | Viewed by 8981

Abstract

The effects on water quality of land use and land cover changes, which are associated with human activities and natural factors, are poorly identified. Fine resolution satellite imagery provides opportunities for land cover monitoring and assessment. The multiple satellite images after typhoon events [...] Read more.

The effects on water quality of land use and land cover changes, which are associated with human activities and natural factors, are poorly identified. Fine resolution satellite imagery provides opportunities for land cover monitoring and assessment. The multiple satellite images after typhoon events collected from 2001 to 2010 covering land areas and land cover conditions are evaluated by the Normalized Difference Vegetation Index (NDVI). The relationship between land cover and observed water quality, such as suspended solids (SS) and nitrate-nitrogens (NO₃-N), are explored in the study area. Results show that the long-term variations in water quality are explained by NDVI data in the reservoir buffer zones. Suspended solid and nitrate concentrations are related to average NDVI values on multiple spatial scales. Annual NO₃-N concentrations are positively correlated with an average NDVI with a 1 km reservoir buffer area, and the SS after typhoon events associated with landslides are negatively correlated with the average NDVI in the entire watershed. This study provides an approach for assessing the influences of land cover on variations in water quality. Full article

(This article belongs to the Special Issue Assessment, Management, and Policy-Making for Environmental Pollution Related to Land Use and Land Cover)

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576 KiB

Open AccessArticle

Short-Term Effects of Gaseous Pollutants and Particulate Matter on Daily Hospital Admissions for Cardio-Cerebrovascular Disease in Lanzhou: Evidence from a Heavily Polluted City in China

by Shan Zheng, Minzhen Wang, Shigong Wang, Yan Tao and Kezheng Shang

Int. J. Environ. Res. Public Health 2013, 10(2), 462-477; https://doi.org/10.3390/ijerph10020462 - 28 Jan 2013

Cited by 40 | Viewed by 8799

Abstract

Panel studies show a consistent association between increase in the cardiovascular hospitalizations with air pollutants in economically developed regions, but little evidence in less developed inland areas. In this study, a time-series analysis was used to examine the specific effects of major air [...] Read more.

Panel studies show a consistent association between increase in the cardiovascular hospitalizations with air pollutants in economically developed regions, but little evidence in less developed inland areas. In this study, a time-series analysis was used to examine the specific effects of major air pollutants [particulate matter less than 10 microns in diameter (PM₁₀), sulfur dioxide (SO₂), and nitrogen dioxides (NO₂)] on daily hospital admissions for cardio-cerebrovascular diseases in Lanzhou, a heavily polluted city in China. We examined the effects of air pollutants for stratified groups by age and gender, and conducted the modifying effect of seasons on air pollutants to test the possible interaction. The significant associations were found between PM₁₀, SO₂ and NO₂ and cardiac disease admissions, SO₂ and NO₂ were found to be associated with the cerebrovascular disease admissions. The elderly was associated more strongly with gaseous pollutants than younger. The modifying effect of seasons on air pollutants also existed. The significant effect of gaseous pollutants (SO₂ and NO₂) was found on daily hospital admissions even after adjustment for other pollutants except for SO₂ on cardiac diseases. In a word, this study provides the evidence for the detrimental short-term health effects of urban gaseous pollutants on cardio-cerebrovascular diseases in Lanzhou. Full article

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Open AccessArticle

Impact of an Electronic Cigarette on Smoking Reduction and Cessation in Schizophrenic Smokers: A Prospective 12-Month Pilot Study

by Pasquale Caponnetto, Roberta Auditore, Cristina Russo, Giorgio Carlo Cappello and Riccardo Polosa

Int. J. Environ. Res. Public Health 2013, 10(2), 446-461; https://doi.org/10.3390/ijerph10020446 - 28 Jan 2013

Cited by 170 | Viewed by 25331

Abstract

Background: Cigarette smoking is a tough addiction to break. This dependence is the most common dual diagnosis for individuals with schizophrenia. Currently three effective drugs are approved for smoking cessation: nicotine replacement therapy (NRT), varenicline and bupropion. However, some serious side effects [...] Read more.

Background: Cigarette smoking is a tough addiction to break. This dependence is the most common dual diagnosis for individuals with schizophrenia. Currently three effective drugs are approved for smoking cessation: nicotine replacement therapy (NRT), varenicline and bupropion. However, some serious side effects of varenicline have been reported, including depression, suicidal thoughts, and suicide. The use of bupropion also has side effects. It should not be used by people who have epilepsy or any condition that lowers the seizure threshold, nor by people who take a specific class of drugs called monoamine oxidase inhibitors. Hence, there are pharmacodynamic reason to believe they could precipitate or exacerbate psychosis. For its capacity to deliver nicotine and provide a coping mechanism for conditioned smoking cues by replacing some of the rituals associated with smoking gestures, electronic-cigarettes may reduce nicotine withdrawal symptoms without serious side effects. Our recent work with ECs in healthy smokers not intending to quit consistently show surprisingly high success rates. We hypothesised that these positive findings could be replicated in difficult patients with schizophrenia This tool may help smokers with schizophrenia remain abstinent during their quitting attempts or to reduce cigarette consumption. Efficacy and safety of these devices in long-term smoking cessation and/or smoking reduction studies have never been investigated for this special population. Methods: In this study we monitored possible modifications in smoking habits of 14 smokers (not intending to quit) with schizophrenia experimenting with the “Categoria” e-Cigarette with a focus on smoking reduction and smoking abstinence. Study participants were invited to attend six study visits: at baseline, week-4, week-8, week-12 week-24 and week 52. Product use, number of cigarettes smoked, carbon monoxide in exhaled breath (eCO) and positive and negative symptoms of schizophrenia levels were measured at each visit. Smoking reduction and abstinence rates were calculated. Adverse events were also reviewed. Results: Sustained 50% reduction in the number of cig/day at week-52 was shown in 7/14 (50%) participants; their median of 30 cig/day decreasing significantly to 15 cig/day (p = 0.018). Sustained smoking abstinence at week-52 was observed in 2/14 (14.3%) participants. Combined sustained 50% reduction and smoking abstinence was shown in 9/14 (64.3%) participants. Nausea was observed in 2/14 (14.4%) of participants, throat irritation in 2/14 (14.4%) of participants, headache in 2/14 (14.4%) of participants , and dry cough in 4/14 (28.6%) of participants. However, these adverse events diminished substantially by week-24. Overall, one to two cartridges/day were used throughout the study. Positive and negative symptoms of schizophrenia are not increased after smoking reduction/cessation in patients using e-cigarettes. Conclusions: We have shown for the first time that the use of e-cigarette substantially decreased cigarette consumption without causing significant side effects in chronic schizophrenic patients who smoke not intending to quit. This was achieved without negative impacts on the symptoms of schizophrenia as assessed by SAPS and SANS symptoms scales. Full article

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Int. J. Environ. Res. Public Health, Volume 10, Issue 2 (February 2013) – 22 articles , Pages 446-746

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