Παρασκευή 29 Ιουλίου 2016

Cross-shift study of exposure-response relationships between bioaerosol exposure and respiratory effects in the Norwegian grain and animal feed production industry

Objective

We have studied cross-shift respiratory responses of several individual bioaerosol components of the dust in the grain and feed industry in Norway.

Methods

Cross-shift changes in lung function and nasal congestion, as well as in respiratory and systemic symptoms of 56 exposed workers and 36 referents, were recorded on the same day as full-shift exposure to the inhalable aerosol fraction was assessed. Exposure–response associations were investigated by regression analysis.

Results

The workers were exposed on average to 1.0 mg/m3 of grain dust, 440 EU/m3 of endotoxin, 6 µg/m3 of β-1,3-glucans, 17x104/m3 of bacteria and 4x104/m3 of fungal spores during work. The exposure was associated with higher prevalence of self-reported eye and airway symptoms, which were related to the individual microbial components in a complex manner. Fatigue and nose symptoms were strongest associated with fungal spores, cough with or without phlegm was associated with grain dust and fungal spores equally strong and wheeze/tight chest/dyspnoea was strongest associated with grain dust. Bioaerosol exposure did not lead to cross-shift lung function decline, but several microbial components had influence on nose congestion.

Conclusions

Exposure to fungal spores and dust showed stronger associations with respiratory symptoms and fatigue than endotoxin exposure. The associations with dust suggest that there are other components in dust than the ones studied that induce these effects.



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IJERPH, Vol. 13, Pages 768: Analysis of Consumption of Energy Drinks by a Group of Adolescent Athletes

Background: Energy drinks (EDs) have become widely popular among young adults and, even more so, among adolescents. Increasingly, they are consumed by athletes, particularly those who have just begun their sporting career. Uncontrolled and high consumption of EDs, in addition to other sources of caffeine, may pose a threat to the health of young people. Hence, our objective was to analyze the consumption of EDs among teenagers engaged in sports, including quantity consumed, identification of factors influencing consumption, and risks associated with EDs and EDs mixed with alcohol (AmEDs). Methods: The study involved a specially designed questionnaire, which was completed by 707 students, 14.3 years of age on average, attending secondary sports schools. Results: EDs were consumed by 69% of the young athletes, 17% of whom drank EDs quite often: every day or 1–3 times a week. Most respondents felt no effects after drinking EDs, but some reported symptoms, including insomnia, anxiety, tachycardia, nervousness and irritability. The major determinant of the choice of EDs was taste (47%), followed by price (21%). One in ten respondents admitted to consumption of AmEDs. Among the consequences reported were: abdominal pains, nausea, vomiting, amnesia, headache, and hangover. Conclusions: EDs consumption among adolescent athletes was relatively high. Considering the habit of AmEDs and literature data, it is worth emphasizing that it may lead to health problems in the near future, alcohol- or drug-dependence, as well as other types of risk behaviour.

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IJERPH, Vol. 13, Pages 770: Prevalence and Risk Factors of Heart Failure with Preserved Ejection Fraction: A Population-Based Study in Northeast China

Background: Heart failure with preserved ejection fraction (HFpEF) has attracted increasing attention worldwide. We aimed to estimate the prevalence of HFpEF and analyze its correlates in a sample of residents of northeast China; Methods: A population-based study of 2230 participants ≥35 years old was conducted in rural areas of Liaoning Province from January 2012 through August 2013. Information about lifestyle and other potential risk factors was obtained. HFpEF was diagnosed according to the recommendations of European Society of Cardiology; Results: The overall prevalence of HFpEF was 3.5% (1.8% in men and 4.9% in women). The prevalence of HFpEF increased with age in both genders and was greater in women than in men for every age group. Multivariable logistic regression analysis found that female gender (OR, 3.575; 95% CI, 1.761–7.256), hypertension (OR, 3.711; 95% CI, 2.064–6.674), and history of heart disease (2.086; 95% CI, 1.243–3.498) were associated factors for prevalent HFpEF; Conclusions: In a general population from rural northeast China, we found that female gender, hypertension, and history of heart disease were risk factors for prevalent HFpEF.

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IJERPH, Vol. 13, Pages 769: The Optimum Production Method for Quality Improvement of Recycled Aggregates Using Sulfuric Acid and the Abrasion Method

There has been increased deconstruction and demolition of reinforced concrete structures due to the aging of the structures and redevelopment of urban areas resulting in the generation of massive amounts of construction. The production volume of waste concrete is projected to increase rapidly over 100 million tons by 2020. However, due to the high cement paste content, recycled aggregates have low density and high absorption ratio. They are mostly used for land reclamation purposes with low added value instead of multiple approaches. This study was performed to determine an effective method to remove cement paste from recycled aggregates by using the abrasion and substituting the process water with acidic water. The aim of this study is to analyze the quality of the recycled fine aggregates produced by a complex method and investigate the optimum manufacturing conditions for recycled fine aggregates based on the design of experiment. The experimental parameters considered were water ratio, coarse aggregate ratio, and abrasion time and, as a result of the experiment, data concerning the properties of recycled sand were obtained. It was found that high-quality recycled fine aggregates can be obtained with 8.57 min of abrasion-crusher time and a recycled coarse aggregate ratio of over 1.5.

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Πέμπτη 28 Ιουλίου 2016

IJERPH, Vol. 13, Pages 767: Polybrominated Diphenyl Ethers in Maternal Serum, Breast Milk, Umbilical Cord Serum, and House Dust in a South Korean Birth Panel of Mother-Neonate Pairs

Polybrominated diphenyl ethers (PBDEs) have been used as flame retardants. Although many reports have indicated an association between exposure to PBDEs and developmental neurotoxicity, the relative contributions of different sources of dust PBDE congeners to the levels in various tissues of mother–baby pairs is not well understood. The aims of this study were thus to measure the quantitative relationship between the level of PBDEs in house dust and tissues of mother-neonate pairs, and to investigate the chemical sources of the PBDEs. Forty-one mother-neonate pairs were recruited and provided samples of maternal serum (n = 29), umbilical cord serum (n = 25), breast milk (n = 50), and house dust (n = 41), where PBDEs were determined with high-resolution gas chromatography coupled with high-resolution mass spectrometry. While deca- (e.g., BDE 209, detected 100%), nona- (BDE 206/207, 95.1%), octa- (BDE 183, 100%), penta- (BDE 99/153, 100%, 98%) and tetra-BDEs (BDE 47, 100%) were detected abundantly in dust, penta- (BDE 99, 76%, 92%) and tetra-BDEs (BDE 47, 84%, 98%) were detected abundantly in umbilical cord serum and breast milk, respectively; tetra-BDEs (BDE 47, 86%) were detected more often relative to other congeners in maternal serum. Spearman’s pairwise comparison showed that the levels of BDE 47 (ρ = 0.52, p < 0.001) and −99 (ρ = 0.64, p < 0.01) in umbilical cord serum were associated with BDE 209 levels in dust; BDE 47 in maternal serum also showed correlation with BDE 99 in cord serum (ρ = 0.48, p < 0.01) but there was no significant correlation between maternal BDE 47 and dust BDE 209. On the other hand, a comparison of the distribution among congeners suggested probable associations of BDE 47 in maternal serum, breast milk, and umbilical cord serum with BDE 209 in dust; and of BDE 99 in maternal and umbilical cord serum, breast milk, and dust with BDE 209 in dust. Although further studies are needed, a radar chart-based distributional comparison among congeners supported associations between BDE 47 or −99 in human tissues and BDE 209 in dust.

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IJERPH, Vol. 13, Pages 766: Expression of Hepcidin and Ferroportin in the Placenta, and Ferritin and Transferrin Receptor 1 Levels in Maternal and Umbilical Cord Blood in Pregnant Women with and without Gestational Diabetes

Background: Regulation of iron transfer from mother to fetus via the placenta is not fully understood and the relationship between stored iron status in the mothers’ serum and gestational diabetes (GDM) in case–control studies is controversial. The present study aimed to detect circulating soluble transferrin receptor (sTfR) and ferritin levels in maternal and umbilical cord blood. We also examined the expression of hepcidin (Hep), transferrin receptor (TfR1), and ferroportin (FPN) in the placenta in pregnant women with and without GDM at full term. Methods: Eighty-two women participated (42 with GDM and 40 without GDM [controls]). Maternal samples were collected at 37–39 weeks’ gestation. Umbilical cord blood was collected at birth. Ferritin and sTfR levels in maternal serum and umbilical cord blood, and Hep, TfR1, and FPN protein expression in plac enta were compared between the GDM and non-GDM groups. Serum ferritin (SF) was measured by electrochemiluminescence assay and sTfR was measured by ELISA. Hep, TfR1, and FPN expression was measured by immunohistochemistry. Results: Maternal serum sTfR levels were significantly elevated in the GDM group compared with the non-GDM group (p = 0.003). SF levels in cord blood in the GDM group were significantly higher than those in the non-GDM group (p = 0.003). However, maternal hemoglobin and SF, and umbilical cord sTfR levels were not different between the groups. In placental tissue, FPN expression was higher and hepcidin expression was lower in the GDM group compared with the non-GDM group (p = 0.000 and p = 0.044, respectively). There was no significant difference in TfR1 between the groups (p = 0.898). Conclusions: Women with GDM transport iron more actively than those without GDM at term pregnancy. Maternal iron metabolism in GDM may play a role in fetal/placental iron demand and in the overall outcome of pregnancy.

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IJERPH, Vol. 13, Pages 764: Assessing the Contribution of the Environmental Parameters to Eutrophication with the Use of the “PaD” and “PaD2” Methods in a Hypereutrophic Lake

Lake Pamvotis (Greece) is a shallow hypereutrophic lake with a natural tendency to eutrophication. Several restoration measures were applied, but with no long-term success. To examine the causes for this an Artificial Neural Network (ANN) was created in order to simulate the chlorophyll-a (Chl-a) levels and to investigate the role of the associated environmental parameters. The ANN managed to simulate with good correlation the simulated Chl-a and can be considered as a reliable predictor. The relative importance of the environmental parameters to the simulated Chl-a was calculated with the use of the “Partial Derivatives” (“PaD”) sensitivity method. The water temperature (WT) and soluble reactive phosphorus (SRP) had the highest relative importance, with values of 50% and 17%, respectively. The synergistic effect of the paired parameters was calculated with the use of the “PaD2” algorithm. The SRP-WT paired parameter was the most influential, with a relative contribution of 22%. The ANN showed that Lake Pamvotis is prone to suffer the effects of climatic change, because of the major contribution of WT. The ANN also revealed that combined nutrients reduction would improve water quality status. The ANN findings can act as an advisory tool regarding any restoration efforts.

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IJERPH, Vol. 13, Pages 762: Bi-Objective Modelling for Hazardous Materials Road–Rail Multimodal Routing Problem with Railway Schedule-Based Space–Time Constraints

The transportation of hazardous materials is always accompanied by considerable risk that will impact public and environment security. As an efficient and reliable transportation organization, a multimodal service should participate in the transportation of hazardous materials. In this study, we focus on transporting hazardous materials through the multimodal service network and explore the hazardous materials multimodal routing problem from the operational level of network planning. To formulate this problem more practicably, minimizing the total generalized costs of transporting the hazardous materials and the social risk along the planned routes are set as the optimization objectives. Meanwhile, the following formulation characteristics will be comprehensively modelled: (1) specific customer demands; (2) multiple hazardous material flows; (3) capacitated schedule-based rail service and uncapacitated time-flexible road service; and (4) environmental risk constraint. A bi-objective mixed integer nonlinear programming model is first built to formulate the routing problem that combines the formulation characteristics above. Then linear reformations are developed to linearize and improve the initial model so that it can be effectively solved by exact solution algorithms on standard mathematical programming software. By utilizing the normalized weighted sum method, we can generate the Pareto solutions to the bi-objective optimization problem for a specific case. Finally, a large-scale empirical case study from the Beijing–Tianjin–Hebei Region in China is presented to demonstrate the feasibility of the proposed methods in dealing with the practical problem. Various scenarios are also discussed in the case study.

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Τετάρτη 27 Ιουλίου 2016

IJERPH, Vol. 13, Pages 765: Endocrine Aspects of Environmental “Obesogen” Pollutants

Growing evidence suggests the causal link between the endocrine-disrupting chemicals (EDCs) and the global obesity epidemics, in the context in the so-called “obesogenic environment”. Dietary intake of contaminated foods and water, especially in association with unhealthy eating pattern, and inhalation of airborne pollutants represent the major sources of human exposure to EDCs. This is of particular concern in view of the potential impact of obesity on chronic non-transmissible diseases, such as type 2 diabetes, cardiovascular disease, and hormone-sensitive cancers. The key concept is the identification of adipose tissue not only as a preferential site of storage of EDCs, but also as an endocrine organ and, as such, susceptible to endocrine disruption. The timing of exposure to EDCs is critical to the outcome of that exposure, with early lifetime exposures (e.g., fetal or early postnatal) particularly detrimental because of their permanent effects on obesity later in life. Despite that the mechanisms operating in EDCs effects might vary enormously, this minireview is aimed to provide a general overview on the possible association between the pandemics of obesity and EDCs, briefly describing the endocrine mechanisms linking EDCs exposure and latent onset of obesity.

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Authors' reply to letters from Egilman et al and Oliver et al

Dr Egilman and colleagues claim our report1 implies that chrysotile does not cause mesothelioma. So did the International Chrysotile Association, the website of which highlighted our paper with the misleading headline ‘reliable scientific data confirms negligible role of chrysotile in UK patients with asbestos-related lung disease’.2 Our results are consistent with the strong evidence that chrysotile did not cause a large proportion of UK mesotheliomas, but they certainly do not show that the risk is negligible. We said ‘the rapid clearance of chrysotile from the lung with a half-life of a few months explains its virtual absence in our samples, and implies that we cannot estimate its effects except by noting that amphibole lung burdens account very well for mesothelioma incidence’. In relation to lung cancer, we said, ‘the contribution of chrysotile to current UK lung cancer rates is not known and may be impossible to...



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Unreliable proposed 'new standard for assessing asbestos exposure

Gilham and colleagues conclude that there is a linear dose–response relationship between lung asbestos burden and the development of mesothelioma, and that the lung burden should be considered a reliable tool to predict future mesothelioma rates in participants born since 1965.

The paper and commentary are based on incorrect assumptions that generate both an invalid analysis and invalid conclusions:

The authors exclusively rely on asbestos fibre counts measured in lung tissue decades after exposures had taken place, as an indicator of asbestos dose.

Only 2% of the fibres identified were chrysotile, while chrysotile represented as much as 90% of the asbestos used in the UK. Chrysotile is not lung biopersistent; but biopersistence correlates with neither lung nor mesothelioma risk. For example, in 1978, Peto,1 one of the coauthors with Gilham and colleagues, wrote, ‘The epidemiologic evidence that pleural mesothelioma can be caused by chrysotile alone is supported by the observation...



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New standard for assessing asbestos exposure and its consequences?

Comment

Bofetta and La Vecchia1, in their commentary, state that ‘The paper by Gilham et al, published in Occupational and Environmental Medicine, is important for a number of methodological and substantive reasons...’.2 In fact, there are methodological and substantive flaws in the paper that call into question the study results and authors' conclusions.2

The authors rely on occupational history as a key point of reference in asbestos exposure assessment. Lifetime occupational history was obtained through telephone interviews of patients with malignant mesothelioma and from general population and lung cancer controls. The implication is that these interviews were conducted directly with study subjects. However, the authors state that informed consent for postmortem sample analysis was obtained from 77% of patients with mesothelioma ‘and their next of kin’ and do not indicate if there were different rates of primary versus next-of-kin sources of the occupational history...



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Occupational exposure to chemicals drives the increased risk of asthma and rhinitis observed for exposure to vapours, gas, dust and fumes: a cross-sectional population-based study

Objectives

Occupational exposure to the composite measure vapours, gases, dusts and fumes (VGDF), contribute to the burden of asthma and rhinitis. The objective was to evaluate occupational exposure to VGDF, which is further divided into the components chemicals, organic and inorganic dust in relation to asthma and rhinitis.

Methods

Previously examined participants from three population-based cohorts in the Obstructive Lung disease In Northern Sweden (OLIN) studies were re-examined during 2002–2004. In total, 4036 participated in a structured interview and answered a questionnaire on occupational exposures.

Results

Occupational exposure to VGDF increased the risk of asthma, and concomitant asthma and rhinitis. Exposure to chemicals, but not dust, showed a similar pattern. Exposure to chemicals increased the risks (OR, 95% CI) of rhinitis without asthma (1.29, 1.10 to 1.52), asthma without rhinitis (1.42, 1.15 to 1.77) and concomitant asthma and rhinitis (1.60, 1.31 to 1.96) when adjusted for confounders such as age, smoking habits, body mass index and sex. The association between exposure to chemicals and asthma and rhinitis remained independent of exposure to dust and was also so when excluding exposure to isocyanates and welding fumes. The results were similar for women and men, as well as for never-smokers and participants without a history of allergy.

Conclusions

In this cross-sectional population-based study, occupational exposure to chemicals contributed substantially to the increased risk of asthma and rhinitis observed for occupational exposure to VGDF.



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Occupational exposure to solar ultraviolet radiation and the risk of prostate cancer

Objectives

Preventable risk factors for prostate cancer are poorly understood; sun exposure is a possible protective factor. The goal of this study was to investigate prostate cancer risk in outdoor workers, a population with high sun exposure.

Methods

Prostate cancer cases and controls from a large study (conducted between 1994 and 1997) were used for this analysis. A job exposure matrix (JEM) was used to assign solar ultraviolet radiation (UVR) at work as moderate (2 to <6 hours outside/day) or high (≥6 hours). Average daily satellite UV-B measures were linked to the latitude/longitude of the residences of each participant. Several other exposure metrics were also examined, including ever/never exposed and standard erythemal dose by years (SEDxyears). Logistic regression was used to evaluate the association between solar UVR exposure and the odds of prostate cancer.

Results

A total of 1638 cases and 1697 controls were included. Men of Indian and Asian descent had reduced odds of prostate cancer (ORs 0.17 (0.08 to 0.35) and 0.25 (0.15 to 0.41), respectively) compared with Caucasian men, as did single men (OR 0.76 (0.58 to 0.98)) compared with married men. Overall, no statistically significant associations were observed between sun exposure and prostate cancer with 1 exception. In the satellite-enhanced JEM that considered exposure in high category jobs only, prostate cancer odds in the highest quartile of cumulative exposure was decreased compared with unexposed men (OR 0.68 (0.51 to 0.92)).

Conclusions

This study found limited evidence for an association with prostate cancer, with the exception of 1 statistically significant finding of a decreased risk among workers with the longest term and highest sun exposure.



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Biomechanical and psychosocial exposures are independent risk factors for carpal tunnel syndrome: assessment of confounding using causal diagrams

Background

Between 2001 and 2010, six research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries to estimate exposure–response relationships.

Objective

This analysis examined the presence and magnitude of confounding between biomechanical and workplace psychosocial factors and incidence of dominant-hand CTS.

Methods

1605 participants, without CTS at enrolment, were followed for up to 3.5 years (2471 person-years). Demographic information, medical history and workplace psychosocial stress measures were collected at baseline. Individual workplace biomechanical exposures were collected for each task and combined across the workweek using time-weighted averaging (TWA). CTS case criteria were based on symptoms and results of electrophysiological testing. HRs were estimated with Cox proportional hazard models. Confounding was assessed using causal diagrams and an empirical criterion of 10% or greater change in effect estimate magnitude.

Results

There were 109 incident CTS cases (IR=4.41/100 person-years; 6.7% cumulative incidence). The relationships between CTS and forceful repetition rate, % time forceful hand exertion and the Threshold Limit Value for Hand Activity Level (TLV-HAL) were slightly confounded by decision latitude with effect estimates being attenuated towards the null (10–14% change) after adjustment. The risk of CTS among participants reporting high job strain was attenuated towards the null by 14% after adjusting for the HAL Scale or the % time forceful hand exertions.

Conclusions

Although attenuation of the relationships between CTS and some biomechanical and work psychosocial exposures was observed after adjusting for confounding, the magnitudes were small and confirmed biomechanical and work psychosocial exposures as independent risk factors for incident CTS.



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IJERPH, Vol. 13, Pages 759: Risk Factors Associated with Peer Victimization and Bystander Behaviors among Adolescent Students

Despite the prevalence of the phenomena of peer victimization and bystander behaviors, little data has generated to describe their relationships and risk factors. In this paper, a self-administered survey using a cross-sectional cluster-random sampling method in a sample of 5450 participants (2734 girls and 2716 boys) between 4th and 11th grades was conducted at six schools (two primary schools and four middle schools) located in Shantou, China. Self-reported peer victimization, bystander behaviors and information regarding parents’ risky behaviors and individual behavioral factors were collected. Multinomial logistic regression analysis was applied to evaluate risk factors affecting peer victimization and bystander behaviors. The results indicated that urban participants were more likely to become bullying victims but less likely to become passive bystanders. Contrarily, bullying victimization was related to the increasing of passive bystander behaviors. Father drinking and mother smoking as independent factors were risk factors for peer victimization. Participants who were smoking or drinking had a tendency to be involved in both peer victimization and passive bystander behaviors. This study suggested that bystander behaviors, victims’ and parents’ educations play a more important role in peer victimization than previously thought.

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IJERPH, Vol. 13, Pages 761: Breakfast Consumption and Its Associations with Health-Related Behaviors among School-Aged Adolescents: A Cross-Sectional Study in Zhejiang Province, China

Evidence indicates that breakfast consumption is associated with a cluster of health-related behaviors, yet studies in mainland China are scarce. This study is conducted to describe the frequency of breakfast consumption among Chinese adolescents and examine its associations with other dietary, physical activity, sedentary, sleep, cigarette-smoking, and alcohol-drinking behaviors. Breakfast consumption and other health-related behaviors data was collected via a self-administered questionnaire in a cross-sectional study in Zhejiang Province, China. A total of 19,542 school-aged adolescents were recruited in this survey. The associations between breakfast consumption and other health-related behaviors were examined using logistic regression models. A significantly higher prevalence of daily breakfast consumption was found among students who were younger (p for trend <0.001), from urban schools (p < 0.001), and academic high schools (p < 0.001). More frequent vegetable and milk consumption, greater physical activity, and longer sleep duration were positively associated with daily breakfast consumption, while soft drinks and fast food consumption, computer use, cigarette-smoking and alcohol-drinking behaviors were inversely associated. The prevalence of irregular breakfast consumption was relatively high among Chinese adolescents in Zhejiang Province. Daily breakfast consumption was associated with a constellation of health-related behaviors.

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IJERPH, Vol. 13, Pages 763: Mortality from Unspecified Unintentional Injury among Individuals Aged 65 Years and Older by U.S. State, 1999–2013

Introduction: Recent changes in unspecified unintentional injury mortality for the elderly by U.S. state remain unreported. This study aims to examine U.S. state variations in mortality from unspecified unintentional injury among Americans aged 65+, 1999–2013; Methods: Using mortality rates from the U.S. CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™), we examined unspecified unintentional injury mortality for older adults aged 65+ from 1999 to 2013 by state. Specifically, the proportion of unintentional injury deaths with unspecified external cause in the data was considered. Linear regression examined the statistical significance of changes in proportion of unspecified unintentional injury from 1999 to 2013; Results: Of the 36 U.S. states with stable mortality rates, over 8-fold differences were observed for both the mortality rates and the proportions of unspecified unintentional injury for Americans aged 65+ during 1999–2013. Twenty-nine of the 36 states showed reductions in the proportion of unspecified unintentional injury cause, with Oklahoma (−89%), Massachusetts (−86%) and Oregon (−81%) displaying the largest changes. As unspecified unintentional injury mortality decreased, mortality from falls in 28 states and poisoning in 3 states increased significantly. Mortality from suffocation in 15 states, motor vehicle traffic crashes in 12 states, and fire/burn in 8 states also decreased; Conclusions: The proportion of unintentional injuries among older adults with unspecified cause decreased significantly for many states in the United States from 1999 to 2013. The reduced proportion of unspecified injury has implications for research and practice. It should be considered in state-level trend analysis during 1999–2013. It also suggests comparisons between states for specific injury mortality should be conducted with caution, as large differences in unspecified injury mortality across states and over time could create bias for specified injury mortality comparisons.

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IJERPH, Vol. 13, Pages 760: Association of Perceived Stress with Atopic Dermatitis in Adults: A Population-Based Study in Korea

Atopic dermatitis (AD) is a widely prevalent skin disease that affects both children and adults. The aim of the study was to assess the association of perceived stress (single-item, self-reported) with AD (self-reported) in a sample of Korean adults using a cross-sectional research design. A cross-sectional study was conducted using data from 33,018 adults aged 20 years and older collected in the 2007–2012 Korea National Health and Nutrition Examination Surveys (KNHANES). An increased level of self-reported stress was positively associated with an increased prevalence of AD in Korean adults (p for trend <0.001). After adjusting for covariates, the odds ratios (ORs) of AD among participants reporting high and very high levels of stress were 1.81 (95% confidence interval (CI): 1.22, 2.67) and 2.17 (95% CI: 1.38, 3.42), respectively, compared with those who reported low levels of stress. This study found a statistically significant association between perceived stress and AD among Korean adults.

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Τρίτη 26 Ιουλίου 2016

Consecutive results of blood cell count and retrospective biodosimetry: useful tools of health protection regulation for radiation workers

Background

Industrial radiography is known to be one of the most vulnerable lines of work among the range of different radiation work. According to the relevant law in Korea, every worker registered in this work should check their blood cell counts every year in addition to their thermoluminescent dosimeter (TLD) doses. Since the law was enacted, however, few follow-up studies have been carried out based on the obtained results.

Objectives

To ascertain the clinical usefulness of complete blood cell count (CBC) results and suggest a proper protocol of health protection for radiation workers.

Methods

After reviewing all the consecutive results of CBC and TLD doses from radiation workers registered nationwide, we selected two groups of high-risk radiation workers, CBC-high risk (CBC-HR) and TLD-high risk (TLD-HR) groups. A control group of unexposed healthy adults was also included. We compared the absorbed doses calculated by cytogenetic biodosimetry among those three groups, and examined possible confounding factors for each group.

Results

Both groups of high-risk radiation workers, CBC-HR and TLD-HR, showed higher chromosome aberrations than the control group. In the control group, previous medical history of a CT scan increased the frequency of chromosome aberrations. In contrast, the frequency of chromosome aberrations in the high-risk radiation workers was affected not by the previous CT history but only by the duration of their work.

Conclusions

We ascertain that reviewing consecutive results of blood cell counts and cytogenetic biodosimetry are useful complementary tools to TLD doses for health protection regulation. Several confounding factors including work duration and previous medical history need to be considered for the interpretation of biodosimetry results.



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The Psychological Cost of Making Control Responses in the Nonstereotype Direction

Objective:

The aim of this study was to develop a scale for the "psychological cost" of making control responses in the nonstereotype direction.

Background:

Wickens, Keller, and Small suggested values for the psychological cost arising from having control/display relationships that were not in the common stereotype directions. We provide values of such costs specifically for these situations.

Method:

Working from data of Chan and Hoffmann for 168 combinations of display location, control type, and display movement direction, we define values for the cost and compare these with the suggested values of Wickens et al.’s Frame of Reference Transformation Tool (FORT) model.

Results:

We found marked differences between the values of the FORT model and the data of our experiments. The differences arise largely from the effects of the Worringham and Beringer visual field principle not being adequately considered in the previous research.

Conclusion:

A better indication of the psychological cost for use of incorrect control/display stereotypes is given. It is noted that these costs are applicable only to the factor of stereotype strength and not other factors considered in the FORT model.

Application:

Effects of having controls and displays that are not arranged to operate with population expectancies can be readily determined from the data in this paper.



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IJERPH, Vol. 13, Pages 758: Hemoglobin Status and Externalizing Behavioral Problems in Children

Background: Still considered one of the most prevalent nutritional problems in the world, anemia has been shown in many studies to have deleterious effects on neurobehavioral development. While most research efforts have focused on investigating the effects of anemia on social and emotional development of infants by using a cross-sectional design, research is still needed to investigate whether early childhood anemia, beyond infantile years, is linked with behavioral problems. Objective: This study assessed whether (1) hemoglobin (Hb) levels in early childhood are associated with externalizing behavior; and (2) this relationship is confounded by social adversity. Methods: Hemoglobin levels were taken from children (N = 98) of the China Jintan Cohort Study at age 4 years, and externalizing behaviors (attention and aggression) were assessed with the Child Behavior Checklist (ASEBA-CBCL) at age 6 years (mean age 5.77 ± 0.39 years old). Results: Compared with other children in the sample, children with relatively lower Hb levels at age 4 had more behavioral problems in both attention and aggression at age 6, independent of social adversity. For boys, this association was significant for attention problems, which did not interact with social adversity. For girls, the association was significant for aggression, which interacted with social adversity. While girls on average exhibited higher social adversity than boys, the main effect of Hb was only significant in girls with low social adversity. Conclusions: These results indicate that there is an inverse association between hemoglobin levels and later behavioral problems. Findings of this study suggest that regular monitoring of children’s hemoglobin levels and appropriate intervention may help with early identification of behavioral problems.

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IJERPH, Vol. 13, Pages 755: Olives and Bone: A Green Osteoporosis Prevention Option

Skeletal degeneration due to aging, also known as osteoporosis, is a major health problem worldwide. Certain dietary components confer protection to our skeletal system against osteoporosis. Consumption of olives, olive oil and olive polyphenols has been shown to improve bone health. This review aims to summarize the current evidence from cellular, animal and human studies on the skeletal protective effects of olives, olive oil and olive polyphenols. Animal studies showed that supplementation of olives, olive oil or olive polyphenols could improve skeletal health assessed via bone mineral density, bone biomechanical strength and bone turnover markers in ovariectomized rats, especially those with inflammation. The beneficial effects of olive oil and olive polyphenols could be attributed to their ability to reduce oxidative stress and inflammation. However, variations in the bone protective, antioxidant and anti-inflammatory effects between studies were noted. Cellular studies demonstrated that olive polyphenols enhanced proliferation of pre-osteoblasts, differentiation of osteoblasts and decreased the formation of osteoclast-like cells. However, the exact molecular pathways for its bone health promoting effects are yet to be clearly elucidated. Human studies revealed that daily consumption of olive oil could prevent the decline in bone mineral density and improve bone turnover markers. As a conclusion, olives, olive oil and its polyphenols are potential dietary interventions to prevent osteoporosis among the elderly.

http://ift.tt/2aaLCy9

IJERPH, Vol. 13, Pages 757: Seasonality and Trend Forecasting of Tuberculosis Prevalence Data in Eastern Cape, South Africa, Using a Hybrid Model

Background: Tuberculosis (TB) is a deadly infectious disease caused by Mycobacteria tuberculosis. Tuberculosis as a chronic and highly infectious disease is prevalent in almost every part of the globe. More than 95% of TB mortality occurs in low/middle income countries. In 2014, approximately 10 million people were diagnosed with active TB and two million died from the disease. In this study, our aim is to compare the predictive powers of the seasonal autoregressive integrated moving average (SARIMA) and neural network auto-regression (SARIMA-NNAR) models of TB incidence and analyse its seasonality in South Africa. Methods: TB incidence cases data from January 2010 to December 2015 were extracted from the Eastern Cape Health facility report of the electronic Tuberculosis Register (ERT.Net). A SARIMA model and a combined model of SARIMA model and a neural network auto-regression (SARIMA-NNAR) model were used in analysing and predicting the TB data from 2010 to 2015. Simulation performance parameters of mean square error (MSE), root mean square error (RMSE), mean absolute error (MAE), mean percent error (MPE), mean absolute scaled error (MASE) and mean absolute percentage error (MAPE) were applied to assess the better performance of prediction between the models. Results: Though practically, both models could predict TB incidence, the combined model displayed better performance. For the combined model, the Akaike information criterion (AIC), second-order AIC (AICc) and Bayesian information criterion (BIC) are 288.56, 308.31 and 299.09 respectively, which were lower than the SARIMA model with corresponding values of 329.02, 327.20 and 341.99, respectively. The seasonality trend of TB incidence was forecast to have a slightly increased seasonal TB incidence trend from the SARIMA-NNAR model compared to the single model. Conclusions: The combined model indicated a better TB incidence forecasting with a lower AICc. The model also indicates the need for resolute intervention to reduce infectious disease transmission with co-infection with HIV and other concomitant diseases, and also at festival peak periods.

http://ift.tt/2aaLjDb

IJERPH, Vol. 13, Pages 753: Hot of Not: Physiological versus Meteorological Heatwaves—Support for a Mean Temperature Threshold

The aim of this study was to determine whether a revised heat warning threshold provides an enhanced predictive tool for increases in Emergency Department heat-related presentations in Canberra, Australia. All Emergency Department triage records containing the word “heat”, as well as those diagnosing a heat related illness for the summer periods 2013/2014, 2014/2015, and 2015/2016 were searched. Then a medical record review was conducted to confirm that the patient’s presentation was related to environmental heat, which was defined by the final clinical diagnosis, presentation complaint and details of the patient’s treatment. Researchers then compared this presentation data, to a mean threshold formula. The mean threshold formula included the past three consecutive daily mean temperatures and the last measured temperature upon presentation. This formula was designed to take into account the variance of night-time lows, with concurrent daily ambient temperatures, and was used to determine whether there was a correlation between heat-related presentations and increasing mean temperatures. Heat-related presentations appeared to occur when the mean threshold temperature reached 25 °C (77 °F), with significant increases when the mean threshold reached 30 °C (86 °F). These results confirm that a mean temperature of 30 °C corresponds to a relevant local public health heat-related threat.

http://ift.tt/2abIxkD

IJERPH, Vol. 13, Pages 754: Impact of Partial and Comprehensive Smoke-Free Regulations on Indoor Air Quality in Bars

In Korea, smoke-free regulations have been gradually implemented in bars based on venue size. Smoking bans were implemented in 2013 for bars ≥150 m2, in 2014 for bars ≥100 m2, and in 2015 for bars of all sizes. The purpose of this study was to determine indoor fine particle (PM2.5) concentrations in bars before and after implementation of the smoke-free policies based on venue size. Indoor PM2.5 concentrations were measured with real-time aerosol monitors at four time points: (1) pre-regulation (n = 75); (2) after implementing the ban in bars ≥150 m2 (n = 75); (3) after implementing the ban in bars ≥100 m2 (n = 107); and (4) when all bars were smoke-free (n = 79). Our results showed that the geometric mean of the indoor PM2.5 concentrations of all bars decreased from 98.4 μg/m3 pre-regulation to 79.5, 42.9, and 26.6 μg/m3 after the ban on smoking in bars ≥150 m2, ≥100 m2, and all bars, respectively. Indoor PM2.5 concentrations in bars of each size decreased only after the corresponding regulations were implemented. Although smoking was not observed in Seoul bars after smoking was banned in all bars, smoking was observed in 4 of 21 bars in Changwon. Our study concludes that the greatest decrease in PM2.5 concentrations in bars was observed after the regulation covering all bars was implemented. However, despite the comprehensive ban, smoking was observed in bars in Changwon. Strict compliance with the regulations is needed to improve indoor air quality further.

http://ift.tt/2aboqmx

IJERPH, Vol. 13, Pages 756: Dietary Fluoride Intake and Associated Skeletal and Dental Fluorosis in School Age Children in Rural Ethiopian Rift Valley

An observational study was conducted to determine dietary fluoride intake, diet, and prevalence of dental and skeletal fluorosis of school age children in three fluorosis endemic districts of the Ethiopian Rift Valley having similar concentrations of fluoride (F) in drinking water (~5 mg F/L). The duplicate plate method was used to collect foods consumed by children over 24 h from 20 households in each community (n = 60) and the foods, along with water and beverages, were analyzed for fluoride (F) content. Prevalence of dental and skeletal fluorosis was determined using presence of clinical symptoms in children (n = 220). Daily dietary fluoride intake was at or above tolerable upper intake level (UL) of 10 mg F/day and the dietary sources (water, prepared food and beverages) all contributed to the daily fluoride burden. Urinary fluoride in children from Fentale and Adamitulu was almost twice (>5 mg/L) the concentration found in urine from children from Alaba, where rain water harvesting was most common. Severe and moderate dental fluorosis was found in Alaba and Adamitulu, the highest severity and prevalence being in the latter district where staple foods were lowest in calcium. Children in all three areas showed evidence of both skeletal and non-skeletal fluorosis. Our data support the hypothesis that intake of calcium rich foods in addition to using rain water for household consumption and preparation of food, may help in reducing risk of fluorosis in Ethiopia, but prospective studies are needed.

http://ift.tt/2a8bGzM

IJERPH, Vol. 13, Pages 750: Incorporating Environmental Justice into Second Generation Indices of Multiple Deprivation: Lessons from the UK and Progress Internationally

Second generation area-based indices of multiple deprivation have been extensively used in the UK over the last 15 years. They resulted from significant developments in political, technical, and conceptual spheres for deprivation data. We review the parallel development of environmental justice research and how and when environmental data was incorporated into these indices. We explain the transfer of these methods from the UK to Germany and assess the progress internationally in developing such indices. Finally, we illustrate how billions of pounds in the UK was allocated by using these tools to tackle neighbourhood deprivation and environmental justice to address the determinants of health.

http://ift.tt/2a2UJSq

Δευτέρα 25 Ιουλίου 2016

Comparing plasma, serum and whole blood indium concentrations from workers at an indium-tin oxide (ITO) production facility

Objective

Occupational exposure to indium compounds including indium-tin oxide (ITO) can result in potentially fatal indium lung disease. We compared plasma, serum and whole blood indium concentrations (InP, InS and InB) from workers at a single ITO production facility to assess the comparability of these matrices used for biological monitoring of indium exposure.

Method

InP, InS and InB were measured using inductively coupled mass spectrometry from consenting workers at an ITO production facility with specimen collection occurring during June–July 2014. Matched pairs from workers were assessed to determine the matrix relationships using the Pearson correlation, paired t-tests, per cent difference, linear regression and statistics.

Results

Indium matrices were collected from 80 workers. Mean (SD) InP, InS and InB were 3.48 (3.84), 3.90 (4.15) and 4.66 (5.32) mcg/L, respectively. The InS–InP difference was 14%; InS was higher in all but two workers. InP and InS were highly correlated (r=>0.99). The InB–InS difference was 19%; InB was higher in 85% of workers. The InB–InP difference was 34%; InB was higher in 66% of workers. InB was highly correlated with both InP and InS (r=0.97 and 0.96, respectively). Statistics were 0.84, 0.83 and 0.82 for InP, InS and InB, respectively, for individuals with each matrix ≥1 mcg/L (p<0.01).

Conclusions

While all matrices were highly correlated, we encourage the use of InP and InS to reliably compare studies across different populations using different matrices. The higher per cent difference and increased variability of InB may limit its utility in comparisons with InP and InS in different populations.



http://ift.tt/2asblaN

Cognitive function and pre-retirement psychosocial work characteristics

Given the centrality of work and employment for material and psychosocial well-being in adult life it is not surprising to learn that adverse working conditions can contribute to significant reductions in health and well-being. However, what is striking is the broad range of health outcomes affected by poor quality of work and employment. In addition to self-reported health and a variety of symptoms, this range includes distinct stress-related physical and mental disorders and, as more recently disclosed, cognitive impairment and risk of dementia. Although the paper of Sabbath et al1 published in this issue is not the first to demonstrate such an association it extends the current state of knowledge in three important ways.

First, by building on one of the leading theoretical models of psychosocial stress at work, demand-control, it links data on the model's single components and its different constellations, as assessed in late midlife, to postretirement...



http://ift.tt/2a4S1ww

Mortality and cancer incidence in a cohort of male paid Australian firefighters

Objectives

To investigate mortality and cancer incidence of paid male Australian firefighters and of subgroups of firefighters by era of first employment, duration of employment and number and type of incidents attended.

Methods

Participating fire agencies supplied records of individual firefighters including their job histories and incidents attended. The cohort was linked to the Australian National Death Index and Australian Cancer Database. SMRs and SIRs were calculated. Firefighters were grouped into tertiles by duration of employment and by number of incidents attended and relative mortality ratios and relative incidence ratios calculated. Analyses were carried out separately for full-time and part-time male firefighters.

Results

Compared to the Australian population, there were significant increases in overall risk of cancer, for all paid firefighters SIR 1.09 (95% CI 1.03 to 1.14), in prostate cancer, full-time firefighters 1.23 (95% CI 1.10 to 1.37), part-time 1.51 (1.28 to 1.77), and melanoma full-time 1.45 (95% CI 1.26 to 1.66), part-time firefighters 1.43 (95% CI 1.15 to 1.76). Kidney cancer was associated with longer service in internal analyses for paid firefighters. Prostate cancer was associated with longer service and increased attendance at fires, particularly structural fires for full-time firefighters.The overall risk of mortality was significantly decreased and almost all major causes of death were significantly reduced for paid firefighters.

Conclusions

Male paid firefighters have an increased risk of cancer. They have reduced mortality compared with the general population, which is likely to be a result of a strong healthy worker effect and likely lower smoking rates among firefighters compared with the Australian population.



http://ift.tt/2asbsTu

IJERPH, Vol. 13, Pages 752: Genetic Variations in the Promoter of the APE1 Gene Are Associated with DMF-Induced Abnormal Liver Function: A Case-Control Study in a Chinese Population

Acute or long-term exposure to N,N-dimethylformamide (DMF) can induce abnormal liver function. It is well known that DMF is mainly metabolized in the liver and thereby produces reactive oxygen species (ROS). The base excision repair (BER) pathway is regarded as a very important pathway involved in repairing ROS-induced DNA damage. Several studies have explored the associations between GSTM1, GSTT1, CYP2E1 polymorphisms and DMF-induced abnormal liver function; however, little is known about how common hOGG1, XRCC1 and APE1 polymorphisms and DMF induce abnormal liver function. The purpose of this study was to investigate whether the polymorphisms in the hOGG1 (rs159153 and rs2072668), XRCC1 (rs25487, rs25489, and rs1799782), APE1 (rs1130409 and 1760944) genes in the human BER pathway were associated with the susceptibility to DMF-induced abnormal liver function in a Chinese population. These polymorphisms were genotyped in 123 workers with DMF-induced abnormal liver function and 123 workers with normal liver function. We found that workers with the APE1 rs1760944 TG/GG genotypes had a reduced risk of abnormal liver function, which was more pronounced in the subgroups that were exposed to DMF for <10 years, exposed to ≥10 mg/m3 DMF, never smoked and never drank. In summary, our study supported the hypothesis that the APE1 rs1760944 T > G polymorphism may be associated with DMF-induced abnormal liver function in the Chinese Han population.

http://ift.tt/2aq4tI4

IJERPH, Vol. 13, Pages 749: Spatiotemporal Interpolation Methods for the Application of Estimating Population Exposure to Fine Particulate Matter in the Contiguous U.S. and a Real-Time Web Application

Appropriate spatiotemporal interpolation is critical to the assessment of relationships between environmental exposures and health outcomes. A powerful assessment of human exposure to environmental agents would incorporate spatial and temporal dimensions simultaneously. This paper compares shape function (SF)-based and inverse distance weighting (IDW)-based spatiotemporal interpolation methods on a data set of PM2.5 data in the contiguous U.S. Particle pollution, also known as particulate matter (PM), is composed of microscopic solids or liquid droplets that are so small that they can get deep into the lungs and cause serious health problems. PM2.5 refers to particles with a mean aerodynamic diameter less than or equal to 2.5 micrometers. Based on the error statistics results of k-fold cross validation, the SF-based method performed better overall than the IDW-based method. The interpolation results generated by the SF-based method are combined with population data to estimate the population exposure to PM2.5 in the contiguous U.S. We investigated the seasonal variations, identified areas where annual and daily PM2.5 were above the standards, and calculated the population size in these areas. Finally, a web application is developed to interpolate and visualize in real time the spatiotemporal variation of ambient air pollution across the contiguous U.S. using air pollution data from the U.S. Environmental Protection Agency (EPA)’s AirNow program.

http://ift.tt/2aomw4D

IJERPH, Vol. 13, Pages 751: Multilevel Analysis of Socioeconomic Determinants on Diabetes Prevalence, Awareness, Treatment and Self-Management in Ethnic Minorities of Yunnan Province, China

Objectives: The objective of this manuscript is to investigate socioeconomic differences in prevalence, awareness, treatment and self-management of diabetes among ethnic minority groups in Yunnan Province, China. Methods: We conducted a cross-sectional survey in a sample of 5532 Na Xi, Li Su, Dai and Jing Po ethnic minorities. Multilevel modeling was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for diabetes prevalence, as well as the other outcomes. Results: Higher individual educational level was associated with a higher rate of awareness, treatment, adherence to medicines and monitoring of blood glucose (OR = 1.87, 4.89, 4.83, 6.45; 95% CI: 1.26–2.77, 1.87–12.7, 1.95–11.9, 2.23–18.6, respectively). Diabetic respondents with better household assets tended to receive more treatment (OR = 2.81, 95% CI: 1.11–7.12) and to monitor their blood glucose (OR = 3.29, 95% CI: 1.48–7.30). Diabetic patients with better access to medical services were more likely to treat (OR = 7.09, 95% CI: 2.46–20.4) and adhere to medication (OR = 4.14, 95% CI: 1.46–11.7). Income at the contextual level was significantly correlated with diabetes prevalence, treatment and blood glucose monitoring (OR = 1.84, 3.04, 4.34; 95% CI: 1.20–2.83, 1.20–7.73, 1.45–13.0, respectively). Conclusions: Future diabetes prevention and intervention programs should take both individual and township-level socioeconomic factors into account in the study regions.

http://ift.tt/2aon8au

IJERPH, Vol. 13, Pages 748: Potential Harmful Effects of PM2.5 on Occurrence and Progression of Acute Coronary Syndrome: Epidemiology, Mechanisms, and Prevention Measures

The harmful effects of particulate matter with an aerodynamic diameter of <2.5 µm (PM2.5) and its association with acute coronary syndrome (ACS) has gained increased attention in recent years. Significant associations between PM2.5 and ACS have been found in most studies, although sometimes only observed in specific subgroups. PM2.5-induced detrimental effects and ACS arise through multiple mechanisms, including endothelial injury, an enhanced inflammatory response, oxidative stress, autonomic dysfunction, and mitochondria damage as well as genotoxic effects. These effects can lead to a series of physiopathological changes including coronary artery atherosclerosis, hypertension, an imbalance between energy supply and demand to heart tissue, and a systemic hypercoagulable state. Effective strategies to prevent the harmful effects of PM2.5 include reducing pollution sources of PM2.5 and population exposure to PM2.5, and governments and organizations publicizing the harmful effects of PM2.5 and establishing air quality standards for PM2.5. PM2.5 exposure is a significant risk factor for ACS, and effective strategies with which to prevent both susceptible and healthy populations from an increased risk for ACS have important clinical significance in the prevention and treatment of ACS.

http://ift.tt/2aFc9Fu

Σάββατο 23 Ιουλίου 2016

IJERPH, Vol. 13, Pages 746: Windmill Noise Annoyance, Visual Aesthetics, and Attitudes towards Renewable Energy Sources

A small focused socio-acoustic after-study of annoyance from a windmill park was undertaken after local health officials demanded a health impact study to look into neighborhood complaints. The windmill park consists of 31 turbines and is located in the South of Norway where it affects 179 dwellings. Simple exposure-effect relationships indicate stronger reactions to windmills and wind turbine noise than shown internationally, with the caveat that the sample size is small (n = 90) and responses are colored by the existing local conflict. Pulsating swishing sounds and turbine engine hum are the main causes of noise annoyance. About 60 per cent of those who participated in the survey were of the opinion that windmills degrade the landscape aesthetically, and were far from convinced that land-based windmills are desirable as a renewable energy source (hydropower is an important alternative source of renewables in Norway). Attitudes play an important role in addition to visual aesthetics in determining the acceptance of windmills and the resulting noise annoyance. To compare results from different wind turbine noise studies it seems necessary to assess the impact of important modifying factors.

http://ift.tt/2a12ZHz

IJERPH, Vol. 13, Pages 747: Socio-demographic Differences in Toxic Release Inventory Siting and Emissions in Metro Atlanta

Prior research has found that low socioeconomic status (SES) populations and minorities in some areas reside in communities with disproportionate exposure to hazardous chemicals. The objectives of this study were to evaluate the relevance of socio-demographic characteristics on the presence of Toxic Release Inventory (TRI) facilities, air releases, and prevalence and resolution of air quality complaints in the 20-county Atlanta Metropolitan Statistical Area (MSA). We found that there were 4.7% more minority residents in census tracts where TRI facilities were located. The odds ratio (OR) for the presence of a TRI facility was 0.89 (p < 0.01) for each 1% increase of females with a college degree and 2.4 (p < 0.01) for households with an income of $22,000–$55,000. The estimated reduction in the amount of chemicals emitted per release associated with population of females with a college degree was 18.53 pounds (p < 0.01). Complaints took longer to resolve in census tracts with higher Hispanic populations (OR = 1.031, 95% CI: 1.010–1.054). Overall, results indicate that SES and race/ethnicity are related to TRI facility siting, releases, and complaints in the Atlanta area. These findings have not been documented previously and suggest that lower SES and non-White communities may be disproportionately exposed.

http://ift.tt/2a81SnU

Παρασκευή 22 Ιουλίου 2016

Risk factors for and consequences of persistent lower respiratory symptoms among World Trade Center Health Registrants 10 years after the disaster

Objectives

The prevalence of persistent lower respiratory symptoms (LRS) among rescue/recovery workers, local area workers, residents and passers-by in the World Trade Center Health Registry (WTCHR) was analysed to identify associated factors and to measure its effect on quality of life (QoL) 10 years after 9/11/2001.

Methods

This cross-sectional study included 18 913 adults who completed 3 WTCHR surveys (2003–2004 (Wave 1 (W1)), 2006–2007 (Wave 2 (W2)) and 2011–2012 (Wave 3 (W3)). LRS were defined as self-reported cough, wheeze, dyspnoea or inhaler use in the 30 days before survey. The prevalence of three LRS outcomes: LRS at W1; LRS at W1 and W2; and LRS at W1, W2 and W3 (persistent LRS) was compared with no LRS on WTC exposure and probable mental health conditions determined by standard screening tests. Diminished physical and mental health QoL measures were examined as potential LRS outcomes, using multivariable logistic and Poisson regression.

Results

Of the 4 outcomes, persistent LRS was reported by 14.7%. Adjusted ORs for disaster exposure, probable post-traumatic stress disorder (PTSD) at W2, lacking college education and obesity were incrementally higher moving from LRS at W1, LRS at W1 and W2 to persistent LRS. Half of those with persistent LRS were comorbid for probable PTSD, depression or generalised anxiety disorder. Enrollees with persistent LRS were 3 times more likely to report poor physical health and ~ 50% more likely to report poor mental health than the no LRS group.

Conclusions

LRS, accompanied by mental health conditions and decreased QoL, have persisted for at least 10 years after 9/11/2001. Affected adults require continuing surveillance and treatment.



http://ift.tt/2amcYqe

Effect of fire insulation delamination on structural performance of steel structures during fire following an earthquake or an explosion

Publication date: August 2016
Source:Fire Safety Journal, Volume 84
Author(s): Amir Arablouei, Venkatesh Kodur
In this article a numerical model is presented for simulating fire performance of steel structures following an earthquake or an explosion event. In particular, effect of fire insulation delamination during seismic and blast loading on fire performance of structural members is studied. The extent of delamination of fire insulation over the structural elements is adopted from previous fracture mechanics-based studies. A sequential thermal-structural analysis is carried out to trace the fire performance of beam-column assembly in a moment-resisting frame and a beam-column member supporting heavy axial loads. Results from the analyses clearly show that consequence of delamination of fire insulation from plastic hinge region developed in the beam near the column can be quite substantial.As such, 25% delamination of fire insulation can reduce failure time from 100min to 64min. The lack of full fire insulation over this region can significantly accelerate the progressive collapse of the moment-resisting frame due to development of flexural and shear failure in beams adjacent to columns. Also, results from post-explosion fire analysis demonstrate that detachment of fire insulation from a steel column under blast overpressure can significantly impair structural stability of columns during fire following blast.The beam-column that undergoes fire insulation delamination up to 25%, experiences earlier loss of capacity around 85min as compared to 120min achieved in case of no delamination of fire insulation.



http://ift.tt/2agNQBD

IJERPH, Vol. 13, Pages 744: Exploring Global Exposure Factors Resources for Use in Consumer Exposure Assessments

This publication serves as a global comprehensive resource for readers seeking exposure factor data and information relevant to consumer exposure assessment. It describes the types of information that may be found in various official surveys and online and published resources. The relevant exposure factors cover a broad range, including general exposure factor data found in published compendia and databases and resources about specific exposure factors, such as human activity patterns and housing information. Also included are resources on exposure factors related to specific types of consumer products and the associated patterns of use, such as for a type of personal care product or a type of children’s toy. Further, a section on using exposure factors for designing representative exposure scenarios is included, along with a look into the future for databases and other exposure science developments relevant for consumer exposure assessment.

http://ift.tt/2a12vOR

IJERPH, Vol. 13, Pages 742: DNA Damage in Euonymus japonicus Leaf Cells Caused by Roadside Pollution in Beijing

The inhalable particles from vehicle exhaust can cause DNA damage to exposed organisms. Research on DNA damage is primarily focused on the influence of specific pollutants on certain species or the effect of environmental pollution on human beings. To date, little research has quantitatively studied the relationship between roadside pollution and DNA damage. Based on an investigation of the roadside pollution in Beijing, Euonymus japonicus leaves of differing ages grown in heavily-polluted sections were chosen as biomonitors to detect DNA damage using the comet assay technique. The percentage of DNA in the tail and tail moment was chosen as the analysis index based on SPSS data analysis. The roadside samples showed significantly higher levels of DNA damage than non-roadside samples, which increased in older leaves, and the DNA damage to Euonymus japonicus leaf cells was positively correlated with haze-aggravated roadside pollution. The correlation between damage and the Air Quality Index (AQI) are 0.921 (one-year-old leaves), 0.894 (two-year-old leaves), and 0.878 (three-year-old leaves). Over time, the connection between DNA damage and AQI weakened, with the sensitivity coefficient for δyear 1 being larger than δyear 2 and δyear 3. These findings support the suitability and sensitivity of the comet assay for surveying plants for an estimation of DNA damage induced by environmental genotoxic agents. This study might be applied as a preliminary quantitative method for Chinese urban air pollution damage assessment caused by environmental stress.

http://ift.tt/29ZYU0e

IJERPH, Vol. 13, Pages 745: Efficacy of a Low Dose of Hydrogen Peroxide (Peroxy Ag+) for Continuous Treatment of Dental Unit Water Lines: Challenge Test with Legionella pneumophila Serogroup 1 in a Simulated Dental Unit Waterline

This study was designed to examine the in vitro bactericidal activity of hydrogen peroxide against Legionella. We tested hydrogen peroxide (Peroxy Ag+) at 600 ppm to evaluate Legionella survival in a simulated dental treatment water system equipped with Water Hygienization Equipment (W.H.E.) device that was artificially contaminated. When Legionella pneumophila serogroup (sg) 1 was exposed to Peroxy Ag+ for 60 min we obtained a two decimal log reduction. High antimicrobial efficacy was obtained with extended periods of exposure: four decimal log reduction at 75 min and five decimal log reduction at 15 h of exposure. Involving a simulation device (Peroxy Ag+ is flushed into the simulation dental unit waterlines (DUWL)) we obtained an average reduction of 85% of Legionella load. The product is effective in reducing the number of Legionella cells after 75 min of contact time (99.997%) in the simulator device under test conditions. The Peroxy Ag+ treatment is safe for continuous use in the dental water supply system (i.e., it is safe for patient contact), so it could be used as a preventive option, and it may be useful in long-term treatments, alone or coupled with a daily or periodic shock treatment.

http://ift.tt/2a0Xl5n

IJERPH, Vol. 13, Pages 743: Environmental Risk Factors in Psoriasis: The Point of View of the Nutritionist

Psoriasis is a common, chronic, immune-mediated skin disease with systemic pro-inflammatory activation, where both environmental and genetic factors contribute to its pathogenesis. Among the risk factors for psoriasis, evidence is accumulating that nutrition plays a major role, per se, in psoriasis pathogenesis. In particular, body weight, nutrition, and diet may exacerbate the clinical manifestations, or even trigger the disease. Understanding the epidemiological relationship between obesity and psoriasis is also important for delineating the risk profile for the obesity-related comorbidities commonly found among psoriatic patients. Moreover, obesity can affect both drug’s pharmacokinetics and pharmacodynamics. Additionally, the overall beneficial effects on the obesity-associated comorbidities, clinical recommendations to reduce weight and to adopt a healthy lifestyle could improve the psoriasis severity, particularly in those patients with moderate to severe disease, thus exerting additional therapeutic effects in the conventional treatment in obese patients with psoriasis. Education regarding modifiable environmental factors is essential in the treatment of this disease and represents one of the primary interventions that can affect the prognosis of patients with psoriasis. The goal is to make psoriatic patients and health care providers aware of beneficial dietary interventions. The aim of this review is to assess the relevance of the environmental factors as modifiable risk factors in psoriasis pathogenesis, with particular regard to the involvement of obesity and nutrition in the management of psoriasis, providing also specific nutrition recommendations.

http://ift.tt/29YcmHU

Πέμπτη 21 Ιουλίου 2016

Mortality differences between self-employed and paid employees: a 5-year follow-up study of the working population in Sweden

Objectives

Analyse mortality differences between self-employed and paid employees with a focus on industrial sector, educational level and gender using Swedish register data.

Methods

A cohort of the total working population (4 776 135 individuals; 7.2% self-employed; 18–100 years of age at baseline 2003) in Sweden with a 5-year follow-up (2004–2008) for all-cause and cause-specific mortality (57 743 deaths). Self-employed individuals were categorised as sole proprietors or limited liability company (LLC) owners according to their enterprise's legal form. Cox proportional hazards models were applied to compare mortality rates between sole proprietors, LLC owners and paid employees, adjusted for sociodemographic confounders.

Results

Mortality from cardiovascular diseases was 16% lower and from suicide 26% lower among LLC owners than among paid employees, adjusted for confounders. Within the industrial category, all-cause mortality was 13–15% lower among sole proprietors and LLC owners compared with employees in manufacturing and mining (MM) as well as personal and cultural services (PCS), and 11–20% higher in sole proprietors in trade, transport and communication and the welfare industry (W). A significant three-way interaction indicated 17–23% lower all-cause mortality among male LLC owners in MM and female sole proprietors in PCS, and 50% higher mortality in female sole proprietors in W than in employees in the same industries.

Conclusions

Mortality differences between self-employed individuals and paid employees vary by the legal form of self-employment, across industries, and by gender. Differences in work environment exposures and working conditions, varying market competition across industries and gender segregation in the labour market are potential mechanisms underlying these findings.



http://ift.tt/29WGHXh

IJERPH, Vol. 13, Pages 737: Microbial Contamination and Hygiene of Fresh Cow’s Milk Produced by Smallholders in Western Zambia

A field study was performed to assess safety of smallholder fresh cow’s milk around Mongu, Western Province, Zambia. This involved observation and sampling of milk along the value chain from milking to point-of-sale and storage. Samples were collected from 86 cows, from 9 farmers, selling through two dairy cooperatives, with additional samples from informal markets. Production was very low; around one litre/day/cow and 10 L/day/herd. The milk was typically transported by bicycle in high ambient temperatures without refrigeration until reaching the point-of-sale (journey times of 30–120 min), where it was sold without pasteurisation despite milk-borne zoonoses being endemic (bovine tuberculosis (bTB) and Brucellosis). Although microbiological contamination was initially low, with geometric mean total bacterial count (TBC) of 425 cfu/mL (cfu = colony forming units) upon arrival at point-of-sale, poor hygiene led to high bacterial loads later on (geometric mean TBC > 600,000 cfu/mL after two days refrigeration), with almost all samples culture positive for Staphylococcus aureus and Escherichia coli. After milking, milk was kept for 100–223 min at temperatures favouring microbial growth (median 34 °C) and sold without a microbial kill step. In this situation limited variation in observed standards of milk hygiene had no significant effect on milk end-product bacterial counts. Options for refrigerated transport are limited. Pasteurisation at the cooperative should be investigated, as this would largely remove pathogenic microbes present in the milk whether resulting from cattle infection or poor hygiene during milking and transportation. As milk is also purchased directly from producers, on-farm milk heating options should also be assessed. Smallholders may benefit from access to national markets by providing milk to large dairies, which have systems for ensuring safety. However, this requires significant investment and an increased and more consistent supply of milk; and many consumers, unable to afford milk sold through formal sectors, would not benefit.

http://ift.tt/29PDfZL

IJERPH, Vol. 13, Pages 735: Perception of Air Pollution in the Jinchuan Mining Area, China: A Structural Equation Modeling Approach

Studies on the perception of air pollution in China are very limited. The aim of this paper is to help to fill this gap by analyzing a cross-sectional dataset of 759 residents of the Jinchuan mining area, Gansu Province, China. The estimations suggest that perception of air pollution is two-dimensional. The first dimension is the perceived intensity of air pollution and the second is the perceived hazardousness of the pollutants. Both dimensions are influenced by environmental knowledge. Perceived intensity is furthermore influenced by socio-economic status and proximity to the pollution source; perceived hazardousness is influenced by socio-economic status, family health experience, family size and proximity to the pollution source. There are no reverse effects from perception on environmental knowledge. The main conclusion is that virtually all Jinchuan residents perceive high intensity and hazardousness of air pollution despite the fact that public information on air pollution and its health impacts is classified to a great extent. It is suggested that, to assist the residents to take appropriate preventive action, the local government should develop counseling and educational campaigns and institutionalize disclosure of air quality conditions. These programs should pay special attention to young residents who have limited knowledge of air pollution in the Jinchuan mining area.

http://ift.tt/29O4uru

IJERPH, Vol. 13, Pages 738: Geographic Elevation, Car Driving, and Depression among Elderly Residents in Rural Areas: The Shimane CoHRE Study

Given that public transportation networks are often worse in rural areas than in urban areas, it is difficult for elderly non-drivers to access health-promoting goods, services, and resources related to mental health. Moreover, geographical location, assessed by elevation, could modify this association in a rural area. The aim of this study was to test whether the association between car driving (being a driver or not) and depression, as measured by the Zung Self-Rating Depression Scale (SDS), varied by elevation. Data were collected from a cross-sectional study conducted in the town of Ohnan located in a rural area of Japan. After excluding participants with missing data (n = 26), 876 participants were analysed in this study. After adjustment for potential confounders, being a non-driver had a significantly higher odds ratio of SDS (40+) among elderly people living at a low elevation (odds ratio = 2.17, 95% confidence interval = 1.28–3.71). However, similar findings were not observed among elderly people living at a high elevation. These results suggest that car driving importantly predicts depression in elderly people living at relatively low elevations in rural areas.

http://ift.tt/29NXpHo

IJERPH, Vol. 13, Pages 736: Measurements of Volatile Organic Compounds in a Newly Built Daycare Center

We measured temporal changes in concentrations of total volatile organic compounds (TVOCs) and individual volatile organic compounds in a newly built daycare center. The temporal changes of the TVOC concentrations were monitored with a photo ionization detector (PID), and indoor air was sampled and analyzed by Gas Chromatography/Mass Spectrometry (GC/MS) and high performance liquid chromatography (HPLC) to determine the concentrations of the constituent VOCs. The measurements were performed just after completion of the building and again 3 months after completion. The TVOC concentration exceeded 1000 µg·m−3 for all the sampling locations just after completion of building, and decreased almost one tenth after 3 months, to below the guideline values of the TVOC in Japan at 400 µg·m−3. The concentrations of the target VOCs of which the indoor concentrations are regulated in Japan were below the guideline values for all the cases. The air-exchange rates were determined based on the temporal changes of the TVOC concentrations, and it was found that the countermeasure to increase the air exchange rate successfully decrease the TVOC concentration level in the rooms.

http://ift.tt/29Pv1Rz

IJERPH, Vol. 13, Pages 740: Parent-Child Relationship of Pedometer-Assessed Physical Activity and Proxy-Reported Screen Time in Czech Families with Preschoolers

This study focuses on determining the relationship between parents’ step count (SC) and screen time (ST) and children’s SC and ST on weekdays and at weekends. The participants (278 parents aged 30–45 and their 194 children aged 4–7) were recruited from 10 randomly selected Czech kindergartens. The participants recorded SC and ST duration over a week-long monitoring (≥8 h/day) during September–October 2014 and April–May 2015. The associations between parents’ SC and ST and children’s SC and ST were estimated using general linear regression for weekdays and weekends. Each 2500 SC increase in mothers’/fathers’ daily SC at weekdays (weekends) was associated with an extra 1143/903 (928/753) daily SC in children. Each 60 min of ST increase in mothers’/fathers’ ST at weekdays (weekends) was associated with an extra 7.6/7.6 (16.8/13.0) min of child daily ST. An increase of 2500 mothers’ daily SC was associated with reduction of 2.5 (7.5) min of ST in children at weekdays (weekends). This study reveals a significant relationship between parent-child SC/day, parent-child ST/day, and mothers’ ST and children’s SC at weekends. Weekend days seem to provide a suitable space for the promotion of joint physical activity in parents and their pre-schoolers.

http://ift.tt/2aiU03O

IJERPH, Vol. 13, Pages 739: How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis

Background: High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. Methods: High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries. This retrospective study reviewed the data of 101 motorcyclists and 32 car occupants who experienced a high-grade BHSI from 1 January 2011 to 31 December 2013. Two-sided Fisher’s exact or Pearson’s chi-square tests were used to compare categorical data, unpaired Student’s t-test was used to analyze normally distributed continuous data, and Mann–Whitney’s U test was used to compare non-normally distributed data. Results: In this study, the majority (76%, 101/133) of high-grade BHSI were due to motorcycle crashes. Car occupants had a significantly higher injury severity score (ISS; 26.8 ± 10.9 vs. 20.7 ± 10.4, respectively, p = 0.005) and organ injured score (OIS; 3.8 ± 1.0 vs. 3.4 ± 0.6, respectively, p = 0.033), as well as a significantly longer hospital length of stay (LOS; 21.2 days vs. 14.6 days, respectively, p = 0.038) than did motorcyclists. Car occupants with high-grade BHSI also had worse clinical presentations than their motorcyclist counterparts, including a significantly higher incidence of hypotension, hyperpnea, tube thoracostomy, blood transfusion >4 units, LOS in intensive care unit >5 days, and complications. However, there were no differences in the percentage of angiography or laparotomy performed or mortality rate between these two groups of patients. Conclusions: This study demonstrated that car occupants with high-grade BHSI were injured more severely, had a higher incidence of worse clinical presentation, had a longer hospital LOS, and had a higher incidence of complications than motorcyclists. The results also implied that specific attention should be paid to those car occupants with high-grade BHSI, whose critical condition should not be underestimated because of the concept that the patients within in a car are much safer.

http://ift.tt/2aeKr3e

IJERPH, Vol. 13, Pages 741: Contamination and Risk Assessment of Heavy Metals in Lake Bed Sediment of a Large Lake Scenic Area in China

The exposure of heavy metals to lake bed sediment of scenic areas may pose risks on aquatic ecosystems and human health, however very few studies on risk assessment have been reported for scenic areas. Accordingly, this study determined concentration levels, and assessed contamination characteristics and risks, of heavy metals in lake bed sediment of National Scenic Areas Songhuahu (NSAS) in China. The concentrations of Zn, Cr, Pb, Ni, and Cu were determined in 29 bed sediment samples. Results showed that the mean values of Zn, Cr, Pb, Ni, and Cu were 92.69, 90.73, 38.29, 46.77, and 49.44 mg/kg, respectively. Pearson correlation coefficients indicated that organic matter was a major factor influencing distribution of heavy metals. The results for enrichment factors indicated that contamination rates and anthropogenic inputs of single heavy metals decreased in the order Cu > Ni > Pb > Cr > Zn; results of Nemerow integrated pollution index suggested that 72.41% of sampling sites were exposed to low to moderately integrated pollution, and 27.59% of sampling sites were exposed to strongly integrated pollution. According to results for potential ecological risk index, ecological risks of single and all the heavy metals in bed sediment from all the sampling sites were low. Human risks were assessed with hazardous quotients, and the results suggested that exposure of heavy metals to bed sediment posed no or little risk to human health, and the pathway of ingestion significantly contributed to human health risks.

http://ift.tt/2aiTJ0J

Τετάρτη 20 Ιουλίου 2016

IJERPH, Vol. 13, Pages 730: A Meta-Analysis of the Efficacy of Interferon Monotherapy or Combined with Different Nucleos(t)ide Analogues for Chronic Hepatitis B

Background: The aim of the present study was to compare the efficacy of interferon (IFN) with or without different nucleos(t)ide analogues (NAs). Methods: The PubMed, Wan Fang and CNKI databases were searched to identify relevant trials up to May 2015. Meta-analysis was performed with Review Manager 5.0. The stability and reliability were evaluated by publication bias tests. Results: Fifty-six studies fulfilled the criteria for the meta-analysis. Compared with IFN monotherapy, combination therapy were superior in HBV DNA undetectable rate (Risk Ratio (RR) = 1.55, 95% confidence interval (CI): 1.44–1.66, p < 0.00001), HBeAg and HBsAg loss rate (RR = 1.38, 95% CI: 1.22–1.56, p < 0.00001; RR = 1.69, 95% CI: 1.03–2.78, p = 0.04, respectively) at the end of week 48 treatment. Sub-analysis showed the RRs of virological response for entecavir (ETV), adefovir (ADV), and lamivudine (LAM) were 1.64, 1.61 and 1.52, respectively; RRs of HBeAg loss rate were 1.34, 1.71 and 1.34, respectively. However, at the end of follow-up, IFN plus NAs therapy was better than IFN monotherapy only in terms of HBV DNA undetectable rate (p = 0.0007). Conclusions: Combination therapy was better than IFN monotherapy in virological and serological responses at the end of treatment. After follow-up, only HBV DNA undetectable rate was superior for combination therapy.

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IJERPH, Vol. 13, Pages 734: Infection Rates by Dengue Virus in Mosquitoes and the Influence of Temperature May Be Related to Different Endemicity Patterns in Three Colombian Cities

Colombia is an endemic country for dengue fever where the four serotypes of virus dengue (DENV1–4) circulate simultaneously, and all types are responsible for dengue cases in the country. The control strategies are guided by entomological surveillance. However, heterogeneity in aedic indices is not well correlated with the incidence of the disease in cities such as Riohacha, Bello and Villavicencio. As an alternative, molecular detection of dengue virus in mosquitoes has been proposed as a useful tool for epidemiological surveillance and identification of serotypes circulating in field. We conducted a spatiotemporal fieldwork in these cities to capture adult mosquitoes to assess vector infection and explain the differences between Breteau indices and disease incidence. DENV infection in females and DENV serotype identification were evaluated and infection rates (IR) were estimated. The relationship between density, dengue cases and vector index was also estimated with logistic regression modeling and Pearson’s correlation coefficient. The lack of association between aedic indices and dengue incidence is in agreement with the weak associations between the density of the mosquitoes and their infection with DENV in the three cities. However, association was evident between the IR and dengue cases in Villavicencio. Furthermore, we found important negative associations between temperature and lag time from two to six weeks in Riohacha. We conclude that density of mosquitoes is not a good predictor of dengue cases. Instead, IR and temperature might explain better such heterogeneity.

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IJERPH, Vol. 13, Pages 731: Understanding the Influence of Environment on Adults’ Walking Experiences: A Meta-Synthesis Study

The environment has an important impact on physical activity, especially walking. The relationship between the environment and walking is not the same as for other types of physical activity. This study seeks to comprehensively identify the environmental factors influencing walking and to show how those environmental factors impact on walking using the experiences of adults between the ages of 18 and 65. The current study is a meta-synthesis based on a systematic review. Seven databases of related disciplines were searched, including health, transportation, physical activity, architecture, and interdisciplinary databases. In addition to the databases, two journals were searched. Of the 11,777 papers identified, 10 met the eligibility criteria and quality for selection. Qualitative content analysis was used for analysis of the results. The four themes identified as influencing walking were “safety and security”, “environmental aesthetics”, “social relations”, and “convenience and efficiency”. “Convenience and efficiency” and “environmental aesthetics” could enhance the impact of “social relations” on walking in some aspects. In addition, “environmental aesthetics” and “social relations” could hinder the influence of “convenience and efficiency” on walking in some aspects. Given the results of the study, strategies are proposed to enhance the walking experience.

http://ift.tt/2aaFn32

IJERPH, Vol. 13, Pages 733: Quantitative Microbial Risk Assessment in Occupational Settings Applied to the Airborne Human Adenovirus Infection

Quantitative Microbial Risk Assessment (QMRA) methodology, which has already been applied to drinking water and food safety, may also be applied to risk assessment and management at the workplace. The present study developed a preliminary QMRA model to assess microbial risk that is associated with inhaling bioaerosols that are contaminated with human adenovirus (HAdV). This model has been applied to air contamination data from different occupational settings, including wastewater systems, solid waste landfills, and toilets in healthcare settings and offices, with different exposure times. Virological monitoring showed the presence of HAdVs in all the evaluated settings, thus confirming that HAdV is widespread, but with different average concentrations of the virus. The QMRA results, based on these concentrations, showed that toilets had the highest probability of viral infection, followed by wastewater treatment plants and municipal solid waste landfills. Our QMRA approach in occupational settings is novel, and certain caveats should be considered. Nonetheless, we believe it is worthy of further discussions and investigations.

http://ift.tt/2a8Btoy

IJERPH, Vol. 13, Pages 732: The Relation of Moderate Alcohol Consumption to Hyperuricemian in a Rural General Population

Background: although alcohol abuse is known to increase serum uric acid, the relation between moderate drinking and uric acid have remained poorly understood. We performed this study to evaluate whether different alcohol consumption level has different effects on the risk of hyperuricemia based on a rural general population. Method: multi-stage cluster sampling method was used to select a representative sample of individuals aged 35 years or older. Participants were asked to provide information about their alcohol consumption. Data regarding the demographic and lifestyle characteristics and the blood biochemical indexes of these participants were collected by well-trained personnel. Results: in total, 11,039 participants aged 35 years or older were included (4997 men and 6042 women). The prevalence of hyperuricemia in the different male alcohol consumption groups was 11.9% in non-drinkers, 12.6% in moderate drinkers, and 16.3% in heavy drinkers (p < 0.001). In females, the rates were 6.3% in non-drinkers, 8.1% in moderate drinkers, and 6.6% for heavy drinkers (p = 0.818). In males, multivariate logistic regression analyses shows heavy drinkers had an approximately 1.7-fold higher risk of hyperuricemia (OR: 1.657, 95% CI: 1.368 to 2.007, p < 0.001) than non-drinkers; moderate drinkers did not experience a significant increase in risk (OR: 1.232, 95% CI: 0.951 to 1.596, p = 0.114)). Multivariate logistic regression analyses of females showed that, compared with non-drinkers, neither moderate nor heavy drinkers had a significantly increased risk of hyperuricemia (OR: 1.565, 95% CI: 0.521 to 4.695, p = 0.425 for heavy drinkers; OR: 0.897, 95% CI: 0.117 to 6.855, p = 0.916 for moderate drinkers). Conclusions: heavy alcohol consumption increased the risk of hyperuricemia for males but not for females. Among both males and females, moderate alcohol consumption did not increase the risk of hyperuricemia.

http://ift.tt/29Ob6S0

IJERPH, Vol. 13, Pages 727: Spatial Distribution, Sources Apportionment and Health Risk of Metals in Topsoil in Beijing, China

In order to acquire the pollution feature and regularities of distribution of metals in the topsoil within the sixth ring road in Beijing, a total of 46 soil samples were collected, and the concentrations of twelve elements (Nickel, Ni, Lithium, Li, Vanadium, V, Cobalt, Co, Barium, Ba, Strontium, Sr, Chrome, Cr, Molybdenum, Mo, Copper, Cu, Cadmium, Cd, Zinc, Zn, Lead, Pb) were analyzed. Geostatistics and multivariate statistics were conducted to identify spatial distribution characteristics and sources. In addition, the health risk of the analyzed heavy metals to humans (adult) was evaluated by an U.S. Environmental Protection Agency health risk assessment model. The results indicate that these metals have notable variation in spatial scale. The concentration of Cr was high in the west and low in the east, while that of Mo was high in the north and low in the south. High concentrations of Cu, Cd, Zn, and Pb were found in the central part of the city. The average enrichment degree of Cd is 5.94, reaching the standard of significant enrichment. The accumulation of Cr, Mo, Cu, Cd, Zn, and Pb is influenced by anthropogenic activity, including vehicle exhaustion, coal burning, and industrial processes. Health risk assessment shows that both non-carcinogenic and carcinogenic risks of selected heavy metals are within the safety standard and the rank of the carcinogenic risk of the four heavy metals is Cr > Co > Ni > Cd.

http://ift.tt/29MvOCH

Τρίτη 19 Ιουλίου 2016

Validation of the Attention-Related Driving Errors Scale (ARDES) in an English-Speaking Sample

Objective:

The goal for this study was to develop an English translation of the Attention-Related Driving Errors Scale (ARDES-US) and to determine its potential relationship with driver history and other demographic variables.

Background:

Individual differences in performance on vigilance and cognitive tasks are well documented, but less is known about susceptibility to attention-related errors while driving. The ARDES has been developed and administered in both Spanish and Chinese but to our knowledge has never been administered or examined in an English-speaking population.

Method:

Two hundred ninety-six English-speaking individuals completed a series of self-report measures, including the ARDES-US, Attention-Related Cognitive Errors Scale, Mindful Attention Awareness Scale, and Cognitive Failures Questionnaire.

Results:

A confirmatory factor analysis using maximum-likelihood estimates with robust standard errors revealed results largely consistent with previous versions of the ARDES, namely, the ARDES-Spain and ARDES-Argentina. Additionally, a number of new results emerged. Specifically, women, drivers who received traffic tickets within the previous 2 years, and those with a lower level of education all had a greater propensity toward self-reported driver inattention as measured by the ARDES-US. Further analyses revealed that these findings were independent of age, years of driving experience, and driving frequency.

Conclusion:

These results suggest that the ARDES-US is a valid and reliable measure of driver inattention with an English-speaking American sample.

Application:

Potential applications of the ARDES-US include identifying individuals who are at greater risk of attention-related errors while driving and suggesting individually tailored training and safety countermeasures.



http://ift.tt/29NnRfM

IJERPH, Vol. 13, Pages 726: Shisha Smoking Practices, Use Reasons, Attitudes, Health Effects and Intentions to Quit among Shisha Smokers in Malaysia

Despite its popularity, shisha smoking practices, reasons for its use, attitudes, detrimental health effects and intention to quit among shisha users in Malaysia have never been investigated. A total of 503 shisha users responded to a cross-sectional study conducted between July 2015 and March 2016. The majority of users were young people aged 21–30; a small minority were underage. The reasons for shisha use were its growing popularity as a favourite pastime activity and the perception of shisha use as cool and trendy. Just over half (57.3%) agree that shisha use exposes the smoker to large amounts of smoke and the majority were unsure about the health risks of shisha smoking compared to tobacco smoking. The three most common detrimental health effects reported by the study respondents were dry throat, headache and nausea. Regular shisha users have significantly higher detrimental health effects compared to no-regular shisha users. Shisha users with a duration of smoking of 6–12 months (odds ratio (OR) 3.212; 95% confidence interval (CI) 1.651–6.248) and 6 months and below (OR 2.601; 95% CI 1.475–4.584) were significantly more likely to have a higher proportion who intend quitting smoking than shisha users of more than 12 months duration.

http://ift.tt/29RYmN2

IJERPH, Vol. 13, Pages 725: A Survey of Jellyfish Sting Knowledge among Naval Personnel in Northeast China

Background: Jellyfish envenomation is common along the coastal area, and can cause severe consequences. Naval personnel are among the high-risk population for this injury. The aim of this study was to assess knowledge regarding jellyfish envenomation among naval personnel in a navy unit in northeast China. Methods: A predesigned questionnaire was distributed to 120 naval members in January 2015. The data of 108 respondents were included in the statistical analysis. Results: We found that 38.0% of the respondents selected jellyfish sting as the common wound in their units, and 13.0% had experienced or observed this injury. In addition, 63.0% of the participants rated their own knowledge as “low” or “none”. The average score they got was 5.77 ± 2.50, with only 16.7% getting a score above 60% of the full score. The correct rates of five questions were below 60%. No statistical differences existed in the knowledge score among different groups of respondents defined by socio-demographic variables. Conclusions: Jellyfish sting is common in this navy unit, but personnel got a low score on the knowledge assessment. They also lacked confidence in first aid. Medical education and training should be implemented to address this issue.

http://ift.tt/29QKB48

IJERPH, Vol. 13, Pages 724: Environment and Health: Not Only Cancer

The Hippocratic tradition emphasized environmental causes of diseases and the need for harmony between the individual and the natural environment as the right philosophy to maintain a good health status. Public awareness and scientific attention concerning environmental pollution is usually focused on the consequent increased risk of developing cancer. Air pollution has been recognized by the World Health Organization (WHO) to cause cardiovascular and respiratroy diseases, as well as lung cancer, after acute/chronic exposure to fine particulates (PM2.5 and PM10) even at concentrations which are 50% lower than those accepted as legal limits in many developed countries. An increase of 10 µg/m3 of PM2.5 produces a +4%–6% of overall mortality, a +10% of cardiovascular disease prevalence (arithmyas, acute myocardial infarctions, and heart failure) and a +22% of lung cancer prevalence. In addition to these chronic effects, acute hospitalizations are also affected, especially among susceptible populations such as children and diabetic patients. Water and soil contamination also have an additional detrimental effect on people’s health. Other issues concerning environment contamination and human health include male/female fertility, metabolic and thyroid conditions, but also professional exposures resulting in occupational diseases. Moreover, in the perspective of “gender medicine”, different acute or chronic effects of environmental pollution should be specifically assessed both in men and in women. This special issue on “Environmental Diseases” is aimed at providing a global overview about different threats to human health possibily originating from environmental contamination.

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IJERPH, Vol. 13, Pages 728: Association by Spatial Interpolation between Ozone Levels and Lung Function of Residents at an Industrial Complex in South Korea

Spatial interpolation is employed to improve exposure estimates and to assess adverse health effects associated with environmental risk factors. Since various studies have reported that high ozone (O3) concentrations can give rise to adverse effects on respiratory symptoms and lung function, we investigated the association between O3 levels and lung function using a variety of spatial interpolation techniques and evaluated how different methods for estimating exposure may influence health results for a cohort from an industrial complex (Gwangyang Bay) in South Korea in 2009. To estimate daily concentrations of O3 in each subject, four different methods were used, which include simple averaging, nearest neighbor, inverse distance weighting, and kriging. Also, to compare the association between O3 levels and lung function by age-groups, we explored ozone’s impacts on three age-related groups: children (9–14 years), adults (15–64 years), and the elderly (≥65 years). The overall change of effect size on lung function in each age group tended to show similar patterns for lag and methods for estimating exposure. A significant negative association was only observed between O3 levels and FVC and FEV1 for most of the lag and methods in children. The largest effect of O3 levels was found at the average for the lung function test day and last 2 days (0–2 days). In conclusions, the spatial interpolation methods may benefit in providing individual-level exposure with appropriate temporal resolution from ambient monitors. However, time-activity patterns of residents, monitoring site locations, methodological choices, and other factors should be considered to minimize exposure misclassification.

http://ift.tt/29QHTaQ

IJERPH, Vol. 13, Pages 729: Geographical Inequalities in Surgical Treatment for Localized Female Breast Cancer, Queensland, Australia 1997–2011: Improvements over Time but Inequalities Remain

The uptake of breast conserving surgery (BCS) for early stage breast cancer varies by where women live. We investigate whether these geographical patterns have changed over time using population-based data linkage between cancer registry records and hospital inpatient episodes. The study cohort consisted of 11,631 women aged 20 years and over diagnosed with a single primary invasive localised breast cancer between 1997 and 2011 in Queensland, Australia who underwent either BCS (n = 9223, 79%) or mastectomy (n = 2408, 21%). After adjustment for socio-demographic and clinical factors, compared to women living in very high accessibility areas, women in high (Odds Ratio (OR) 0.58 (95% confidence intervals (CI) 0.49, 0.69)), low (OR 0.47 (0.41, 0.54)) and very low (OR 0.44 (0.34, 0.56)) accessibility areas had lower odds of having BCS, while  the odds for women from middle (OR 0.81 (0.69, 0.94)) and most disadvantaged (OR 0.87 (0.71, 0.98)) areas was significantly lower than women living in affluent areas. The association between accessibility and the type of surgery reduced over time (interaction p = 0.028) but not for area disadvantage (interaction p = 0.209). In making informed decisions about surgical treatment, it is crucial that any geographical-related barriers to implementing their preferred treatment are minimised.

http://ift.tt/29RU4mB

IJERPH, Vol. 13, Pages 723: The Epidemiologic, Microbiologic and Clinical Picture of Bacteremia among Febrile Infants and Young Children Managed as Outpatients at the Emergency Room, before and after Initiation of the Routine Anti-Pneumococcal Immunization

We described the occult bacteremia (OB) and bacteremia with diagnosed focus (BwF) picture among children managed as outpatients at the pediatric emergency room (PER) in southern Israel, before and after the introduction of pneumococcal conjugate vaccines (PCVs) introduction in a retrospective study enrolling all three- to 36-month-old patients with fever >38.0 °C during 2005–2014. Of 511 (0.82% of all febrile patients) true bacteremias, 230 (45%) were managed as outpatients; 96 of 230 (41.7%) had OB and 134 (3.59%) had BwF. OB and BwF rates were 0.22% and 3.02%, respectively. A significant decrease was noted in OB and BwF rates (p = 0.0008 and p = 0.02, respectively). S. pneumoniae (SP, 37.5%), K. kingae (11.4%) and Brucella spp. (8.7%) were the most common OB pathogens and SP (29.8%), S. viridans (13.4%), and Brucella spp. (12.7%) were the most common in BwF patients. PCV13 serotypes were not found among the serotypes isolated post-PCV13 introduction. During 2010–2014 there was an increase in non-PCV13 serotype isolation (p = 0.005). SP was the main pathogen isolated among patients with pneumonia, acute otitis media (AOM) and periorbital cellulitis (62.5%, 33.3% and 60%, respectively). OB and BwF decreased following the introduction of PCVs and SP was the main pathogen in both conditions. Vaccine-SP serotypes were not isolated in OB after PCV13 introduction and non-vaccine serotypes increased significantly.

http://ift.tt/29Qszep

Δευτέρα 18 Ιουλίου 2016

The Contribution of Biomechanical-Biological Interactions of the Spine to Low Back Pain

Objective:

The objective of this mini-review is to examine a subset of literature that demonstrates multiple interactions between mechanics and biology within the spine and propose how incorporation of these mechano-biologic interactions can be applied to improve the conceptual understanding of tissue tolerances.

Background:

Low back pain represents a major musculoskeletal problem in the workplace. Traditional biomechanical assessments have employed tissue tolerances as an approach for reducing workplace injuries; however, development of more universal biologically sensitive tolerances requires incorporation of mechano-biologic interactions.

Methods:

A focused literature review addressing the interactions between mechanical loading and biology in the spine.

Results:

Mechanical loads applied to the body are distributed across all spatial scales from the body to the tissues to the cells. These mechanical loads regulate cellular metabolism and over time can lead to tissue strengthening or weakening. Mechanical loading also interacts with the biologic environment (e.g., tissue inflammation, nerve sensitization) to influence the perception of pain, thereby changing the risk of experiencing pain. Biologic tissues also exhibit time-dependent changes in mechanical behaviors that occur throughout the day and with disease, suggesting tissue tolerances are time dependent.

Conclusion:

Incorporating mechano-biologic interactions into the traditional tissue tolerance paradigm through describing tissue tolerances as a function of multiple factors (e.g., preexisting risk factors, underlying pathology, and time) may lead to the development of tissue tolerances that are more representative of the in vivo situation.

Application:

Efforts must work toward incorporating biological concepts into tissue tolerances in order to improve risk assessment tools.



http://ift.tt/2a40FO7