IJERPH, Vol. 14, Pages 239: Exploring the Linkage between Urban Flood Risk and Spatial Patterns in Small Urbanized Catchments of Beijing, China

In the context of global urbanization, urban flood risk in many cities has become a serious environmental issue, threatening the health of residents and the environment. A number of hydrological studies have linked urban flooding issues closely to the spectrum of spatial patterns of urbanization, but relatively little attention has been given to small-scale catchments within the realm of urban systems. This study aims to explore the hydrological effects of small-scaled urbanized catchments assigned with various landscape patterns. Twelve typical residential catchments in Beijing were selected as the study areas. Total Impervious Area (TIA), Directly Connected Impervious Area (DCIA), and a drainage index were used as the catchment spatial metrics. Three scenarios were designed as different spatial arrangement of catchment imperviousness. Runoff variables including total and peak runoff depth (Qt and Qp) were simulated by using Strom Water Management Model (SWMM). The relationship between catchment spatial patterns and runoff variables were determined, and the results demonstrated that, spatial patterns have inherent influences on flood risks in small urbanized catchments. Specifically: (1) imperviousness acts as an effective indicator in affecting both Qt and Qp; (2) reducing the number of rainwater inlets appropriately will benefit the catchment peak flow mitigation; (3) different spatial concentrations of impervious surfaces have inherent influences on Qp. These findings provide insights into the role of urban spatial patterns in driving rainfall-runoff processes in small urbanized catchments, which is essential for urban planning and flood management.

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IJERPH, Vol. 14, Pages 238: The Disease Burden and Clinical Characteristics of Inflammatory Bowel Disease in the Chinese Population: A Systematic Review and Meta-Analysis

The temporal trend of inflammatory bowel disease (IBD) incidence is reported to be increasing in worldwide regions; however, reports focusing on China are sparse. The aim of this study was to provide an overview of the disease burden and clinical features of IBD in the Chinese population. We searched Medline, EMBASE, and another two Chinese databases. A parallel literature review and data extraction were conducted. Meta-analysis was performed to estimate the summary incidence rate of Crohn’s disease (CD) and ulcerative colitis (UC). The constituent ratios with 95% CI were calculated for clinical phenotypes and classifications. The literature review included 47 publications. The summary incidence rate of IBD was 1.74 (95% CI: 1.08; 2.40) per 100,000 person years, and the corresponding incidence rates of CD and UC were 0.40 (95% CI: 0.23; 0.57) and 1.18 (95% CI: 0.81; 1.56) per 100,000 person years, respectively. The sex distribution analysis indicated a male predominance in both CD (sex ratio: 1.64; 95% CI: 1.47–1.84) and UC (sex ratio: 1.29; 95% CI: 1.21–1.38). The clinical characteristics were summarized using data from 2283 CD cases and 17,958 UC cases; in which the majority of CD patients were diagnosed between 17–40 years of age, with non-stricturing and non-penetrating disease, varied disease locations, and less extra-intestinal manifestation. UC cases were featured with later disease diagnosis, a more severe disease course, more segmental lesions, and less extra-intestinal manifestations. Our study provided an estimated disease burden of IBD and demonstrated distinct clinical features in the Chinese population. Large-scale population-based studies are needed to further evaluate these findings.

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Malignant mesothelioma due to asbestos exposure in dental tape

Although most cases of malignant mesothelioma of the pleura are caused by one or more readily recognized sources of exposure to asbestos, cases of the disease with more occult exposure occur, especially since asbestos has been used in over 3,000 products. Dental lining tape contained asbestos from the 1930s until at least the 1970s and was used in the lost wax method of casting crowns, bridges, and other metal dental prosthetic devices. We report six cases of pathology-verified malignant mesothelioma, mostly among dentists, following exposure to airborne dust from asbestos dental tape, which resulted in asbestos tort litigation. According to evidence available at present, chrysotile asbestos was the type of asbestos used in dental tape in the past in the United States, and the described cases followed relatively brief and intermittent exposure to this type of asbestos. These cases underscore the need for comprehensive exposure histories to determine exposure scenarios. Am. J. Ind. Med. © 2017 Wiley Periodicals, Inc .

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The development and testing of a tool to assess joint health and safety committee functioning and effectiveness

Background

Concern regarding functioning and effectiveness of joint health and safety committees (JHSCs) in Ontario hospitals was raised following the Severe Acute Respiratory Syndrome outbreak in 2003. A subsequent literature review revealed a lack of studies focused within the healthcare sector.

Methods

A tool to measure JHSC effectiveness was developed by a panel of occupational health and safety experts based on a framework from the healthcare sector. Usability testing was conducted in two phases with members of five hospital JHSCs before, during and after a committee meeting.

Results

Usability of the tool was scored high overall with an average of > 4 on a 5 point scale across twelve items. Downward adjustment of self-assessment scores was reported following JHSC meetings.

Conclusion

Findings demonstrated that the tool was easy to use, effective in supporting discussion and in assisting participants in reaching consensus on rating a large number of JHSC characteristics. Am. J. Ind. Med. © 2017 Wiley Periodicals, Inc.

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Risk factors for malignant mesothelioma in people with no known exposure to asbestos

Objectives

Malignant mesothelioma (MM) is a rare and generally fatal cancer, usually caused by asbestos, although about 5–10% of cases report no asbestos exposure. This study aimed to identify sources whereby people in Western Australia (WA) may be unknowingly exposed to asbestos or to other exposures which may cause MM.

Methods

Cases with no known asbestos exposure were selected from the WA Mesothelioma Register (WAMR). Matched controls were selected from hospital patients admitted for conditions unrelated to asbestos. Occupational histories were coded by an industrial hygienist. Data were analyzed using conditional logistic regression.

Results

Thirty-eight MM participants and 134 controls were recruited. Risk of MM was increased (OR = 3.1, 95%CI 1.0–9.6) after no known, but likely, exposure to asbestos at work.

Conclusions

Because of its extensive use, few people in WA have never been exposed to asbestos. Unrecognized exposure may cause most MM cases initially regarded as “no exposure.” Am. J. Ind. Med. 9999:1–5, © 2017 Wiley Periodicals, Inc.

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IJERPH, Vol. 14, Pages 240: The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study

Background: Suboptimal health status (SHS) is the intermediate health state between health and disease, it is medically undiagnosed and is also termed functional somatic syndrome. Although its clinical manifestations are complicated and various, SHS has not reached the disease status. Unhealthy lifestyle is associated with many chronic diseases and mortality. In accordance with the impact of lifestyle on health, it is intriguing to determine the association between unhealthy lifestyle and SHS risk. Methods: We conducted a nested case-control study among healthy Chinese college students from March 2012 to September 2013, which was nested in a prospective cohort of 5676 students. We performed 1:1 incidence density sampling with matched controls for birth year, sex, grade, specialty and individual character. SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Exposure was defined as an unhealthy lifestyle per the frequency of six behavioral dimensions from the Health-promoting Lifestyle Profile (HPLP-II). Results: We matched 543 cases of SHS (42.66%) in a cohort of 1273 students during the 1.5 years mean follow-up time with controls. A significant difference (t = 9.79, p < 0.001) and a reduction in HPLP-II total score was present at 1.5 years follow-up (135.93 ± 17.65) compared to baseline (144.48 ± 18.66). A level-response effect was recorded with an increase of the total HPLP-II (every dimension was correlated with a decreased SHS risk). Compared to respondents with the least exposure (excellent level), those reporting a general HPLP-II level were approximately 2.3 times more likely to develop SHS (odd ratio = 2.333, 95% CI = 1.471 to 3.700); and those with less HPLP-II level (good level) were approximately 1.6 times more likely (1.644, 1.119–2.414) to develop SHS (p < 0.05). Our data indicated that unhealthy lifestyle behavior with respect to behavioral dimensions significantly affected SHS likelihood. Further analyses revealed a marked increase (average increased 14.73 points) in lifestyle level among those SHS regression to health after 1.5 years, with respect to the HPLP-II behavioral dimensions, in addition to the total score (t = -15.34, p < 0.001). Conclusions: SHS is highly attributable to unhealthy lifestyles, and the Int. J. Environ. Res. Public Health 2017, 14, 240 2 of 17 mitigation of modifiable lifestyle risk factors may lead to SHS regression. Increased efforts to modify unhealthy lifestyles are necessary to prevent SHS.

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IJERPH, Vol. 14, Pages 233: A Cross-Sectional Study of the Prevalence of Metabolic Syndrome and Associated Factors in Colombian Collegiate Students: The FUPRECOL-Adults Study

Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors.

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IJERPH, Vol. 14, Pages 234: Companion Animals and Child/Adolescent Development: A Systematic Review of the Evidence

Childhood and adolescence are important developmental phases which influence health and well-being across the life span. Social relationships are fundamental to child and adolescent development; yet studies have been limited to children’s relationships with other humans. This paper provides an evidence review for the potential associations between pet ownership and emotional; behavioural; cognitive; educational and social developmental outcomes. As the field is in the early stages; a broad set of inclusion criteria was applied. A systematic search of databases and grey literature sources found twenty-two studies meeting selection criteria. The review found evidence for an association between pet ownership and a wide range of emotional health benefits from childhood pet ownership; particularly for self-esteem and loneliness. The findings regarding childhood anxiety and depression were inconclusive. Studies also showed evidence of an association between pet ownership and educational and cognitive benefits; for example, in perspective-taking abilities and intellectual development. Evidence on behavioural development was unclear due to a lack of high quality research. Studies on pet ownership and social development provided evidence for an association with increased social competence; social networks; social interaction and social play behaviour. Overall, pet ownership and the significance of children’s bonds with companion animals have been underexplored; there is a shortage of high quality and longitudinal studies in all outcomes. Prospective studies that control for a wide range of confounders are required.

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IJERPH, Vol. 14, Pages 235: The Relationship between Neighbourhood Green Space and Child Mental Wellbeing Depends upon Whom You Ask: Multilevel Evidence from 3083 Children Aged 12–13 Years

Recent reviews of the rapidly growing scientific literature on neighbourhood green space and health show strong evidence for protective and restorative effects on mental wellbeing. However, multiple informants are common when reporting mental wellbeing in studies of children. Do different informants lead to different results? This study utilised nationally representative data on Goodman’s 25-item Strengths and Difficulties Questionnaire reported by 3083 children (aged 12–13 years old), and their parents and teachers. Multilevel models were used to investigate whether similar associations between child mental wellbeing (as measured using the total difficulties score and the internalising and externalising subscales) and neighbourhood green space quantity and quality are obtained regardless of the informant. After adjustment for confounders, higher green space quantity and quality were associated with consistently more favourable child mental wellbeing on all three measures, regardless of the informant. However, associations with green space quantity were statistically significant (p < 0.05) only for the parent-reported total difficulties score and the internalising subscale. Significant associations with green space quality were consistently observed for both parent- and child-reported outcomes. Teacher-reported outcomes were not significantly associated with green space exposure. Future studies of green space and child health should acknowledge when different informants of outcomes could lead to different conclusions.

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IJERPH, Vol. 14, Pages 236: Use of the QuantiFERON-TB Gold In-Tube Test in the Diagnosis and Monitoring of Treatment Efficacy in Active Pulmonary Tuberculosis

The value of QuantiFERON in the diagnosis of tuberculosis disease and in the monitoring of the response to anti-tuberculosis treatment is unclear. The aims of this study were to evaluate the accuracy of the QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of tuberculosis and in the monitoring of the response to anti-tuberculosis treatment in patients with active pulmonary tuberculosis (PTB). Between January 2013 and December 2015, 133 cases with active PTB and 133 controls with no mycobacterial infection, matched by age (within 3 years) and by the week that they visited Tainan Chest Hospital, were enrolled in the study. Serial testing by QFT-GIT at baseline and after 2 and 6 months of treatment was performed. At these time points, a comparison of the performance of QFT-GIT with that of sputum culture status among study subjects was conducted. Compared to baseline, 116 (87.2%) cases showed a decreased response, whereas 17 (12.8%) showed persistent or stronger interferon-gamma (IFN-γ) responses at 2 months. PTB patients IFN-γ responses declined significantly from baseline to 2 months (median, 6.32 vs. 4.12; p < 0.005). The sensitivity values of the QFT-GIT test for the detection of pulmonary tuberculosis at cut-off points of 0.35 IU/mL, 0.20 IU/mL, and 0.10 IU/mL were 74.4%, 78.2%, and 80.5%, respectively. The specificity values at cut-off points of 0.35 IU/mL, 0.20 IU/mL, and 0.10 IU/mL were 66.2%, 63.9%, and 57.1%, respectively. Our results support the QFT-GIT assay as a potential tool for diagnosing tuberculosis and for monitoring the efficacy of anti-tuberculosis treatment.

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IJERPH, Vol. 14, Pages 237: Spatiotemporal Patterns of the Use of Urban Green Spaces and External Factors Contributing to Their Use in Central Beijing

Urban green spaces encourage outdoor activity and social communication that contribute to the health of local residents. Examining the relationship between the use of urban green spaces and factors influencing their utilization can provide essential references for green space site selection in urban planning. In contrast to previous studies that focused on internal factors, this study highlights the external factors (traffic convenience, population density and commercial facilities) contributing to the use of urban green spaces. We conducted a spatiotemporal analysis of the distribution of visitors in 208 selected green spaces in central Beijing. We examined the relationship between the spatial pattern of visitor distribution within urban green spaces and external factors, using the Gini coefficient, kernel density estimation, and geographical detectors. The results of the study were as follows. The spatial distribution of visitors within central Beijing’s green spaces was concentrated, forming different agglomerations. The three examined external factors are all associated with the use of green spaces. Among them, commercial facilities are the important external factor associated with the use of green spaces. For the selection of sites for urban green spaces, we recommend consideration of external factors in order to balance urban green space utilization.

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IJERPH, Vol. 14, Pages 232: Toxicity Research of PM2.5 Compositions In Vitro

According to the published literature, we surmise that particulate matter (PM) concentration, individually, may be less important than components in explaining health effects. PM2.5 (aerodynamic diameter <2.5 μm) had similar cytotoxicity (e.g., cell viability reduction, oxidative damage, inflammatory effects and genetic toxicity) on different types of cells. The studies of cells are readily available for detailed mechanistic investigations, which is more appropriate for learning and comparing the mechanism caused by single or mixed ingredients coating a carbon core. No review exists that holistically examines the evidence from all components-based in vitro studies. We reviewed published studies that focus on the cytotoxicity of normal PM2.5. Those studies suggested that the toxicity of mixed compositions differs greatly from the single ingredients in mixed components and the target cells. The cytotoxic responses caused by PM2.5 components have not shown a consistent association with clear, specific health effects. The results may be beneficial for providing new targets for drugs for the treatment of PM2.5-related diseases.

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IJERPH, Vol. 14, Pages 230: Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study

Long-term morbidities can develop after traumatic brain injury (TBI). Some studies have suggested that the risk of stroke is higher after TBI, but the association between concussion and stroke remains unclear. Using a national cohort, the authors analyzed the incidence of both hemorrhagic and ischemic strokes in patients with previous concussion. A representative cohort of approximately one million people was followed up for four years. Patients with new-onset concussion were identified (n = 13,652) as the concussion group. Subsequently, the incidence rates of later stroke events in the concussion group were compared to a sex-, age- and propensity score–matched comparison group (n = 13,652). The overall incidence rate of stroke in the concussion group was higher than that of the comparison group (9.63 versus 6.52 per 1000 person-years, p < 0.001). Significantly higher stroke risk was observed in the concussion group than in the comparison group (crude hazard ratio 1.48, p < 0.001; adjusted HR 1.65, p < 0.001). In the concussion group, the cumulative incidence rates of both ischemic stroke and hemorrhagic stroke were higher than those of the comparison group (8.9% vs. 5.8% and 2.7% vs. 1.6%, respectively, both p < 0.001). Concussion is an independent risk factor for both ischemic and hemorrhagic strokes. Prevention and monitoring strategies of stroke are therefore suggested for patients who have experienced concussion.

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IJERPH, Vol. 14, Pages 231: Financial Stress and Smoking within a Large Sample of Socially Disadvantaged Australians

Financial stress is associated with fewer quit attempts and higher relapse rates. This study aimed to compare financial stress among smokers, ex-smokers and never smokers in a highly socioeconomically disadvantaged sample. The study also aimed to determine whether specific indicators of financial stress differ according to smoking status. Adult clients seeking welfare assistance from two Social and Community Service Organisation sites in New South Wales, Australia, were invited to complete a cross-sectional survey between March 2012 and December 2013. Responses to a financial stress scale, smoking status and demographics were collected. Linear and logistic regression modelling was used to examine associations between smoking status and financial stress. A total of 1463 participants completed the survey. Current smokers had significantly higher total financial stress scores than ex-smokers and non-smokers respectively. Current smokers also had higher odds of severe financial stress indicators, such as going without meals (Odds Ratio = 2.2 and 2.0), than both non-smokers and ex-smokers. Even among a highly socioeconomically disadvantaged sample with high levels of financial stress, smoking status further exacerbates experiences of deprivation. Given the relationship between financial stress, socioeconomic disadvantage and difficulty quitting, it is important to provide enhanced cessation support to smokers experiencing financial stress.

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IJERPH, Vol. 14, Pages 229: Occupational Safety and Health Conditions Aboard Small- and Medium-Size Fishing Vessels: Differences among Age Groups

Although marine fishing is one of the most hazardous occupations, research on the occupational safety and health (OSH) conditions aboard marine fishing vessels is scarce. For instance, little is known about the working conditions of vulnerable groups such as young and aging fishermen. The objective of the current paper is to study the OSH conditions of young and aging fishermen compared to middle-aged fishermen in the small- and medium-size (SM) marine fishing sector. A cross-sectional study was designed, and 686 fishermen working aboard SM fishing vessels were interviewed to collect information about their safety and health. The associations of physical and psychosocial work conditions with safety and health outcomes, e.g., injuries, illnesses and job satisfaction, are presented. The results of the current study can be utilized in the design of effective accident prevention and OSH training programs for the three age groups and in the regulation of working conditions aboard fishing vessels.

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IJERPH, Vol. 14, Pages 227: Analysis of Blood Concentrations of Zinc, Germanium, and Lead and Relevant Environmental Factors in a Population Sample from Shandong Province, China

Trace elements, including zinc (Zn) and germanium (Ge), are essential for health; deficiency or excess levels of trace elements results is harmful. As a result of industrial and agricultural production, Pb widely exists in people’s living environment. It is absorbed mainly through the respiratory and digestive tracts, producing systemic harm. Reference values for a normal, healthy population are necessary for health assessment, prevention and treatment of related diseases, and evaluation of occupational exposures. Reference ranges for the Chinese population have not been established. From March 2009 to February 2010; we collected data and blood samples (n = 1302) from residents aged 6–60 years living in Shandong Province, China. We measured blood concentrations of Zn, Ge, and Pb using inductively coupled plasma mass spectrometry to determine reference ranges. Results were stratified by factors likely to affect the concentrations of these trace elements: sex, use of cosmetics or hair dye, age, alcohol intake, smoking habits, and consumption of fried food. The overall geometric mean (GM) concentrations (95% confidence interval) were 3.14 (3.08–3.20) mg/L for Zn, 19.9 (19.3–20.6) μg/L for Ge, and 24.1 (23.2–25.1) μg/L for Pb. Blood Zn concentrations were higher in women than in men (p < 0.001), while the opposite was found for Pb (p < 0.001) and sex did not influence Ge (p = 0.095). Alcohol use was associated with higher blood concentrations of Zn (p = 0.002), Ge (p = 0.002), and Pb (p = 0.001). The GM concentration of Zn was highest in 20–30-year-olds (p < 0.001), while Pb concentrations were highest in 12–16-year-olds (p < 0.001). Use of hair dye was associated with lower blood concentrations of Ge (p < 0.05). GM blood concentrations of Pb differed significantly between those who consumed fried foods 1–2 times/month (18.7 μg/L), 1–2 times/week (20.9 μg/L), and every day (28.5 μg/L; p < 0.001). Blood Pb concentrations were higher in subjects who used cosmetics (p < 0.05), hair dye (p < 0.05), and who smoked cigarettes (p < 0.001) than in those who did not.

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IJERPH, Vol. 14, Pages 228: Consumption of Sugar-Sweetened Beverages in Mississippi: Is There A Disparity? Behavioral Risk Factor Surveillance System, 2012

Although consumption of sugar-sweetened beverages (SSBs) is a key contributor to epidemic obesity and has dramatically increased over the past decade in the United States, little is known about its prevalence and associated factors. Data from the 2012 Behavior Risk Factor Surveillance System (BRFSS) were used to estimate the prevalence of SSB consumption and to explore the associations between socio-demographic characteristics, behavioral factors and SSB intake in Mississippi (n = 7220). Descriptive statistics, Chi-square tests and logistic regressions were conducted using SAS Proc Survey procedures, to account for the BRFSS′s multistage complex survey design and sample weights. Overall prevalence of self-reported daily SSB intake was 41.1%. Our findings showed that males (aOR = 1.4, 95% CI: 1.2–1.7, ref = female), blacks (aOR = 1.7, 95% CI: 1.4–2.1, ref = whites), adults aged 18–24 years (aOR = 5.0, 95% CI: 3.4–7.5, ref = 65 years or older), those with less than high school education (aOR = 1.9, 95% CI: 1.4–2.6, ref = college graduate), annual income <$25,000 (aOR = 1.3, 95% CI: 1.1–1.7, ref ≥ $50,000) and $25,000–49,999 (aOR = 1.3, 95% CI: 1.1–1.6, ref ≥ $50,000), those with no physical activity (OR = 1.3, 95% CI: 1.1–1.6, ref = physically active), daily smokers (aOR = 2.2, 95% CI: 1.7–2.7, ref = non-smokers), and those who reported eating at fast food or chain restaurants (aOR = 1.8, 95% CI: 1.2–2.5, ref = do not eat at fast food or chain restaurants) were more likely to consume SSBs, raising concerns about overweight and obesity in Mississippi.

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IJERPH, Vol. 14, Pages 222: High Prevalence and Genetic Polymorphisms of Legionella in Natural and Man-Made Aquatic Environments in Wenzhou, China

Natural and engineered water systems are the main sources of Legionnaires’ disease. It is essential from a public health perspective to survey water environments for the existence of Legionella. To analyze the main serogroups, genotypes and pathogenicity of the pathogen, a stratified sampling method was adopted to collect water samples randomly from shower water, cooling tower water, and local public hot springs in Wenzhou, China. Suspected strains were isolated from concentrated water samples. Serum agglutination assay and real-time PCR (Polymerase chain reaction) were used to identify L. pneumophila. Sequence-based typing (SBT) and pulsed-field gel electrophoresis (PFGE) were used to elucidate the genetic polymorphisms in the collected isolates. The intracellular growth ability of the isolates was determined through their interaction with J774 cells and plating them onto BCYE (Buffered Charcoal Yeast Extract) agar plates. Overall, 25.56% (46/180) of water samples were Legionella-positive; fifty-two strains were isolated and two kinds of serogroups were co-detected from six water samples from 2015 to 2016. Bacterial concentrations ranged from 20 CFU/100 mL to 10,720 CFU/100 mL. In detail, the Legionella-positive rates of shower water, cooling tower water and hot springs water were 15.45%, 13.33%, and 62.5%, respectively. The main serogroups were LP1 (30.69%) and LP3 (28.85%) and all strains carried the dot gene. Among them, 52 isolates and another 10 former isolates were analyzed by PFGE. Nineteen distinct patterns were observed in 52 strains isolated from 2015 to 2016 with three patterns being observed in 10 strains isolated from 2009 to 2014. Seventy-three strains containing 52 from this study and 21 former isolates were selected for SBT analysis and divided into 25 different sequence types in 4 main clonal groups belonging to 4 homomorphic types. Ten strains were chosen to show their abilities to grow and multiply in J744 cells. Taken together, our results demonstrate a high prevalence and genetic polymorphism of Legionella in Wenzhou’s environmental water system. The investigated environmental water sources pose a potential threat to the public where intervention could help to prevent the occurrence of Legionnaires’ disease.

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Electric arc explosions—A review

Publication date: April 2017
Source:Fire Safety Journal, Volume 89
Author(s): Vytenis Babrauskas
When an electric arc is created, a pressure event occurs. There can be two aspects to this: the shock and sound waves propagated from the expanding arc channel, and the bulk pressurization of the enclosure, if arcing is taking place within a closed volume. The present paper is the first systematic review of the research on both these pressure phenomena. Quantitative studies on electrical arc explosion pressures date back to the 1920s, although arc pressures generated by lightning, which is a type of electric arc discharge, have been studied since the 1700s, but understanding of the phenomena is still not complete or exhaustive. Experimental data are compared to theoretical predictions. It is shown that in an enclosed volume some extremely high pressures can be generated, if the arc current is sufficient. Such pressures can destroy buildings and mechanical equipment and cause injuries or death to nearby individuals. Even without enclosures, the shock waves produced from high energy arcs can cause injuries, although arc flash injury may be of greater concern. Injury potential generally requires that high currents be available, and serious damages or injuries are not associated with low-energy arcing occurrences.



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Total radiative heat loss and radiation distribution of liquid pool fire flames

Publication date: April 2017
Source:Fire Safety Journal, Volume 89
Author(s): Liang Zhou, Dong Zeng, Dongyang Li, Marcos Chaos
The radiative characteristics of laboratory-scale pool fire flames have been studied in detail. Experiments were conducted in the ASTM E2058/ISO 12136 Fire Propagation Apparatus (FPA). Eleven liquid fuels with different sooting propensities, including alcohols and alkanes, burning in a 9.5cm diameter quartz dish were considered. Radiative power distribution (along the flame axis) and global radiant emission were measured for all the fuels by using slit and wide-view-angle radiometers, respectively. The effects of measurement location and fuel type on the measured data were investigated. Radiation distribution profiles for a given fuel, when adequately normalized, show little sensitivity to the horizontal separation distance of the slit radiometer. Fuels with similar chemical structures exhibit similar distributions, consistent with flame image analyses. The radiative power distributions along with the wide-view-angle radiometer data were used to derive radiant fractions for the pool fires studied by applying a multiple-point source (MPS) radiation model. To examine the sensitivity of the calculated radiant fractions to the measurement location, the position of the wide-view-angle radiometer was considerably varied both vertically and horizontally. The results show that the radiant fractions derived based on the measured radiative power distribution are independent of the location of the wide-view-angle radiometer and consistent with literature values. Therefore, the approach developed in this study presents a flexible methodology apt for the accurate determination of radiation properties of diffusion flames in a laboratory setting.



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An experimental study of full-scale open floor plan enclosure fires

Publication date: April 2017
Source:Fire Safety Journal, Volume 89
Author(s): J.P. Hidalgo, A. Cowlard, C. Abecassis-Empis, C. Maluk, A.H. Majdalani, S. Kahrmann, R. Hilditch, M. Krajcovic, J.L. Torero
A full-scale experimental series is undertaken to generate a comprehensive data set to study and characterise fires in large open-plan spaces, typical of contemporary infrastructure and Tall Buildings in particular. Developments in the understanding of enclosure fire dynamics for large spaces is intended to complement the knowledge of relatively smaller, low ventilation spaces developed from the extensive body of research that underpins the original compartment fire framework.A total of twelve experiments are conducted, ten using box gas burners and two using a bed of wood cribs. Both the fire development and ventilation characteristics are varied systematically to enable the careful examination of the effect of each on the fire dynamics within the compartment. For this set of tests, sensor instrumentation is, as far as practicable, provided at a resolution to enable benchmarking of field models. These tests form part of the Real Fires for the Safe Design of Tall Buildings Project.The current paper, the first in a series of publications, provides a thorough description of the full-scale experimental compartment, the various sensing techniques deployed within it, and the range of combined fire and ventilation conditions for each of the twelve tests performed. Characteristic results from the first experiment that forms part of the ‘Edinburgh Tall Building Fire Tests’ (ETFT) test series are presented.



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Numerical modelling of high strength steel beams at elevated temperature

Publication date: April 2017
Source:Fire Safety Journal, Volume 89
Author(s): H. Varol, K.A. Cashell
High strength steels are increasingly common in structural engineering applications owing to their favourable strength to weight ratio, excellent sustainability credentials and attractive physical and mechanical properties. However, these grades are under-used in structures owing to a lack of reliable information relating to their structural performance, particularly at elevated temperature. This paper presents a review of high strength steels in structural applications including the key design considerations. Particular focus is given to the lateral torsional buckling response of laterally unrestrained beams. A finite element model is developed to investigate this behaviour at ambient and elevated temperature. A series of beams between 500 and 4500mm in length are studied in order to develop buckling curves which are comparable with current design provisions. At ambient temperature, it is shown that all of the buckling curves currently included in Eurocode 3 Part 1-1 give unsatisfactory and potentially unsafe predictions. In elevated temperature conditions, the buckling curves presented in Eurocode 3 Part 1–2 depict the behaviour reasonably well but, at relatively high slenderness values, the standard does not always provide a safe prediction. Revised bucking curves are proposed for high strength steel beams for laterally unrestrained beams made from high strength steel.



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Comparison of competency priorities between UK occupational physicians and occupational health nurses

Objectives

The competencies required of occupational physicians (OPs) and occupational health nurses (OHNs) separately have been studied in various countries but little research has made direct comparisons between these two key occupational health (OH) professional groups. The aim of this study was to compare current competency priorities between UK OPs and OHNs.

Methods

A modified Delphi study conducted among professional organisations and networks of UK OPs and OHNs. This formed part of a larger Delphi, including international OPs. It was undertaken in two rounds (round 1—‘rating’, round 2—‘ranking’), using a questionnaire based on available OH competency guidance, the literature, expert panel reviews and conference discussions.

Results

In each round (rating/ranking), 57/49 and 48/54 responses were received for OPs and OHNs respectively. The principle domain (PD) competency ranks were very highly correlated (Spearman’s r=0.972) with the same PDs featuring in the top four and bottom three positions. OPs and OHNs ranked identically for the top two PDs (good clinical care and general principles of assessment and management of occupational hazards to health). Research methods was ranked lowest by both groups.

Conclusions

This study has observed a high level of agreement among UK OPs and OHNs on current competency priorities. The ‘clinically focused’ competency priorities likely reflect that although OH practice will broaden in response to various factors, traditional ‘core’ OH activities will still be required. These mutually identified priorities can serve to strengthen collaboration between these groups, develop joint education/training programmes and identify common professional development opportunities.

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IJERPH, Vol. 14, Pages 220: Influencing Factors of the Body Mass Index of Elementary Students in Southern Taiwan

The body mass index (BMI) of school children in Taiwan is markedly increasing. According to statistical data from the Taiwan Ministry of Education, the prevalence of obesity in school children from the southern part of the country is the highest in Taiwan. Thus, exploring the factors influencing BMI in elementary school children from southern Taiwan is crucial. This study investigated the influencing factors including physical activity levels, sedentary behaviors, dietary habits, and perceived body shape on the BMIs of elementary school children from southern Taiwan. A cross-sectional design was used, and the participants consisted of 3251 fifth-grade students (1628 boys, 50.1%; 1623 girls, 49.9%). The average BMI values for boys and girls were 19.69 and 18.70 (kg/cm) respectively. Statistically significant associations were observed between BMI and sex, 31–60 min of daily vigorous or moderate physical activities levels, length of time spent watching television, time spent on video games or the computer, and intake of vegetable or meat gravy with rice (p < 0.001). Perceived body shape also affected the BMI of school children. The results of this study enable educational institutions in Taiwan to understand the factors affecting the BMI of school children and use this information as the basis for future healthy body weight policies.

http://ift.tt/2lujRt0

IJERPH, Vol. 14, Pages 224: Assessing Health-Related Quality of Life of Chinese Adults in Heilongjiang Using EQ-5D-3L

This study aimed to assess health-related quality of life (HRQOL) of Heilongjiang adult populations by using the EuroQol five-dimension three-level (EQ-5D-3L) questionnaire and to identify factors associated with HRQOL. Data from the National Health Services Survey (NHSS) 2008 in Heilongjiang province were obtained. Results of EQ-5D-3L questionnaires completed by 11,523 adult respondents (18 years or older) were converted to health index scores using a recently developed Chinese value set. Multivariate linear regression and logistic regression models were established to determine demographic, socioeconomic, health, and lifestyle factors that were associated with HRQOL and reported problems in the five dimensions of EQ-5D-3L. The Heilongjiang population had a mean EQ-5D-3L index score of 0.959. Lower EQ-5D-3L index scores were associated with older age, lower levels of education, chronic conditions, temporary accommodation, poverty, unemployment, and lack of regular physical activities. Older respondents and those who were unemployed, had chronic conditions, and lived in poverty were more likely to report problems in all of the five health dimensions. Higher educational attainment was associated with lower odds of reporting health problems in mobility, pain/discomfort, and anxiety/depression. Low socioeconomic status is associated with poor HRQOL. Regional population norms for EQ-5D-3L are needed for health economic studies due to great socioeconomic disparities across regions in China. Overall, the Heilongjiang population has a similar level of HRQOL compared with the national average.

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IJERPH, Vol. 14, Pages 221: Implementing a Public Health Objective for Alcohol Premises Licensing in Scotland: A Qualitative Study of Strategies, Values, and Perceptions of Evidence

The public health objective for alcohol premises licensing, established in Scotland in 2005, is unique globally. We explored how public health practitioners engaged with the licensing system following this change, and what helped or hindered their efforts. Semi-structured interviews were conducted with 13 public health actors, audio-recorded, and analysed using an inductive framework approach. Many interviewees viewed the new objective as synonymous with reducing population-level alcohol consumption; however, this view was not always shared by licensing actors, some of whom did not accept public health as a legitimate goal of licensing, or prioritised economic development instead. Some interviewees were surprised that the public health evidence they presented to licensing boards did not result in their hoped-for outcomes; they reported that licensing officials did not always understand or value health data or statistical evidence. While some tried to give “impartial” advice to licensing boards, this was not always easy; others were clear that their role was one of “winning hearts and minds” through relationship-building with licensing actors over time. Notwithstanding the introduction of the public health objective, there remain significant, and political, challenges in orienting local premises licensing boards towards decisions to reduce the availability of alcohol in Scotland.

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IJERPH, Vol. 14, Pages 225: Accelerators: Sparking Innovation and Transdisciplinary Team Science in Disparities Research

Development and implementation of effective, sustainable, and scalable interventions that advance equity could be propelled by innovative and inclusive partnerships. Readied catalytic frameworks that foster communication, collaboration, a shared vision, and transformative translational research across scientific and non-scientific divides are needed to foster rapid generation of novel solutions to address and ultimately eliminate disparities. To achieve this, we transformed and expanded a community-academic board into a translational science board with members from public, academic and private sectors. Rooted in team science, diverse board experts formed topic-specific “accelerators”, tasked with collaborating to rapidly generate new ideas, questions, approaches, and projects comprising patients, advocates, clinicians, researchers, funders, public health and industry leaders. We began with four accelerators—digital health, big data, genomics and environmental health—and were rapidly able to respond to funding opportunities, transform new ideas into clinical and community programs, generate new, accessible, actionable data, and more efficiently and effectively conduct research. This innovative model has the power to maximize research quality and efficiency, improve patient care and engagement, optimize data democratization and dissemination among target populations, contribute to policy, and lead to systems changes needed to address the root causes of disparities.

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IJERPH, Vol. 14, Pages 226: The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China

With the continuous rapid urbanization process over the last three decades, outdoors air pollution has become a progressively more serious public health hazard in China. To investigate the possible associations, lag effects and seasonal differences of urban air quality on respiratory health (allergic rhinitis) in Changchun, a city in Northeastern China, we carried out a time-series analysis of the incidents of allergic rhinitis (AR) from 2013 to 2015. Environmental monitoring showed that PM2.5 and PM10 were the major air pollutants in Changchun, followed by SO2, NO2 and O3. The results also demonstrated that the daily concentrations of air pollutants had obvious seasonal differences. PM10 had higher daily mean concentrations in spring (May, dust storms), autumn (October, straw burning) and winter (November to April, coal burning). The mean daily number of outpatient AR visits in the warm season was higher than in the cold season. The prevalence of allergic rhinitis was significantly associated with PM2.5, PM10, SO2 and NO2, and the increased mobility was 10.2% (95% CI, 5.5%–15.1%), 4.9% (95% CI, 0.8%–9.2%), 8.5% (95% CI, −1.8%–19.8%) and 11.1% (95% CI, 5.8%–16.5%) for exposure to each 1-Standard Deviation (1-SD) increase of pollutant, respectively. Weakly or no significant associations were observed for CO and O3. As for lag effects, the highest Relative Risks (RRs) of AR from SO2, NO2, PM10 and PM2.5 were on the same day, and the highest RR from CO was on day 4 (L4). The results also indicated that the concentration of air pollutants might contribute to the development of AR. To summarize, this study provides further evidence of the significant association between ambient particulate pollutants (PM2.5 and PM10, which are usually present in high concentrations) and the prevalence of respiratory effects (allergic rhinitis) in the city of Changchun, located in Northeastern China. Environmental control and public health strategies should be enforced to address this increasingly challenging problem.

http://ift.tt/2mp0Vtu

IJERPH, Vol. 14, Pages 219: Network Analysis: A Novel Approach to Understand Suicidal Behaviour

Although suicide is a major public health issue worldwide, we understand little of the onset and development of suicidal behaviour. Suicidal behaviour is argued to be the end result of the complex interaction between psychological, social and biological factors. Epidemiological studies resulted in a range of risk factors for suicidal behaviour, but we do not yet understand how their interaction increases the risk for suicidal behaviour. A new approach called network analysis can help us better understand this process as it allows us to visualize and quantify the complex association between many different symptoms or risk factors. A network analysis of data containing information on suicidal patients can help us understand how risk factors interact and how their interaction is related to suicidal thoughts and behaviour. A network perspective has been successfully applied to the field of depression and psychosis, but not yet to the field of suicidology. In this theoretical article, I will introduce the concept of network analysis to the field of suicide prevention, and offer directions for future applications and studies.

http://ift.tt/2mg4wL7

IJERPH, Vol. 14, Pages 218: Trends of Esophageal Cancer Mortality in Rural China from 1989 to 2013: An Age-Period-Cohort Analysis

Background: Esophageal cancer is one of the most common cancers in rural China. The aim of this study was to describe the time trends of esophageal cancer mortality in rural China and to better elucidate the causes of these trends. Methods: The mortality data were obtained from the World Health Organization Mortality Database and the China Health Statistical Yearbook Database. The mortality data were analyzed with age-period-cohort (APC) analysis. Results: Our study indicates that the Age-Standardized Mortality Rates (ASMRs) in rural China generally decreased from 1989 to 2003, and thereafter increased until the year 2008 in both sexes. After 2008, the ASMRs decreased again. The results of APC analysis suggest that the general decrease in esophageal cancer mortality in rural China from 1989 to 2003 might be caused by the downtrend of the cohort effects and period effects, while the general increase in mortality from 2004 to 2008 might be caused by the uptrend of the period effects. The decrease in mortality after 2008 may be relevant to the Four Trillion RMB Investment Plan launched by the Chinese Government. Conclusions: The declining cohort effects were probably related to the improvement of socioeconomic status in childhood and the decreasing consumptions of alcohol drinking and smoking, while the trends of the period effects were relevant to the changes in the dietary pattern. Our findings may help predict future changes in esophageal cancer mortality.

http://ift.tt/2mbs9Yw

IJERPH, Vol. 14, Pages 223: Simultaneous Detection of Nine Key Bacterial Respiratory Pathogens Using Luminex xTAG® Technology

Early diagnosis and treatment are crucial to the outcome of lower respiratory tract infections (LRTIs). In this study, we developed an assay combining multiplex PCR and Luminex technology (MPLT) for the detection of nine important respiratory bacterial pathogens, which frequently cause LRTIs. These were Streptococcus pneumoniae, Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pyogenes, Haemophilus influenzae, Mycoplasma pneumoniae, Legionella spp., Pseudomonas aeruginosa, and Klebsiella pneumoniae. Through the hybridization reaction between two new synthesized multiplex PCR products and MagPlex-TAG Microspheres, we demonstrate that the detection limits for these nine pathogens were as low as 102–103 CFU/mL. Furthermore, 86 clinical bronchoalveolar lavage fluid specimens were used to evaluate this method. Compared with the results of nine simplex real-time PCR reactions targeting these nine pathogens, this MPLT assay demonstrated a high diagnostic accuracy for Streptococcus pneumoniae (sensitivity, 87.5% and specificity, 100%). Furthermore, sensitivity and specificity for the other eight pathogens all attained 100% diagnostic accuracy. In addition, the consistency between MPLT and the nine real-time PCR reactions exceeded 98.8%. In conclusion, MPLT is a high-throughput, labor-saving and reliable method with high sensitivity and specificity for identifying nine respiratory pathogens responsible for LRTIs. Indeed, this assay may be a promising supplement to conventional methods used to diagnose LRTIs.

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IJERPH, Vol. 14, Pages 216: DNA Methylation Status of PAX1 and ZNF582 in Esophageal Squamous Cell Carcinoma

Hypermethylation of specific gene promoters is an important mechanism of carcinogenesis. A high frequency of promoter methylation of PAX1 and ZNF582 genes has been detected in cervical cancer. In the present study, we investigated the methylation status of PAX1 and ZNF582 genes in esophageal squamous cell carcinoma (ESCC) tissues. Tumor and paracancerous tissues were obtained from 14 ESCC patients. Genomic DNA was extracted from both tumor and paracancerous tissues, and the concentration of DNA were determined. DNA methylation analysis of PAX1 and ZNF582 genes was carried out using quantitative methylation-specific PCR. To assess the diagnostic performance of the two methylated genes for cancer detection, receiver operating characteristic (ROC) curves were generated. Sensitivities and specificities were tested at cut-offs obtained from the ROC curves. The methylation levels of both PAX1 and ZNF582 genes were significantly higher in tumor tissues compared to non-tumor paracancerous tissues. The methylation rates of PAX1 and ZNF582 in ESCC tumor and paracancerous tissues were 100% and 21.4% (p = 0.006), 85.7% and 0% (p < 0.001), respectively. The sensitivities and specificities of PAX1 and ZNF582 methylation for the detection of cancer were 100% and 85.7%, and 78.6% and 100%, respectively. The DNA methylation levels and frequencies of PAX1 and ZNF582 genes were markedly higher in ESCC tumor tissues compared to those in paracancerous tissues. Moreover, the conclusions were verified by using The Cancer Genome Atlas (TCGA) datasets. DNA methylation status of these two genes showed a relatively good sensitivity and specificity for the detection of ESCC tumors. This data suggests that DNA methylation testing holds a great promise for ESCC screening and warrants further prospective population-based studies.

http://ift.tt/2lobzTO

IJERPH, Vol. 14, Pages 217: Comparison of Influenza Epidemiological and Virological Characteristics between Outpatients and Inpatients in Zhejiang Province, China, March 2011–June 2015

Given the rapid rate of global spread and consequently healthcare costs related to influenza, surveillance plays an important role in monitoring the emerging pandemics in China. However, the characteristics of influenza in Southeast of China haven’t been fully studied. Our study use the surveillance data collected from 16 sentinel hospitals across Zhejiang Province during March 2011 through June 2015, including the demographic information and respiratory specimens from influenza-like illness (ILI) patients and severe acute respiratory illness (SARI) patients. As analysis results, most SARI and ILI patients were in the age group of 0–4 years old (62.38% of ILI and 71.54% of SARI). The respiratory specimens have statistically significantly higher positive rate for influenza among ILI patients than that among SARI patients (p < 0.001). The comparison between ILI patients and SARI patients shows no statistically significantly difference in detecting influenza virus type and influenza A virus subtype. The SARI and ILI patients were found to be positively correlated for overall positive rate (r = 0.63, p < 0.001), the weekly percentage of A(H1N1)pdm09 (r = 0.51, p < 0.001), influenza B virus (r = 0.17, p = 0.013), and A/H3N2 (r = 0.43, p < 0.001) among all the positive numbers. Our study demonstrated that the activities of influenza virus, including its subtypes, had a similar temporal pattern between ILI and SARI cases.

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IJERPH, Vol. 14, Pages 215: Removal Capacities of Polycyclic Aromatic Hydrocarbons (PAHs) by a Newly Isolated Strain from Oilfield Produced Water

The polycyclic aromatic hydrocarbon (PAH)-degrading strain Q8 was isolated from oilfield produced water. According to the analysis of a biochemical test, 16S rRNA gene, house-keeping genes and DNA–DNA hybridization, strain Q8 was assigned to a novel species of the genus Gordonia. The strain could not only grow in mineral salt medium (MM) and utilize naphthalene and pyrene as its sole carbon source, but also degraded mixed naphthalene, phenanthrene, anthracene and pyrene. The degradation ratio of these four PAHs reached 100%, 95.4%, 73.8% and 53.4% respectively after being degraded by Q8 for seven days. A comparative experiment found that the PAHs degradation efficiency of Q8 is higher than that of Gordonia alkaliphila and Gordonia paraffinivorans, which have the capacities to remove PAHs. Fourier transform infrared spectra, saturate, aromatic, resin and asphaltene (SARA) and gas chromatography–mass spectrometry (GC–MS) analysis of crude oil degraded by Q8 were also studied. The results showed that Q8 could utilize n-alkanes and PAHs in crude oil. The relative proportions of the naphthalene series, phenanthrene series, thiophene series, fluorene series, chrysene series, C21-triaromatic steroid, pyrene, and benz(a)pyrene were reduced after being degraded by Q8. Gordonia sp. nov. Q8 had the capacity to remediate water and soil environments contaminated by PAHs or crude oil, and provided a feasible way for the bioremediation of PAHs and oil pollution.

http://ift.tt/2maH81v

IJERPH, Vol. 14, Pages 211: Basigin rs8259 Polymorphism Confers Decreased Risk of Chronic Heart Failure in a Chinese Population

Left ventricular remodeling is an essential risk factor contributing to the pathogenesis of chronic heart failure (CHF). Basigin (BSG) promotes cardiovascular inflammation and myocardial remodeling processes by induction of extracellular matrix metalloproteinases and inflammatory cytokines. BSG rs8259 polymorphism was associated with BSG expression and risk of acute coronary syndrome. Therefore, we investigated whether rs8259 polymorphism contributes to risk and prognosis of CHF in Chinese patients. In total 922 adult patients with CHF and 1107 matched healthy controls were enrolled. BSG rs8259 polymorphism was genotyped using PCR-restriction fragment length polymorphism. Whole blood BSG mRNA expression data from Genotype-Tissue Expression project was accessed. Evaluation of follow-up data was performed in only 15.2% (140) of the patients with CHF. BSG rs8259 TT genotype was associated with a decreased risk of CHF (OR = 0.83, 95% CI = 0.72–0.96, p = 0.010), especially in patients with hypertension (OR = 0.80, 95% CI = 0.68–0.95, p = 0.011) and coronary heart disease (OR = 0.81, 95% CI = 0.69–0.96, p = 0.013) after adjustment for multiple cardiovascular risk factors. Rs8259 T allele was associated with decreased BSG mRNA in whole blood from 338 healthy normal donors (p = 1.31 × 10−6). However, rs8259 polymorphism failed to exhibit an association with cardiovascular mortality (p = 0.283). BSG rs8259 polymorphism may contribute to decreased risk of CHF in a Chinese Han population.

http://ift.tt/2lqArZn

IJERPH, Vol. 14, Pages 214: Urban Pollutant Transport and Infiltration into Buildings Using Perfluorocarbon Tracers

People spend the majority of their time indoors and therefore the quality of indoor air is worthy of investigation; indoor air quality is affected by indoor sources of pollutants and from pollutants entering buildings from outdoors. In this study, unique perfluorocarbon tracers were released in five experiments at a 100 m and ~2 km distance from a large university building in Manchester, UK and tracer was also released inside the building to measure the amount of outdoor material penetrating into buildings and the flow of material within the building itself. Air samples of the tracer were taken in several rooms within the building, and a CO2 tracer was used within the building to estimate air-exchange rates. Air-exchange rates were found to vary between 0.57 and 10.90 per hour. Indoor perfluorocarbon tracer concentrations were paired to outdoor tracer concentrations, and in-out ratios were found to vary between 0.01 and 3.6. The largest room with the lowest air-exchange rate exhibited elevated tracer concentrations for over 60 min after the release had finished, but generally had the lowest concentrations, the room with the highest ventilation rates had the highest concentration over 30 min, but the peak decayed more rapidly. Tracer concentrations indoors compared to outdoors imply that pollutants remain within buildings after they have cleared outside, which must be considered when evaluating human exposure to outdoor pollutants.

http://ift.tt/2kHxZRd

IJERPH, Vol. 14, Pages 212: The Vulnerability of People to Landslides: A Case Study on the Relationship between the Casualties and Volume of Landslides in China

The lack of a detailed landslide inventory makes research on the vulnerability of people to landslides highly limited. In this paper, the authors collect information on the landslides that have caused casualties in China, and established the Landslides Casualties Inventory of China. 100 landslide cases from 2003 to 2012 were utilized to develop an empirical relationship between the volume of a landslide event and the casualties caused by the occurrence of the event. The error bars were used to describe the uncertainty of casualties resulting from landslides and to establish a threshold curve of casualties caused by landslides in China. The threshold curve was then applied to the landslide cases occurred in 2013 and 2014. The validation results show that the estimated casualties of the threshold curve were in good agreement with the real casualties with a small deviation. Therefore, the threshold curve can be used for estimating potential casualties and landslide vulnerability, which is meaningful for emergency rescue operations after landslides occurred and for risk assessment research.

http://ift.tt/2kHtxSt

IJERPH, Vol. 14, Pages 213: Characterization of Carbonic Anhydrase 9 in the Alimentary Canal of Aedes aegypti and Its Relationship to Homologous Mosquito Carbonic Anhydrases

In the mosquito midgut, luminal pH regulation and cellular ion transport processes are important for the digestion of food and maintenance of cellular homeostasis. pH regulation in the mosquito gut is affected by the vectorial movement of the principal ions including bicarbonate/carbonate and protons. As in all metazoans, mosquitoes employ the product of aerobic metabolism carbon dioxide in its bicarbonate/carbonate form as one of the major buffers of cellular and extracellular pH. The conversion of metabolic carbon dioxide to bicarbonate/carbonate is accomplished by a family of enzymes encoded by the carbonic anhydrase gene family. This study characterizes Aedes aegypti carbonic anhydrases using bioinformatic, molecular, and immunohistochemical methods. Our analyses show that there are fourteen Aedes aegypti carbonic anhydrase genes, two of which are expressed as splice variants. The carbonic anhydrases were classified as either integral membrane, peripheral membrane, mitochondrial, secreted, or soluble cytoplasmic proteins. Using polymerase chain reaction and Western blotting, one of the carbonic anhydrases, Aedes aegypti carbonic anhydrase 9, was analyzed and found in each life stage, male/female pupae, male/female adults, and in the female posterior midgut. Next, carbonic anhydrase 9 was analyzed in larvae and adults using confocal microscopy and was detected in the midgut regions. According to our analyses, carbonic anhydrase 9 is a soluble cytoplasmic enzyme found in the alimentary canal of larvae and adults and is expressed throughout the life cycle of the mosquito. Based on previous physiological analyses of adults and larvae, it appears AeCA9 is one of the major carbonic anhydrases involved in producing bicarbonate/carbonate which is involved in pH regulation and ion transport processes in the alimentary canal. Detailed understanding of the molecular bases of ion homeostasis in mosquitoes will provide targets for novel mosquito control strategies into the new millennium.

http://ift.tt/2lqw6W4

IJERPH, Vol. 14, Pages 210: Association of Sleep Duration, Sleep Quality and Shift-Work Schedule in Relation to Hypertension Prevalence in Chinese Adult Males: A Cross-Sectional Survey

Background: Previous studies indicated that measurement of sleep only by duration and quality may be biased. This study aimed to investigate the interactive association of self-reported sleep duration, quality and shift-work schedule with hypertension prevalence in Chinese adult males. Methods: A total of 4519 Chinese adult males (≥18 years) were enrolled into the cross-sectional survey. Sleep attributes were measured from the responses to the standard Pittsburgh Sleep Quality Index and relevant questions in a structured questionnaire survey. The association of sleep duration, quality and shift-work schedule with hypertension prevalence was analyzed using multivariate logistic regression, considering the interaction between them or not. Results: Taking the potential interaction of the three aspects of sleep into consideration, only short sleep duration combined with poor sleep quality was found to be related to hypertension prevalence in Chinese adult males (odds ratio (OR): 1.74, 95% confidence interval (CI): 1.31–2.31), which could be modified by occasional and frequent shift-work schedule (OR: 1.43, 95% CI: 1.05–1.95; OR: 1.97, 95% CI: 1.40–2.79). Conclusions: Short sleep duration was not associated with the prevalence of hypertension in Chinese adult males unless poor sleep quality exists, which could be further modified by shift-work schedule. Assessment of sleep by measuring sleep duration only was not sufficient when exploring the association of sleep with hypertension.

http://ift.tt/2lqFxow

Pulmonary function and airway inflammation among dairy parlor workers after exposure to inhalable aerosols

Background

Inhalation exposure to organic dust causes lung inflammation among agricultural workers. Due to changes in production and work organization, task-based inhalation exposure data, including novel lung inflammation biomarkers, will inform exposure recommendations for dairy farm workers.

Methods

Linear regression was used to estimate the associations of airborne exposure to dust concentration, endotoxin, and muramic acid with pulmonary outcomes (i.e., FEV₁, exhaled nitric oxide). Logistic regression was used to estimate associations with self-reported pulmonary symptoms.

Results

Mean exposure concentration to inhalable dust, endotoxin, and muramic acid were 0.55 mg/m³, 118 EU/m³, and 3.6 mg/m³, respectively. We found cross-shift differences for exhaled nitric oxide (P = 0.005) and self-reported pulmonary symptoms (P = 0.008) but no association of exposure with respiratory outcomes.

Conclusions

Inhalation exposures during parlor tasks, which were lower than previously reported and were not associated with cross-shift measures of pulmonary health among dairy workers. Modern milking parlor designs may be contributing to lower inhalation exposure. Am. J. Ind. Med. 60:255–263, 2017. © 2017 Wiley Periodicals, Inc.

http://ift.tt/2lfpjjs

Facilitators and barriers to the adoption of ergonomic solutions in construction

Background

Rates of musculoskeletal disorders in construction remain high. Few studies have described barriers and facilitators to the use of available ergonomic solutions. This paper describes these barriers and facilitators and their relationship to the level of adoption.

Methods

Three analysts rated 16 proposed ergonomic solutions from a participatory ergonomics study and assessed the level of adoption, six adoption characteristics, and identified the category of adoption from a theoretical model.

Results

Twelve solutions were always or intermittently used and were rated positively for characteristics of relative advantage, compatibility with existing work processes and trialability. Locus of control (worker vs. contractor) was not related to adoption. Simple solutions faced fewer barriers to adoption than those rated as complex.

Conclusions

Specific adoption characteristics can help predict the use of new ergonomic solutions in construction. Adoption of complex solutions must involve multiple stakeholders, more time, and shifts in culture or work systems. Am. J. Ind. Med. 60:295–305, 2017. © 2017 Wiley Periodicals, Inc.

http://ift.tt/2m58BSa

Risk of work injury among adolescent students from single and partnered parent families

Background

Parental involvement in keeping their children safe at work has been examined in a handful of studies, with mixed results. Evidence has suggested that non-work injury risk is higher among children from single-parent families, but little is known about their risk for work-related injuries.

Methods

Five survey cycles of the Canadian Community Health Survey were pooled to create a nationally representative sample of employed 15–19-year old students (N = 16,620). Multivariable logistic regression estimated the association between family status and work injury.

Results

Risk of work-related repetitive strains (OR:1.24, 95%CI: 0.69–2.22) did not differ by family type. However, children of single parents were less likely to sustain a work injury receiving immediate medical care (OR:0.43, 95%CI: 0.19–0.96).

Conclusion

Despite advantages and disadvantages related to family types, there is no evidence that work-related injury risk among adolescents from single parent families is greater than that of partnered-parent families. Am. J. Ind. Med. 60:285–294, 2017. © 2017 Wiley Periodicals, Inc.

http://ift.tt/2lfzowV

Risk of indium lung disease in display panel manufacturing workers

http://ift.tt/2m5ppZl

Silica exposure and disease in semi-precious stone craftsmen, Minas Gerais, Brazil

Background

Brazil is an exporter of precious stones and craftsmen often work in poor conditions. We assessed silica-related diseases among crystal craftsmen and the complexity of its control.

Methods

Case-series including 118 subjects evaluated from 2006 to 2015, based on medical interviews, chest X-rays, spirometry, and respirable silica samples.

Results

Median age and length of exposure were 32 and 13 years, respectively. Silicosis, with 1/0 as a threshold, was diagnosed radiologically in 57 individuals (48.3%). Respirable silica concentrations were 0.9–29.3 times greater than the Brazilian occupational exposure limit. A Receiver Operating Characteristic (ROC) curve with the same diagnosis threshold showed best discrimination at a cut point of 12.5 years of exposure, corresponding to 4.85 mg-y/m³ of cumulative silica exposure. There was a significant decline in FEV₁ across radiological and cumulative silica exposure categories. Eleven individuals (9.3%) had mycobacterial diseases at baseline or follow-up.

Conclusion

Crystal craftsmen continue to suffer from silicosis, lung function impairment, comorbidity, and death due to silicosis. To date collective protection in some work sheds has not diminished silica levels. Long-term follow-up is needed to evaluate further improvements in preventive measures. Am. J. Ind. Med. 60:239–247, 2017. © 2017 Wiley Periodicals, Inc.

http://ift.tt/2lfomI8

Association between parental access to paid sick leave and children's access to and use of healthcare services

Background

We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits.

Methods

We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models.

Results

Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12.5% [95%CI: 1.06–1.19] higher and receiving annual medical checkups were 13.2% [95%CI: 1.04–1.23] higher than those of children without PPSL. With PPSL, the odds of children receiving delayed medical care because of time mismatch were 13.3% [95%CI: 0.76–0.98] lower, and being taken to ER were 53.6% [95%CI: 0.27–0.81] lower than those of children without PPSL. PPSL was associated with 11% [95%CI: 0.82–0.97] fewer ER visits per year.

Conclusion

PPSL may improve children's access and use of healthcare services and reduce the number of ER visits. Am. J. Ind. Med. 60:276–284, 2017. © 2017 Wiley Periodicals, Inc.

http://ift.tt/2m5cDdk

IJERPH, Vol. 14, Pages 206: An Increase in Consuming Adequately Iodized Salt May Not Be Enough to Rectify Iodine Deficiency in Pregnancy in an Iodine-Sufficient Area of China

Universal salt iodization (USI) has been implemented for two decades in China. It is crucial to periodically monitor iodine status in the most vulnerable population, such as pregnant women. A cross-sectional study was carried out in an evidence-proved iodine-sufficient province to evaluate iodine intake in pregnancy. According to the WHO/UNICEF/ICCIDD recommendation criteria of adequate iodine intake in pregnancy (150–249 µg/L), the median urinary iodine concentration (UIC) of the total 8159 recruited pregnant women was 147.5 µg/L, which indicated pregnant women had iodine deficiency at the province level. Overall, 51.0% of the total study participants had iodine deficiency with a UIC < 150 µg/L and only 32.9% of them had adequate iodine. Participants living in coastal areas had iodine deficiency with a median UIC of 130.1 µg/L, while those in inland areas had marginally adequate iodine intake with a median UIC of 158.1 µg/L (p < 0.001). Among the total study participants, 450 pregnant women consuming non-iodized salt had mild-moderate iodine deficiency with a median UIC of 99.6 µg/L; 7363 pregnant women consuming adequately iodized salt had a lightly statistically higher median UIC of 151.9 µg/L, compared with the recommended adequate level by the WHO/UNICEF/ICCIDD (p < 0.001). Consuming adequately iodized salt seemed to lightly increase the median UIC level, but it may not be enough to correct iodine nutrition status to an optimum level as recommended by the WHO/UNICEF/ICCIDD. We therefore suggest that, besides strengthening USI policy, additional interventive measure may be needed to improve iodine intake in pregnancy.

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IJERPH, Vol. 14, Pages 207: Impact of Particular Matter Exposure and Surrounding “Greenness” on Chronic Absenteeism in Massachusetts Public Schools

Chronic absenteeism is associated with poorer academic performance and higher attrition in kindergarten to 12th grade (K-12) schools. In prior research, students who were chronically absent generally had fewer employment opportunities and worse health after graduation. We examined the impact that environmental factors surrounding schools have on chronic absenteeism. We estimated the greenness (Normalized Difference Vegetation Index (NDVI)) and fine particulate matter air pollution (PM2.5) within 250 m and 1000 m respectively of each public school in Massachusetts during the 2012–2013 academic year using satellite-based data. We modeled chronic absenteeism rates in the same year as a function of PM2.5 and NDVI, controlling for race and household income. Among the 1772 public schools in Massachusetts, a 0.15 increase in NDVI during the academic year was associated with a 2.6% (p value < 0.0001) reduction in chronic absenteeism rates, and a 1 μg/m3 increase in PM2.5 during the academic year was associated with a 1.58% (p value < 0.0001) increase in chronic absenteeism rates. Based on these percentage changes in chronic absenteeism, a 0.15 increase in NDVI and 1 μg/m3 increase in PM2.5 correspond to 25,837 fewer students and 15,852 more students chronically absent each year in Massachusetts respectively. These environmental impacts on absenteeism reinforce the need to protect green spaces and reduce air pollution around schools.

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IJERPH, Vol. 14, Pages 208: The Feasibility of Embedding Data Collection into the Routine Service Delivery of a Multi-Component Program for High-Risk Young People

Background: There is little evidence about how to improve outcomes for high-risk young people, of whom Indigenous young people are disproportionately represented, due to few evaluation studies of interventions. One way to increase the evidence is to have researchers and service providers collaborate to embed evaluation into the routine delivery of services, so program delivery and evaluation occur simultaneously. This study aims to demonstrate the feasibility of integrating best-evidence measures into the routine data collection processes of a service for high-risk young people, and identify the number and nature of risk factors experienced by participants. Methods: The youth service is a rural based NGO comprised of multiple program components: (i) engagement activities; (ii) case management; (iii) diversionary activities; (iv) personal development; and (v) learning and skills. A best-evidence assessment tool was developed by staff and researchers and embedded into the service’s existing intake procedure. Assessment items were organised into demographic characteristics and four domains of risk: education and employment; health and wellbeing; substance use; and crime. Descriptive data are presented and summary risk variables were created for each domain of risk. A count of these summary variables represented the number of co-occurring risks experienced by each participant. The feasibility of this process was determined by the proportion of participants who completed the intake assessment and provided research consent. Results: This study shows 85% of participants completed the assessment tool demonstrating that data on participant risk factors can feasibly be collected by embedding a best-evidence assessment tool into the routine data collection processes of a service. The most prevalent risk factors were school absence, unemployment, suicide ideation, mental distress, substance use, low levels of physical activity, low health service utilisation, and involvement in crime or with the juvenile justice system. All but one participant experienced at least two co-occurring domains of risk, and the majority of participants (58%) experienced co-occurring risk across four domains. Conclusions: This is the first study to demonstrate that best-evidence measures can feasibly be embedded into the routine data collection processes of a service for high-risk young people. This process allows services to tailor their activities to the most prevalent risks experienced by participants, and monitor these risks over time. Replication of this process in other services would improve the quality of services, facilitate more high quality evaluations of services, and contribute evidence on how to improve outcomes for high-risk young people.

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IJERPH, Vol. 14, Pages 209: Optimistic Bias, Risk Factors, and Development of High Blood Pressure and Obesity among African American Adolescents in Mississippi (USA)

Childhood obesity has reached epidemic proportions and is linked to hypertension among African American youth. Optimistic bias influences behavior of youth causing them to underestimate their susceptibility to negative health outcomes. This study explored adolescent behaviors and prevalence of high blood pressure and obesity in a school district. We examined the relationship between individual health risk practices and optimistic bias on health outcomes; 433 African American high school students were administered a survey and had their obesity and blood pressure measured by the school nurse. Canonical correlational analyses were used to examine relationships between health risk practices and descriptive statistics for optimistic bias and health outcomes. Engaging in moderate exercise for at least 30 min in the last 7 days and lower blood pressure was the only statistically significant relationship. Two-thirds of the students did not perceive themselves to be at risk of developing cardiovascular disease with males at greater risk than females, despite the presence of clinical risk factors for hypertension and obesity. Reducing health optimistic bias is an effective way of motivating young people to adopt more positive behaviors using educational institutions to implement intervention programs that promote positive health behavior as a way to reduce health disparities.

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IJERPH, Vol. 14, Pages 205: Smart Device Use and Perceived Physical and Psychosocial Outcomes among Hong Kong Adolescents

Excessive electronic screen-based activities have been found to be associated with negative outcomes. The aim of this study was to investigate the prevalences and patterns of smart device activities and the purposes and perceived outcomes related to smart device use, and the differences in patterns of smart device activities between adolescents who did and did not perceive these outcomes. The study was a cross-sectional survey of Hong Kong primary and secondary school students. Demographic characteristics, purpose and pattern of the activities, and frequencies of the outcomes were measured. Data from 960 adolescents aged 10–19 were analyzed. Nearly 86% of the sample use smart device daily. The one-week prevalence of perceived sleep deprivation, eye discomfort, musculoskeletal discomfort, family conflict and cyberbullying victimization related to smart device use were nearly 50%, 45%, 40%, 20% and 5% respectively. More than 25% of the respondents were at risk of negative outcomes related to smart device activities for more than 1 h per day, browsing and gaming on at least 4 days per week and watching TV/movies and posting on more than 2 days per week. Their patterns of smart device activities may put a significant number of them at risk of negative outcomes.

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IJERPH, Vol. 14, Pages 204: Environmental Criteria in the Spanish Public Works Procurement Process

Green Public Procurement (GPP) is defined as a process of contracting products, services, and works with the least possible damage to the environment during their life cycle. In order to improve the knowledge about GPP, a study of the use of environmental tendering criteria in the Spanish public construction sector has been performed. The results of this study show that the use of environmental criteria in Spanish public sector construction procurement is low in comparison to a certain group of countries, known as “Green 7”, in the European Union. Environmental criteria is the fourth criterion in importance, but its weight in the global of the process is much lower than other criteria such as price, memory of the construction process and the delivery time. National administrations use environmental criteria more frequently because they have more resources and staff training about environmental issues. Environmental criteria are more used in the tendering of civil projects and works whose budget exceeds ten million euro due to the environmental impact of these kind and/or size of projects.

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Skin temperatures of a pre-cooled wet person exposed to engulfing flames

Publication date: April 2017
Source:Fire Safety Journal, Volume 89
Author(s): Torgrim Log
In a television show, a wetted bare-skinned person slid through engulfing kerosene pool fire flames. The 0.74s flame exposure resulted in pain and light sun burns. The heat and mass transfer involved in this dangerous stunt have been analyzed in order to evaluate whether or not the thin water layer represented an important heat protection measure. It is estimated that the wetted person was exposed to heat fluxes in the range of 80–90kW/m². Analytical solutions of the heat equation were used to evaluate water-spray pre-cooling, heating during flame exposure and post-flame relaxation of skin temperature gradients. It is shown that the water layer carried on the skin into the flames represented limited heat protection. The 30s cold water-spray pre-cooling prior to the flame exposure was the most important heat protection mechanism. Larger flames of higher emissivity, longer period of flame exposure, warmer pre-cooling water or shorter pre-cooling period would most likely have resulted in severe skin burns.



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IJERPH, Vol. 14, Pages 203: Driver’s Cognitive Workload and Driving Performance under Traffic Sign Information Exposure in Complex Environments: A Case Study of the Highways in China

Complex traffic situations and high driving workload are the leading contributing factors to traffic crashes. There is a strong correlation between driving performance and driving workload, such as visual workload from traffic signs on highway off-ramps. This study aimed to evaluate traffic safety by analyzing drivers’ behavior and performance under the cognitive workload in complex environment areas. First, the driving workload of drivers was tested based on traffic signs with different quantities of information. Forty-four drivers were recruited to conduct a traffic sign cognition experiment under static controlled environment conditions. Different complex traffic signs were used for applying the cognitive workload. The static experiment results reveal that workload is highly related to the amount of information on traffic signs and reaction time increases with the information grade, while driving experience and gender effect are not significant. This shows that the cognitive workload of subsequent driving experiments can be controlled by the amount of information on traffic signs. Second, driving characteristics and driving performance were analyzed under different secondary task driving workload levels using a driving simulator. Drivers were required to drive at the required speed on a designed highway off-ramp scene. The cognitive workload was controlled by reading traffic signs with different information, which were divided into four levels. Drivers had to make choices by pushing buttons after reading traffic signs. Meanwhile, the driving performance information was recorded. Questionnaires on objective workload were collected right after each driving task. The results show that speed maintenance and lane deviations are significantly different under different levels of cognitive workload, and the effects of driving experience and gender groups are significant. The research results can be used to analyze traffic safety in highway environments, while considering more drivers’ cognitive and driving performance.

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IJERPH, Vol. 14, Pages 202: Electronic Cigarette Use and Smoking Abstinence in Japan: A Cross-Sectional Study of Quitting Methods

The benefit of electronic cigarettes (e-cigarettes) in smoking cessation remains controversial. Recently, e-cigarettes have been gaining popularity in Japan, without evidence of efficacy on quitting cigarettes. We conducted an online survey to collect information on tobacco use, difficulties in smoking cessation, socio-demographic factors, and health-related factors in Japan. Among the total participants (n = 9055), 798 eligible persons aged 20–69 years who smoked within the previous five years were analyzed to assess the relationship between the outcome of smoking cessation and quitting methods used, including e-cigarettes, smoking cessation therapy, and unassisted. E-cigarette use was negatively associated with smoking cessation (odds ratio (OR) = 0.632; 95% confidence interval (CI) = 0.414–0.964) after adjusting for gender, age, health-related factors, and other quitting methods. Conversely, smoking cessation therapy (i.e., varenicline) was significantly associated with smoking cessation (OR = 1.885; 95% CI = 1.018–3.492) in the same model. For effective smoking cessation, e-cigarette use appears to have low efficacy among smokers in Japan. Allowing for the fact that this study is limited by its cross-sectional design, follow-up studies are needed to assess the prospective association between e-cigarette use and smoking cessation.

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IJERPH, Vol. 14, Pages 200: UV-Radiation: From Physics to Impacts

Ultraviolet (UV) radiation has affected life at least since the first life forms moved out of the seas and crawled onto the land. Therefore, one might assume that evolution has adapted to natural UV radiation. However, evolution is mostly concerned with the propagation of the genetic code, not with a long, happy, and fulfilling life. Because rickets is bad for a woman giving birth, the beneficial effects of UV-radiation outweigh the adverse effects like aged skin and skin tumors of various grades of malignancy that usually only afflict us at older age. Anthropogenic damage to the stratospheric ozone layer and frighteningly high rates of melanoma skin cancer in the light-skinned descendants of British settlers in Australia piqued interest in the health impacts of UV radiation. A changing cultural perception of the beauty of tanned versus light skin and commercial interests in selling UV-emitting devices such as tanning booths caught public health experts off-guard. Counseling and health communication are extremely difficult when dealing with a “natural” risk factor, especially when this risk factor cannot (and should not) be completely avoided. How much is too much for whom or for which skin type? How even measure “much”? Is it the (cumulative) dose or the dose rate that matters most? Or should we even construct a more complex metric such as the cumulative dose above a certain dose rate threshold? We find there are still many open questions, and we are glad that this special issue offered us the opportunity to present many interesting aspects of this important topic.

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IJERPH, Vol. 14, Pages 199: Thermophilic Fungi to Dominate Aflatoxigenic/Mycotoxigenic Fungi on Food under Global Warming

Certain filamentous fungi produce mycotoxins that contaminate food. Mycotoxin contamination of crops is highly influenced by environmental conditions and is already affected by global warming, where there is a succession of mycotoxigenic fungi towards those that have higher optimal growth temperatures. Aflatoxigenic fungi are at the highest limit of temperature although predicted increases in temperature are beyond that constraint. The present paper discusses what will succeed these fungi and represents the first such consideration. Aflatoxins are the most important mycotoxins and are common in tropical produce, much of which is exported to temperate regions. Hot countries may produce safer food under climate change because aflatoxigenic fungi will be inhibited. The same situation will occur in previously temperate regions where these fungi have recently appeared, although decades later. Existing thermotolerant and thermophilic fungi (TTF) will dominate, in contrast to the conventional mycotoxigenic fungi adapting or mutating, as it will be quicker. TTF produce a range of secondary metabolites, or potential mycotoxins and patulin which may become a new threat. In addition, Aspergillus fumigatus will appear more frequently, a serious human pathogen, because it is (a) thermotolerant and (b) present on crops: hence this is an even greater problem. An incubation temperature of 41 °C needs employing forthwith to detect TTF. Finally, TTF in crops requires study because of the potential for diseases in humans and animals under climate change.

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IJERPH, Vol. 14, Pages 201: Determinants of Health Care Services Utilization among First Generation Afghan Migrants in Istanbul

There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. One hundred and fifty-five Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors. Health services utilization was lowest for outpatient specialists (20%) and highest for nonprescription medications (37%). Female gender and higher income predicted encounters with primary care physicians. Income, and other enabling factors such as family presence in Turkey predicted encounters with outpatient specialists. Perceived illness-related need factors had little to no influence on use of services; however, asylum difficulties increased the likelihood for encounters with primary care physicians, outpatient services, and the use of prescription medications. This study suggests that health services use among Afghan migrants in Turkey is low considering the extent of their perceived illness-related needs, which may be further exacerbated by the precarious conditions in which they live.

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Role of maternal occupational physical activity and psychosocial stressors on adverse birth outcomes

Objectives

We examined the association of an array of estimated maternal occupational physical activities and psychosocial stressors during pregnancy with odds for preterm birth (PTB) and small-for-gestational age (SGA).

Methods

Data for infants born without major birth defects delivered from 1997 to 2009 whose mothers reported working at least 1 month during pregnancy were obtained from the National Birth Defects Prevention Study. We linked occupational codes to the US Department of Labor's Occupational Information Network, which provides estimates of exposure for multiple domains of physical activity and psychosocial stressors by occupational categories. We conducted factor analysis using principal components extraction with 17 occupational activities and calculated factor scores. ORs for PTB and SGA across quartiles of factor scores in each trimester were computed using logistic regression.

Results

Factor analysis grouped occupational domains into 4 groups based on factor loadings. These groups were ‘occupational physical activity’, ‘interpersonal stressor’, ‘automated work’ and ‘job responsibility’. High levels of ‘occupational physical activity’ were significantly associated with SGA (adjusted OR (AOR) for highest quartile compared with lowest quartile of factor score: 1.36; 95% CIs 1.02 to 1.82; p for trend=0.001) and were also positively associated with PTB (AOR: 1.24; 95% CI 0.93 to 1.64; p for trend=0.01). No clear results were observed across domains of psychosocial stressors.

Conclusions

Our findings expand understanding of associations between occupational physical activity and psychosocial stressors and PTB and SGA and suggest that additional research is needed to further examine these relationships.

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Residual fibre lung burden among patients with pleural mesothelioma who have been occupationally exposed to asbestos

Objectives

To evaluate the lungs asbestos fibres concentration in participants with malignant pleural mesothelioma (MPM) who have been occupationally exposed.

Methods

The lung samples were obtained from pleuropneumonectomies or autopsies of 271 male MPMs. The lung samples were examined through scanning electron microscopy. Retrospective assessment was used to assess for asbestos exposure. This study includes 248 MPMs with an occupational exposure defined as either ‘definite’ or ‘probable’ or ‘possible’.

Results

The participants had finished working in asbestos exposure conditions more than 20 years ago (on average 26.1±11.0 years). The fibre burden resulted with a geometric mean equal to 2.0 (95% CI 1.6 to 2.4) million fibres per gram of dry lung tissue. The burden was higher among participants employed in asbestos textiles industry and in shipyards with insulation material, if compared with construction workers or non-asbestos textile workers or participants working in chemicals or as auto mechanics. 91.3% of MPMs had a detectable amount of amphibole fibres. A strong lung clearance capability was evident among workers exposed to chrysotile fibres. Owing to that, the 1997 Helsinki Criteria for occupational exposure were reached in <35% of cases among participant working in construction, in metallurgical industry, in chemical or textile industry and among those performing brake repair activities.

Conclusions

The MPM cases are now occurring in Italy in participants who ceased occupational asbestos exposure decades before the analysis. A large majority still shows a residual content of amphibole fibres, but given the lung clearance capability, attribution to occupational exposure cannot rely only on fibres detection.

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Work-related physical exposure and low back pain

For some musculoskeletal disorders, the negative effects of specific occupational exposures are mainly short-term effects. However, for low back pain (LBP), long-term effects are also important. The article by Lallukka et al.1 in this issue of the Journal reminds us of that fact, with a study in Finland based on a very long follow-up, more than 30 years. In this study focusing first on cardiovascular risk, 414 women and 324 men, aged 18–24 years in 1986, were followed-up until 2007. The information on LBP in 2007 included local and radiating LBP; presence or absence of LBP at baseline was also recorded, with some information on frequency. Physical heaviness of work was recorded in 1986 and also in 2007, based on a single question with a scale of six possible answers, from ‘light sedentary work’ to ‘physically very heavy work’. Smoking and body mass index could be taken into account in...

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Prenatal NO2 exposure and ultrasound measures of foetal growth: a prospective cohort study in Wuhan, China

Objectives

To examine the relationship between prenatal nitrogen dioxide (NO₂) exposure and foetal growth in a prospective cohort of 1001 Chinese women.

Methods

The maternal NO₂ exposure levels were estimated using land-use regression models based on home address. The biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL) and estimated foetal weight (EFW) were evaluated via ultrasonography. The multiple linear regression model was used to adjust for confounders, and the mixed-effect model was used to assess longitudinal effect.

Results

With a 10 μg/m³ increase in NO₂ exposure, the BPD, HC, AC, FL and EFW in the second trimester decreased by 0.40 mm (95% CI –0.56 to –0.24), 1.07 mm (95% CI –1.60 to –0.54), 1.02 mm (95% CI –1.57 to –0.48), 0.24 mm (95% CI –0.37 to –0.12) and 7.84 g (95% CI –11.59 to –4.08), respectively; the BPD and HC in the third trimester decreased by 0.26 mm (95% CI –0.50 to –0.02) and 0.71 mm (95% CI –1.37 to –0.06), respectively. The longitudinal analyses showed inverse associations of NO₂ exposure with BPD, HC, AC and FL (all p<0.05). The stratified analyses showed that the effects of NO₂ on the HC, FL and EFW in the second trimester were stronger among female babies and that the effect of NO₂ on EFW in the third trimester was stronger among smoking mothers (all p<0.05).

Conclusions

In this prospective study of Chinese women, maternal NO₂ exposure was inversely associated with foetal growth, and the association was stronger among female babies and smoking mothers.

http://ift.tt/2lqULM1

Early work-related physical exposures and low back pain in midlife: the Cardiovascular Risk in Young Finns Study

Objective

To examine whether heavy physical workload in young adulthood increases the risk of local and radiating low back pain (LBP) in midlife.

Methods

Longitudinal nationally representative Young Finns Study data among women (n=414) and men (n=324), aged 18–24 years in 1986 (baseline), were used. Physical heaviness of work was reported at baseline and follow-up (2007), and local and radiating LBP at follow-up. Covariates were age, smoking and body mass index. Logistic regression was used to examine the associations between physical heaviness of work and LBP. Additionally, the mediating effect of back pain at baseline was examined (the Sobel test).

Results

After adjustment for the covariates, and as compared with sedentary/light physical workload, heavy physical workload was associated with radiating LBP among women (OR 4.09, 95% CI 1.62 to 10.31) and men (OR 2.01, 95% CI 1.06 to 3.82). Among men, early back pain mediated the association (p value from the Sobel test=0.006). Among women, early exposure to physically heavy work showed the most consistent associations, while early and late exposures were associated with radiating and local LBP among men. Persistently heavy physical work was associated with radiating LBP among women and men.

Conclusions

Physically heavy work at a young age can have a long-lasting effect on the risk of LBP, radiating LBP in particular. These results highlight the need to consider early and persistent exposures to prevent the adverse consequences of physical workload for the low back.

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Focusing on the biological night: towards an epidemiological measure of circadian disruption

In 2007, the International Agency for Research on Cancer (IARC) convened an expert working group who examined all relevant information and concluded that "Shiftwork that involves circadian disruption is probably carcinogenic to humans (Group 2A)."1 As a key element of their classification, IARC judged that there was "sufficient evidence in experimental animals for the carcinogenicity of light during the daily dark period (biological night) [emphasis added]."1 However, while IARC identified a key role for ‘biological night’ in animals, it is more difficult to define—and work with—a biological night in humans. This editorial suggests ‘how’ we can do this in practice to arrive at an epidemiological measure of circadian disruption.

Remarkably, the key link in the ‘probable’ chain of causation between shift work and cancer, that is, circadian disruption, is nowhere defined in the IARC monograph.1 However, we would expect it to occur in...

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Associations among rotating night shift work, sleep and skin cancer in Nurses' Health Study II participants

Background

Night shift work and sleep duration have been associated with breast and other cancers. Results from the few prior studies of night shift work and skin cancer risk have been mixed and not fully accounted for other potentially important health-related variables (eg, sleep characteristics). This study evaluated the relationship between rotating night shift work and skin cancer risk and included additional skin cancer risk factors and sleep-related variables.

Methods

The current study used data from 74 323 Nurses’ Health Study (NHS) II participants. Cox proportional hazards models were used to estimate multivariable-adjusted HRs and 95% CIs for skin cancers across categories of shift work and sleep duration.

Results

Over 10 years of follow-up, 4308 basal cell carcinoma (BCC), 334 squamous cell carcinoma (SCC) and 212 melanoma cases were identified. Longer duration of rotating night shifts was associated with a linear decline in risk of BCC (HR=0.93, 95% CI 0.90 to 0.97 per 5-year increase). Shift work was not significantly associated with either melanoma (HR=1.02, 95% CI 0.86 to 1.21) or SCC (HR=0.92, 95% CI 0.80 to 1.06). A short sleep duration (≤6 hours per day) was associated with lower risks of melanoma (HR=0.68, 95% CI 0.46 to 0.98) and BCC (HR=0.93, 95% CI 0.86 to 1.00) compared with the most common report of 7 hours. SCC was not associated with duration of sleep (HR=0.94, 95% CI 0.83 to 1.06).

Conclusions

Longer duration of rotating night shift work and shorter sleep duration were associated with lower risk of some skin cancers. Further research is needed to confirm and identify the mechanisms underlying these associations.

http://ift.tt/2kFKBDm

Post-9/11/2001 lung function trajectories by sex and race in World Trade Center-exposed New York City emergency medical service workers

Objective

To determine whether lung function trajectories after 9/11/2001 (9/11) differed by sex or race/ethnicity in World Trade Center-exposed Fire Department of the City of New York emergency medical service (EMS) workers.

Method

Serial cross-sectional study of pulmonary function tests (PFTs) taken between 9/11 and 9/10/2015. We used data from routine PFTs (forced expiratory volume in 1 s (FEV₁) and FEV₁% predicted), conducted at 12–18 month intervals. FEV₁ and FEV₁% predicted were assessed over time, stratified by sex, and race/ethnicity. We also assessed FEV₁ and FEV₁% predicted in current, former and never-smokers.

Results

Among 1817 EMS workers, 334 (18.4%) were women, 979 (53.9%) self-identified as white and 939 (51.6%) were never-smokers. The median follow-up was 13.1 years (IQR 10.5–13.6), and the median number of PFTs per person was 11 (IQR 7–13). After large declines associated with 9/11, there was no discernible recovery in lung function. In analyses limited to never-smokers, the trajectory of decline in adjusted FEV₁ and FEV₁% predicted was relatively parallel for men and women in the 3 racial/ethnic groups. Similarly, small differences in FEV₁ annual decline between groups were not clinically meaningful. Analyses including ever-smokers were essentially the same.

Conclusions

14 years after 9/11, most EMS workers continued to demonstrate a lack of lung function recovery. The trajectories of lung function decline, however, were parallel by sex and by race/ethnicity. These findings support the use of routine, serial measures of lung function over time in first responders and demonstrate no sex or racial sensitivity to exposure-related lung function decline.

http://ift.tt/2kFNRif