International Journal of Environmental Research and Public Health

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Open AccessArticle

Optimization Study of Small-Scale Solar Membrane Distillation Desalination Systems (s-SMDDS)

by Hsuan Chang, Cheng-Liang Chang, Chen-Yu Hung, Tung-Wen Cheng and Chii-Dong Ho

Int. J. Environ. Res. Public Health 2014, 11(11), 12064-12087; https://doi.org/10.3390/ijerph111112064 - 24 Nov 2014

Cited by 22 | Viewed by 8456

Abstract

Membrane distillation (MD), which can utilize low-grade thermal energy, has been extensively studied for desalination. By incorporating solar thermal energy, the solar membrane distillation desalination system (SMDDS) is a potential technology for resolving energy and water resource problems. Small-scale SMDDS (s-SMDDS) is an [...] Read more.

Membrane distillation (MD), which can utilize low-grade thermal energy, has been extensively studied for desalination. By incorporating solar thermal energy, the solar membrane distillation desalination system (SMDDS) is a potential technology for resolving energy and water resource problems. Small-scale SMDDS (s-SMDDS) is an attractive and viable option for the production of fresh water for small communities in remote arid areas. The minimum cost design and operation of s-SMDDS are determined by a systematic method, which involves a pseudo-steady-state approach for equipment sizing and dynamic optimization using overall system mathematical models. Two s-SMDDS employing an air gap membrane distillation module with membrane areas of 11.5 m² and 23 m² are analyzed. The lowest water production costs are $5.92/m³ and $5.16/m³ for water production rates of 500 kg/day and 1000 kg/day, respectively. For these two optimal cases, the performance ratios are 0.85 and 0.91; the recovery ratios are 4.07% and 4.57%. The effect of membrane characteristics on the production cost is investigated. For the commercial membrane employed in this study, the increase of the membrane mass transfer coefficient up to two times is beneficial for cost reduction. Full article

(This article belongs to the Special Issue Water Desalination)

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Graphical abstract

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Open AccessCommunication

Barriers and Facilitators to Being Physically Active on a Rural U.S. Northern Plains American Indian Reservation

by Lisa Jahns, Leander R. McDonald, Ann Wadsworth, Charles Morin and Yan Liu

Int. J. Environ. Res. Public Health 2014, 11(11), 12053-12063; https://doi.org/10.3390/ijerph111112053 - 21 Nov 2014

Cited by 10 | Viewed by 6260

Abstract

The objective of the present study was to identify barriers to and facilitators of physical activity among American Indian adults living on a rural, U.S. Northern Plains reservation using the nominal group technique (NGT). NGT is a method of data generation and interpretation [...] Read more.

The objective of the present study was to identify barriers to and facilitators of physical activity among American Indian adults living on a rural, U.S. Northern Plains reservation using the nominal group technique (NGT). NGT is a method of data generation and interpretation that combines aspects of qualitative (free generation of responses) and quantitative (systematic ranking of responses) methodologies. Adults participated in one of two NGT sessions asking about either barriers to (n = 6), or facilitators of (n = 5), being physically active. Participants nominated and ranked 21 barriers and 18 facilitators. Barriers indicated lack of knowledge of how to fit physical activity into a daily schedule, work, caring for family members, and prioritizing sedentary pursuits. Other responses included environmental barriers such as lack of access and transportation to a gym, unsafe walking conditions, and inclement weather. Facilitators to following recommendations included knowledge of health benefits of physical activity and the perception of physical activity as enjoyable, including feeling good when working out. Environmental facilitators included being outdoors walking and biking as well as parks and exercise facilities. Responses provided direction for locally designed community-based programs to promote facilitators and decrease barriers to individual’s engagement in physical activity. Full article

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Open AccessArticle

Tuberculosis among Healthcare Workers in Southeastern China: A Retrospective Study of 7-Year Surveillance Data

by Bin Chen, Xiaomeng Wang, Jiemin Zhong, Songhua Chen, Beibei Wu, Hui-Chi Yeh, Zhenggang Jiang, Zhengting Wang, Hua Gu and Jianmin Jiang

Int. J. Environ. Res. Public Health 2014, 11(11), 12042-12052; https://doi.org/10.3390/ijerph111112042 - 20 Nov 2014

Cited by 8 | Viewed by 6511

Abstract

The baseline prevalence and characteristics of tuberculosis (TB) among general healthcare workers (HCWs) in southeastern China remains unknown. We conducted a retrospective study based on the TB surveillance data in Zhejiang Province from 2005 to 2011, which were extracted from the national Tuberculosis [...] Read more.

The baseline prevalence and characteristics of tuberculosis (TB) among general healthcare workers (HCWs) in southeastern China remains unknown. We conducted a retrospective study based on the TB surveillance data in Zhejiang Province from 2005 to 2011, which were extracted from the national Tuberculosis Information Management System (TIMS). We calculated and compared annual notification rates of different occupational groups and analyzed the epidemiological and clinical characteristics. The annual TB notification rates among general HCWs declined steadily from 2005 to 2011. On average, HCWs showed annual TB notification rates lower than the general population but higher than teachers. Recorded HCW TB patients averaged 35.5 years of age, with females outnumbering males (58.0% > 42.0%). The proportion of pulmonary tuberculosis (PTB) was higher among male than in the female patients (88.5% > 83.4%, P = 0.031). Our study suggested that general HCWs run a higher occupational risk than teachers although the two groups are socioeconomically comparable and that the priority should be given to the young female HCWs for TB prevention in healthcare institutions. Full article

(This article belongs to the Special Issue Preventive Medicine)

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863 KiB

Open AccessArticle

Surveying Mercury Levels in Hair, Blood and Urine of under 7-Year Old Children from a Coastal City in China

by Guixia Chen, Xiaoxin Chen, Chonghuai Yan, Xingdong Wu and Guozhang Zeng

Int. J. Environ. Res. Public Health 2014, 11(11), 12029-12041; https://doi.org/10.3390/ijerph111112029 - 20 Nov 2014

Cited by 29 | Viewed by 6721

Abstract

Aim: The average mercury load in children under 7-years old was determined in a populated but not overly industrial coastal area in China. Methods: 395 blood samples, 1072 urine samples, and 581 hair samples were collected from 1076 children, aged 0 [...] Read more.

Aim: The average mercury load in children under 7-years old was determined in a populated but not overly industrial coastal area in China. Methods: 395 blood samples, 1072 urine samples, and 581 hair samples were collected from 1076 children, aged 0 to 6 years, from eight representative communities of Xiamen, China. Mercury levels in the samples were surveyed. Results: The 95% upper limits of mercury in blood, urine, and hair for the children were 2.30, 1.50 and 2100.00 μg/kg, respectively. Levels tended to increase with age. Correlation analyses showed that mercury levels in blood and urine correlated with those in hair (n = 132), r = 0.49, p < 0.0001 and r = 0.20, p = 0.0008; however, blood mercury levels did not correlate with urine levels (n = 284), r = 0.07, p = 0.35. Conclusions: Surveying the average mercury load in children 0 to 6 years, and the 95% upper limit value of mercury in their blood, urine, and hair should help guide risk assessment and health management for children. Full article

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Open AccessArticle

Smoke-Free Homes and Home Exposure to Secondhand Smoke in Shanghai, China

by Pinpin Zheng, Carla J. Berg, Michelle C. Kegler, Wenjie Fu, Jing Wang, Xilan Zhou, Dong Liu and Hua Fu

Int. J. Environ. Res. Public Health 2014, 11(11), 12015-12028; https://doi.org/10.3390/ijerph111112015 - 20 Nov 2014

Cited by 21 | Viewed by 6695

Abstract

Few studies have examined home exposure to secondhand smoke (SHS) in China. This study aimed to document: (1) the prevalence and correlates of exposure to SHS in homes (in adult non-smokers) in Shanghai, and (2) enforcement of rules, harm reduction behaviors, and self-efficacy [...] Read more.

Few studies have examined home exposure to secondhand smoke (SHS) in China. This study aimed to document: (1) the prevalence and correlates of exposure to SHS in homes (in adult non-smokers) in Shanghai, and (2) enforcement of rules, harm reduction behaviors, and self-efficacy for maintaining smoke-free homes in Shanghai. A total of 500 participants were recruited using a multistage proportional random sampling design in an urban and suburban district to complete a survey. Among the total 355 nonsmokers, 127 (35.8%) participants reported being exposed to SHS in the past 7 days. Participants living with smokers in the home, with no smoking restriction at home, and having children younger than 18 were more likely to be exposed to SHS at home. Higher self-efficacy in maintaining a smoke-free home was negatively associated with home SHS exposure. Having visitors who smoke was the greatest policy enforcement challenge. Ineffective measures such as opening windows were more commonly used in homes with partial bans. Educational initiatives to protect against SHS exposure in the home should promote smoke-free homes, address challenges to implementing such policies, and address misconceptions regarding the effectiveness of supposed harm reduction behaviors. Full article

(This article belongs to the Special Issue Tobacco Control)

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Open AccessArticle

A Chemical Risk Ranking and Scoring Method for the Selection of Harmful Substances to be Specially Controlled in Occupational Environments

by Saemi Shin, Hyung-Il Moon, Kwon Seob Lee, Mun Ki Hong and Sang-Hoon Byeon

Int. J. Environ. Res. Public Health 2014, 11(11), 12001-12014; https://doi.org/10.3390/ijerph111112001 - 20 Nov 2014

Cited by 14 | Viewed by 6449

Abstract

This study aimed to devise a method for prioritizing hazardous chemicals for further regulatory action. To accomplish this objective, we chose appropriate indicators and algorithms. Nine indicators from the Globally Harmonized System of Classification and Labeling of Chemicals were used to identify categories [...] Read more.

This study aimed to devise a method for prioritizing hazardous chemicals for further regulatory action. To accomplish this objective, we chose appropriate indicators and algorithms. Nine indicators from the Globally Harmonized System of Classification and Labeling of Chemicals were used to identify categories to which the authors assigned numerical scores. Exposure indicators included handling volume, distribution, and exposure level. To test the method devised by this study, sixty-two harmful substances controlled by the Occupational Safety and Health Act in Korea, including acrylamide, acrylonitrile, and styrene were ranked using this proposed method. The correlation coefficients between total score and each indicator ranged from 0.160 to 0.641, and those between total score and hazard indicators ranged from 0.603 to 0.641. The latter were higher than the correlation coefficients between total score and exposure indicators, which ranged from 0.160 to 0.421. Correlations between individual indicators were low (−0.240 to 0.376), except for those between handling volume and distribution (0.613), suggesting that each indicator was not strongly correlated. The low correlations between each indicator mean that the indicators and independent and were well chosen for prioritizing harmful chemicals. This method proposed by this study can improve the cost efficiency of chemical management as utilized in occupational regulatory systems. Full article

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Open AccessReview

The Impact of the FIFA 11+ Training Program on Injury Prevention in Football Players: A Systematic Review

by Noël C. Barengo, José Francisco Meneses-Echávez, Robinson Ramírez-Vélez, Daniel Dylan Cohen, Gustavo Tovar and Jorge Enrique Correa Bautista

Int. J. Environ. Res. Public Health 2014, 11(11), 11986-12000; https://doi.org/10.3390/ijerph111111986 - 19 Nov 2014

Cited by 142 | Viewed by 31179

Abstract

The FIFA 11+ is a simple, and easy to implement, sports injury prevention program comprising a warm up of 10 conditioning exercises. The aim of this systematic review was to evaluate the impact of the FIFA 11+ on injury incidence, compliance and cost [...] Read more.

The FIFA 11+ is a simple, and easy to implement, sports injury prevention program comprising a warm up of 10 conditioning exercises. The aim of this systematic review was to evaluate the impact of the FIFA 11+ on injury incidence, compliance and cost effectiveness when implemented among football players. MEDLINE, EMBASE and Scopus databases were searched using the search terms “FIFA 11+”, “football”, “soccer”, “injury prevention”, and “The 11”. The titles and abstracts were screened by two independent reviewers and the data were filtered by one reviewer using a standardized extraction form and thereafter checked by another one. The risk of bias and the methodological quality of the studies were evaluated through the PEDro score and Critical Appraisal Skills Programme (CASP). A total of 911 studies were identified, of which 12 met the inclusion criteria of the review. The FIFA 11+ has demonstrated how a simple exercise program completed as part of warm-up can decrease the incidence of injuries in amateur football players. In general, considerable reductions in the number of injured players, ranging between 30% and 70%, have been observed among the teams that implemented the FIFA 11+. In addition, players with high compliance to the FIFA 11+ program had an estimated risk reduction of all injuries by 35% and show significant improvements in components of neuromuscular and motor performance when participating in structured warm-up sessions at least 1.5 times/week. Most studies had high methodological quality and a low risk of bias. Given the large number of people who play football at amateur level and the detrimental impact of sports injuries on a personal and societal level, the FIFA 11+ can be considered as a fundamental tool to minimize the risks of participation in a sport with substantial health benefits. Full article

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Open AccessArticle

Offshore Finfish Aquaculture in the United States: An Examination of Federal Laws That Could be Used to Address Environmental and Occupational Public Health Risks

by Jillian P. Fry, David C. Love, Arunima Shukla and Ryan M. Lee

Int. J. Environ. Res. Public Health 2014, 11(11), 11964-11985; https://doi.org/10.3390/ijerph111111964 - 19 Nov 2014

Cited by 9 | Viewed by 8227

Abstract

Half of the world’s edible seafood comes from aquaculture, and the United States (US) government is working to develop an offshore finfish aquaculture industry in federal waters. To date, US aquaculture has largely been regulated at the state level, and creating an offshore [...] Read more.

Half of the world’s edible seafood comes from aquaculture, and the United States (US) government is working to develop an offshore finfish aquaculture industry in federal waters. To date, US aquaculture has largely been regulated at the state level, and creating an offshore aquaculture industry will require the development of a new regulatory structure. Some aquaculture practices involve hazardous working conditions and the use of veterinary drugs, agrochemicals, and questionable farming methods, which could raise environmental and occupational public health concerns if these methods are employed in the offshore finfish industry in the US. This policy analysis aims to inform public health professionals and other stakeholders in the policy debate regarding how offshore finfish aquaculture should be regulated in the US to protect human health; previous policy analyses on this topic have focused on environmental impacts. We identified 20 federal laws related to offshore finfish aquaculture, including 11 that are relevant to preventing, controlling, or monitoring potential public health risks. Given the novelty of the industry in the US, myriad relevant laws, and jurisdictional issues in an offshore setting, federal agencies need to work collaboratively and transparently to ensure that a comprehensive and functional regulatory structure is established that addresses the potential public health risks associated with this type of food production. Full article

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Open AccessArticle

Occurrence of Virulence Genes Associated with Diarrheagenic Escherichia coli Isolated from Raw Cow’s Milk from Two Commercial Dairy Farms in the Eastern Cape Province, South Africa

by Lesley-Anne Caine, Uchechukwu U. Nwodo, Anthony I. Okoh, Roland N. Ndip and Ezekiel Green

Int. J. Environ. Res. Public Health 2014, 11(11), 11950-11963; https://doi.org/10.3390/ijerph111111950 - 18 Nov 2014

Cited by 32 | Viewed by 6473

Abstract

Escherichia coli remains a public health concern worldwide as an organism that causes diarrhea and its reservoir in raw milk may play an important role in the survival and transport of pathogenic strains. Diarrheagenic E. coli strains are diverse food-borne pathogens and causes [...] Read more.

Escherichia coli remains a public health concern worldwide as an organism that causes diarrhea and its reservoir in raw milk may play an important role in the survival and transport of pathogenic strains. Diarrheagenic E. coli strains are diverse food-borne pathogens and causes diarrhea with varying virulence in humans. We investigated the prevalence of pathogenic E. coli in raw milk from two commercial dairy farms. Four hundred raw milk samples, 200 from each dairy farm, were screened for the presence of fliCH7, eagR, ial, eagg, lt, and papC genes. In dairy farm A, 100 E. coli were identified based on culture, oxidase and Gram staining, while 88 isolates from dairy farm B were identified in the same manner. Gene detection showed fliCH7 27 (54%) to be the highest gene detected from farm A and lt 2 (4%) to be the lowest. The highest gene detected in dairy farm B was fliCH7 16 (43.2%) and papC 1 (2.7%) was the least. The amplification of pathogenic genes associated with diarrheagenic E. coli from cows’ raw milk demonstrates that potentially virulent E. coli strains are widely distributed in raw milk and may be a cause of concern for human health. Full article

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Open AccessArticle

Surveillance of Hospital Contacts among Danish Seafarers and Fishermen with Focus on Skin and Infectious Diseases—A Population-Based Cohort Study

by Linda Kaerlev, Anker Jensen and Harald Hannerz

Int. J. Environ. Res. Public Health 2014, 11(11), 11931-11949; https://doi.org/10.3390/ijerph111111931 - 18 Nov 2014

Cited by 10 | Viewed by 6348

Abstract

Objectives: A systematic overview of time trends in hospital contacts among Danish seafarers and fishermen by job title and analyses on skin and infectious diseases. Methods: Occupational cohorts with hospital contacts 1994–1998 and 1999–2003. Standardized hospital contact ratios (SHCR) were estimated using [...] Read more.

Objectives: A systematic overview of time trends in hospital contacts among Danish seafarers and fishermen by job title and analyses on skin and infectious diseases. Methods: Occupational cohorts with hospital contacts 1994–1998 and 1999–2003. Standardized hospital contact ratios (SHCR) were estimated using national rates and ranked by SHCR size. Results: For non-officers in 1994–1998, infectious diseases had the highest SHCR, followed by neoplastic and endocrinal diseases; in 1999–2003 skin diseases were followed by endocrinal and gastrointestinal diseases. For fishermen in 1994–1998, nervous system, gastrointestinal, and skin diseases had the highest SHCRs; in 1999–2003 it was nervous system, skin, and lymphohematopoietic diseases. As for skin diseases, male fishermen and non-officer seamen generally had increased SHCRs, but engine room personnel specifically had a low SHCR for eczema (eight cases). Fishermen had high SHCRs for tuberculosis in both time periods (six and nine cases, respectively). Non-officer seamen on cargo ships had increased SHCRs for HIV in both time periods and for hepatitis in 1994–1999. Extending the follow-up until 2000 or 2005 showed similar results. Conclusions: Surveillance of seamen’s health gives useful information. The elevated SHCR for HIV infection among non-officers has not declined despite preventive information campaigns. Tuberculosis among fishermen may be due to infection on shore. Skin diseases had very high SHCRs, not due to cutaneous oil exposure. Full article

(This article belongs to the Special Issue Preventive Medicine)

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Open AccessArticle

The Causes and Circumstances of Drinking Water Incidents Impact Consumer Behaviour: Comparison of a Routine versus a Natural Disaster Incident

by Gabriella Rundblad, Olivia Knapton and Paul R. Hunter

Int. J. Environ. Res. Public Health 2014, 11(11), 11915-11930; https://doi.org/10.3390/ijerph111111915 - 18 Nov 2014

Cited by 9 | Viewed by 6077

Abstract

When public health is endangered, the general public can only protect themselves if timely messages are received and understood. Previous research has shown that the cause of threats to public health can affect risk perception and behaviours. This study compares compliance to public [...] Read more.

When public health is endangered, the general public can only protect themselves if timely messages are received and understood. Previous research has shown that the cause of threats to public health can affect risk perception and behaviours. This study compares compliance to public health advice and consumer behaviour during two “Boil Water” notices issued in the UK due to a routine incident versus a natural disaster incident. A postal questionnaire was sent to 1000 randomly selected households issued a routine “Boil Water” notice. Findings were then compared to a previous study that explored drinking water behaviour during a “Boil Water” notice issued after serious floods. Consumers affected by the routine incident showed a significant preference for official water company information, whereas consumers affected by the natural disaster preferred local information sources. Confusion over which notice was in place was found for both incidents. Non-compliance was significantly higher for the natural disaster (48.3%) than the routine incident (35.4%). For the routine incident, compliance with advice on drinking as well as preparing/cooking food and brushing teeth was positively associated with receiving advice from the local radio, while the opposite was true for those receiving advice from the water company/leaflet through the post; we suggest this may largely be due to confusion over needing boiled tap water for brushing teeth. No associations were found for demographic factors. We conclude that information dissemination plans should be tailored to the circumstances under which the advice is issued. Water companies should seek to educate the general public about water notices and which actions are safe and unsafe during which notice, as well as construct and disseminate clearer advice on brushing teeth and preparing/cooking food. Full article

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Open AccessArticle

Mouth-Level Intake of Benzo[a]pyrene from Reduced Nicotine Cigarettes

by Yan S. Ding, Jennye Ward, David Hammond and Clifford H. Watson

Int. J. Environ. Res. Public Health 2014, 11(11), 11898-11914; https://doi.org/10.3390/ijerph111111898 - 18 Nov 2014

Cited by 20 | Viewed by 5829

Abstract

Cigarette smoke is a known source of exposure to carcinogenic polycyclic aromatic hydrocarbons (PAHs), especially benzo[a]pyrene (BaP). Exposure to BaP in cigarette smoke is influenced by how a person smokes and factors, such as tobacco blend. To determine whether sustained use of reduced-nicotine [...] Read more.

Cigarette smoke is a known source of exposure to carcinogenic polycyclic aromatic hydrocarbons (PAHs), especially benzo[a]pyrene (BaP). Exposure to BaP in cigarette smoke is influenced by how a person smokes and factors, such as tobacco blend. To determine whether sustained use of reduced-nicotine cigarettes is associated with changes in exposure to nicotine and BaP, levels of BaP in spent cigarette filter butts were correlated with levels of BaP in cigarette smoke to estimate mouth-level intake (MLI) of BaP for 72 daily smokers given three progressively reduced nicotine content cigarettes. Urinary cotinine, a marker of nicotine exposure, and urinary 1-hydroxypyrene (1-HOP), a marker of PAH exposure, were measured throughout the study. Median daily BaP MLI and urine cotinine decreased in a similar manner as smokers switched to progressively lower nicotine cigarettes, despite relatively constant daily cigarette consumption. 1-HOP levels were less responsive to the use of reduced nicotine content cigarettes. We demonstrate that spent cigarette filter butt analysis is a promising tool to estimate MLI of harmful chemicals on a per cigarette or per-day basis, which partially addresses the concerns of the temporal influence of smoking behavior or differences in cigarette design on exposure. Full article

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Open AccessArticle

Estimating the Heterogeneous Relationship between Peer Drinking and Youth Alcohol Consumption in Chile Using Propensity Score Stratification

by Yoonsun Han, Andrew Grogan-Kaylor, Jorge Delva and Yu Xie

Int. J. Environ. Res. Public Health 2014, 11(11), 11879-11897; https://doi.org/10.3390/ijerph111111879 - 17 Nov 2014

Cited by 5 | Viewed by 6405

Abstract

When estimating the association between peer and youth alcohol consumption, it is critical to account for possible differential levels of response to peer socialization processes across youth, in addition to variability in individual, family, and social factors. Failure to account for intrinsic differences [...] Read more.

When estimating the association between peer and youth alcohol consumption, it is critical to account for possible differential levels of response to peer socialization processes across youth, in addition to variability in individual, family, and social factors. Failure to account for intrinsic differences in youth’s response to peers may pose a threat of selection bias. To address this issue, we used a propensity score stratification method to examine whether the size of the association between peer and youth drinking is contingent upon differential predicted probabilities of associating with alcohol-consuming friends. Analyzing a Chilean youth sample (N = 914) of substance use, we found that youths are susceptible to the detrimental role of peer drinkers, but the harmful relationship with one’s own drinking behavior may be exacerbated among youth who already have a high probability of socializing with peers who drink. In other words, computing a single weighted-average estimate for peer drinking would have underestimated the detrimental role of peers, particularly among at-risk youths, and overestimated the role of drinking peers among youths who are less susceptible to peer socialization processes. Heterogeneous patterns in the association between peer and youth drinking may shed light on social policies that target at-risk youths. Full article

(This article belongs to the Special Issue Substance and Drug Abuse Prevention)

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Open AccessArticle

Seasonal and Spatial Variations of Heavy Metals in Two Typical Chinese Rivers: Concentrations, Environmental Risks, and Possible Sources

by Hong Yao, Xin Qian, Hailong Gao, Yulei Wang and Bisheng Xia

Int. J. Environ. Res. Public Health 2014, 11(11), 11860-11878; https://doi.org/10.3390/ijerph111111860 - 17 Nov 2014

Cited by 51 | Viewed by 5734

Abstract

Ten metals were analyzed in samples collected in three seasons (the dry season, the early rainy season, and the late rainy season) from two rivers in China. No observed toxic effect concentrations were used to estimate the risks. The possible sources of the [...] Read more.

Ten metals were analyzed in samples collected in three seasons (the dry season, the early rainy season, and the late rainy season) from two rivers in China. No observed toxic effect concentrations were used to estimate the risks. The possible sources of the metals in each season, and the dominant source(s) at each site, were assessed using principal components analysis. The metal concentrations in the area studied were found, using t-tests, to vary both seasonally and spatially (P = 0.05). The potential risks in different seasons decreased in the order: early rainy season > dry season > late rainy season, and Cd was the dominant contributor to the total risks associated with heavy metal pollution in the two rivers. The high population and industrial site densities in the Taihu basin have had negative influences on the two rivers. The river that is used as a source of drinking water (the Taipu River) had a low average level of risks caused by the metals. Metals accumulated in environmental media were the main possible sources in the dry season, and emissions from mechanical manufacturing enterprises were the main possible sources in the rainy season. The river in the industrial area (the Wusong River) had a moderate level of risk caused by the metals, and the main sources were industrial emissions. The seasonal and spatial distributions of the heavy metals mean that risk prevention and mitigation measures should be targeted taking these variations into account. Full article

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Open AccessArticle

A Simple Microbiological Tool to Evaluate the Effect of Environmental Health Interventions on Hand Contamination

by Carol Devamani, Guy Norman and Wolf-Peter Schmidt

Int. J. Environ. Res. Public Health 2014, 11(11), 11846-11859; https://doi.org/10.3390/ijerph111111846 - 17 Nov 2014

Cited by 21 | Viewed by 6101

Abstract

The effects of interventions such as sanitation or hand hygiene on hand contamination are difficult to evaluate. We explored the ability of a simple microbiological test to: (1) detect recontamination after handwashing; (2) reflect risk factors for microbial contamination and (3) be applicable [...] Read more.

The effects of interventions such as sanitation or hand hygiene on hand contamination are difficult to evaluate. We explored the ability of a simple microbiological test to: (1) detect recontamination after handwashing; (2) reflect risk factors for microbial contamination and (3) be applicable to large populations. The study was done in rural Andhra Pradesh, India, and Maputo, Mozambique. Participants placed all 10 fingertips on a chromogenic agar that stains Enterococcus spp. and E. coli spp. Outcomes were the number of colonies and the number of fingertips with colonies. In the recontamination study, participants were randomised to handwashing with soap and no handwashing, and tested at 30 min intervals afterwards. In two cross sectional studies, risk factors for hand contamination were explored. Recontamination of hands after washing with soap was fast, with baseline levels reached after 1 h. Child care was associated with higher Enterococcus spp. counts, whereas agricultural activities increased E. coli spp. counts. Food preparation was associated with higher counts for both organisms. In Maputo, counts were not strongly associated with water access, latrine type, education or diarrhoea. The method seems unsuitable for the evaluation of handwashing promotion. It may reflect immediately preceding risk practices but not household-level risk factors. Full article

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Open AccessArticle

Surface Water Quality Monitoring Site Optimization for Poyang Lake, the Largest Freshwater Lake in China

by Hua Wang, Mengan Wu, Yanqing Deng, Chunyan Tang and Rui Yang

Int. J. Environ. Res. Public Health 2014, 11(11), 11833-11845; https://doi.org/10.3390/ijerph111111833 - 17 Nov 2014

Cited by 12 | Viewed by 4803

Abstract

In this paper, we propose a coupled method to optimize the surface water quality monitoring sites for a huge freshwater lake based on field investigations, mathematical analysis, and numerical simulation tests. Poyang Lake, the largest freshwater lake in China, was selected as the [...] Read more.

In this paper, we propose a coupled method to optimize the surface water quality monitoring sites for a huge freshwater lake based on field investigations, mathematical analysis, and numerical simulation tests. Poyang Lake, the largest freshwater lake in China, was selected as the research area. Based on the field investigated water quality data in the 5 years from 2008 to 2012, the water quality inter-annual variation coefficients at all the present sites and the water quality correlation coefficients between adjacent sites were calculated and analyzed to present an optimization scheme. A 2-D unsteady water quality model was established to get the corresponding water quality data at the optimized monitoring sites, which were needed for the rationality test on the optimized monitoring network. We found that: (1) the water quality of Piaoshan (No. 10) fluctuated most distinguishably and the inter-annual variation coefficient of NH₃-N and TP could reach 99.77% and 73.92%, respectively. The four studied indexes were all closely related at Piaoshan (No. 10) and Tangyin (No. 11), and the correlation coefficients of COD and NH₃-N could reach 0.91 and 0.94 separately. (2) It was suggested that the present site No. 10 be removed to avoid repeatability, and it was suggested that the three sites of Changling, Huzhong, and Nanjiang be added to improve the representativeness of the monitoring sites. (3) According to the rationality analysis, the 21 optimized water quality monitoring sites could scientifically replace the primary network, and the new monitoring network could better reflect the water quality of the whole lake. Full article

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Open AccessArticle

The Global Contribution of Outdoor Air Pollution to the Incidence, Prevalence, Mortality and Hospital Admission for Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

by Qingkun Song, David C. Christiani, XiaorongWang and Jun Ren

Int. J. Environ. Res. Public Health 2014, 11(11), 11822-11832; https://doi.org/10.3390/ijerph111111822 - 14 Nov 2014

Cited by 134 | Viewed by 11197

Abstract

Objective: This study aimed to investigate the quantitative effects of outdoor air pollution, represented by 10 µg/m³ increment of PM₁₀, on chronic obstructive pulmonary disease in China, United States and European Union through systematic review and meta-analysis. Methods: [...] Read more.

Objective: This study aimed to investigate the quantitative effects of outdoor air pollution, represented by 10 µg/m³ increment of PM₁₀, on chronic obstructive pulmonary disease in China, United States and European Union through systematic review and meta-analysis. Methods: Publications in English and Chinese from PubMed and EMBASE were selected. The Cochrane Review Handbook of Generic Inverse Variance was used to synthesize the pooled effects on incidence, prevalence, mortality and hospital admission. Results: Outdoor air pollution contributed to higher incidence and prevalence of COPD. Short-term exposure was associated with COPD mortality increased by 6%, 1% and 1% in the European Union, the United States and China, respectively (p < 0.05). Chronic PM exposure produced a 10% increase in mortality. In a short-term exposure to 10 µg/m³ PM₁₀increment COPD mortality was elevated by 1% in China (p < 0.05) and hospital admission enrollment was increased by 1% in China, 2% in United States and 1% in European Union (p < 0.05). Conclusions: Outdoor air pollution contributes to the increasing burdens of COPD.10 µg/m³ increase of PM₁₀ produced significant condition of COPD death and exacerbation in China, United States and European Union. Controlling air pollution will have substantial benefit to COPD morbidity and mortality. Full article

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Open AccessArticle

Factors Contributing to the Risk of HIV Infection in Rural School-Going Adolescents

by Adedapo Awotidebe, Julie Phillips and Willy Lens

Int. J. Environ. Res. Public Health 2014, 11(11), 11805-11821; https://doi.org/10.3390/ijerph111111805 - 14 Nov 2014

Cited by 12 | Viewed by 6701

Abstract

The objective of this study was to determine the factors that increase the risk of HIV infection in rural school-going adolescents and young adults. This was a cross-sectional study of 430 secondary school students (47.4% boys and 52.6% girls) from two rural schools [...] Read more.

The objective of this study was to determine the factors that increase the risk of HIV infection in rural school-going adolescents and young adults. This was a cross-sectional study of 430 secondary school students (47.4% boys and 52.6% girls) from two rural schools in South Africa. Data were collected with a self-administered questionnaire on demographic information, sources of HIV/AIDS information, HIV knowledge, sexual behaviors, communication and negotiation skills, self-efficacy to refuse sex, peer influence and time perspective. Out of 113 (27.2%) participants who reported being sexually active, about 48% reported having had sex before the age of 15 and 42.2% reported penetrative sex with more than one partner in their lifetime. Only 44.8% of them reported consistent and regular use of condoms for every sexual encounter. Peer influence (OR = 3.01 (95% CI = 1.97–4.60)), gender difference (OR = 6.60 (95% CI = 1.62–26.84)) and lack of HIV information (OR = 1.22 (95% CI = 1.03–1.44)) influenced the sexual risk behaviors of the adolescents. Greater numbers of school-going adolescents in rural areas are sexually active. Peer influence, especially in boys, is a factor that increases the preponderance of risky sexual behaviors in adolescents. Positively, adolescents with high knowledge of HIV infection are more likely to use condoms for every sexual encounter. There is a need to strengthen comprehensive sexual health education and youth-friendly HIV prevention strategies to promote abstinence and safe sexual behaviors, especially among boys. Full article

802 KiB

Open AccessReview

Non-Accidental Health Impacts of Wildfire Smoke

by Hassani Youssouf, Catherine Liousse, Laurent Roblou, Eric-Michel Assamoi, Raimo O. Salonen, Cara Maesano, Soutrik Banerjee and Isabella Annesi-Maesano

Int. J. Environ. Res. Public Health 2014, 11(11), 11772-11804; https://doi.org/10.3390/ijerph111111772 - 14 Nov 2014

Cited by 87 | Viewed by 14220

Abstract

Wildfires take a heavy toll on human health worldwide. Climate change may increase the risk of wildfire frequency. Therefore, in view of adapted preventive actions, there is an urgent need to further understand the health effects and public awareness of wildfires. We conducted [...] Read more.

Wildfires take a heavy toll on human health worldwide. Climate change may increase the risk of wildfire frequency. Therefore, in view of adapted preventive actions, there is an urgent need to further understand the health effects and public awareness of wildfires. We conducted a systematic review of non-accidental health impacts of wildfire and incorporated lessons learned from recent experiences. Based on the literature, various studies have established the relationship between one of the major components of wildfire, particulate matter (particles with diameter less than 10 µm (PM₁₀) and less than 2.5 µm (PM_2.5)) and cardiorespiratory symptoms in terms of Emergency Rooms visits and hospital admissions. Associations between wildfire emissions and various subclinical effects have also been established. However, few relationships between wildfire emissions and mortality have been observed. Certain segments of the population may be particularly vulnerable to smoke-related health risks. Among them, people with pre-existing cardiopulmonary conditions, the elderly, smokers and, for professional reasons, firefighters. Potential action mechanisms have been highlighted. Overall, more research is needed to better understand health impact of wildfire exposure. Full article

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1037 KiB

Open AccessArticle

Odor and VOC Emissions from Pan Frying of Mackerel at Three Stages: Raw, Well-Done, and Charred

by Jeong-Hyeon Ahn, Jan E. Szulejko, Ki-Hyun Kim, Yong-Hyun Kim and Bo-Won Kim

Int. J. Environ. Res. Public Health 2014, 11(11), 11753-11771; https://doi.org/10.3390/ijerph111111753 - 14 Nov 2014

Cited by 12 | Viewed by 11970

Abstract

Many classes of odorants and volatile organic compounds that are deleterious to our wellbeing can be emitted from diverse cooking activities. Once emitted, they can persist in our living space for varying durations. In this study, various volatile organic compounds released prior to [...] Read more.

Many classes of odorants and volatile organic compounds that are deleterious to our wellbeing can be emitted from diverse cooking activities. Once emitted, they can persist in our living space for varying durations. In this study, various volatile organic compounds released prior to and during the pan frying of fish (mackerel) were analyzed at three different cooking stages (stage 1 = raw (R), stage 2 = well-done (W), and stage 3 = overcooked/charred (O)). Generally, most volatile organic compounds recorded their highest concentration levels at stage 3 (O), e.g., 465 (trimethylamine) and 106 ppb (acetic acid). In contrast, at stage 2 (W), the lowest volatile organic compounds emissions were observed. The overall results of this study confirm that trimethylamine is identified as the strongest odorous compound, especially prior to cooking (stage 1 (R)) and during overcooking leading to charring (stage 3 (O)). As there is a paucity of research effort to measure odor intensities from pan frying of mackerel, this study will provide valuable information regarding the management of indoor air quality. Full article

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1159 KiB

Open AccessArticle

Comparing Multipollutant Emissions-Based Mobile Source Indicators to Other Single Pollutant and Multipollutant Indicators in Different Urban Areas

by Michelle M. Oakes, Lisa K. Baxter, Rachelle M. Duvall, Meagan Madden, Mingjie Xie, Michael P. Hannigan, Jennifer L. Peel, Jorge E. Pachon, Siv Balachandran, Armistead Russell and Thomas C. Long

Int. J. Environ. Res. Public Health 2014, 11(11), 11727-11752; https://doi.org/10.3390/ijerph111111727 - 14 Nov 2014

Cited by 5 | Viewed by 6080

Abstract

A variety of single pollutant and multipollutant metrics can be used to represent exposure to traffic pollutant mixtures and evaluate their health effects. Integrated mobile source indicators (IMSIs) that combine air quality concentration and emissions data have recently been developed and evaluated using [...] Read more.

A variety of single pollutant and multipollutant metrics can be used to represent exposure to traffic pollutant mixtures and evaluate their health effects. Integrated mobile source indicators (IMSIs) that combine air quality concentration and emissions data have recently been developed and evaluated using data from Atlanta, Georgia. IMSIs were found to track trends in traffic-related pollutants and have similar or stronger associations with health outcomes. In the current work, we apply IMSIs for gasoline, diesel and total (gasoline + diesel) vehicles to two other cities (Denver, Colorado and Houston, Texas) with different emissions profiles as well as to a different dataset from Atlanta. We compare spatial and temporal variability of IMSIs to single-pollutant indicators (carbon monoxide (CO), nitrogen oxides (NO_x) and elemental carbon (EC)) and multipollutant source apportionment factors produced by Positive Matrix Factorization (PMF). Across cities, PMF-derived and IMSI gasoline metrics were most strongly correlated with CO (r = 0.31–0.98), while multipollutant diesel metrics were most strongly correlated with EC (r = 0.80–0.98). NO_x correlations with PMF factors varied across cities (r = 0.29–0.67), while correlations with IMSIs were relatively consistent (r = 0.61–0.94). In general, single-pollutant metrics were more correlated with IMSIs (r = 0.58–0.98) than with PMF-derived factors (r = 0.07–0.99). A spatial analysis indicated that IMSIs were more strongly correlated (r > 0.7) between two sites in each city than single pollutant and PMF factors. These findings provide confidence that IMSIs provide a transferable, simple approach to estimate mobile source air pollution in cities with differing topography and source profiles using readily available data. Full article

(This article belongs to the Special Issue Air Pollution Modeling)

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812 KiB

Open AccessArticle

Resistance to Extended-Spectrum β-Lactamases in Salmonella from a Broiler Supply Chain

by Jane Mary Lafayette Neves Gelinski, Amanda Bombassaro, César Milton Baratto and Vânia Aparecida Vicente

Int. J. Environ. Res. Public Health 2014, 11(11), 11718-11726; https://doi.org/10.3390/ijerph111111718 - 13 Nov 2014

Cited by 8 | Viewed by 6213

Abstract

The prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae varies worldwide, however, the incidence of ESBL-producing environmental Salmonella isolates is increasing. Salmonella is still one of the most important pathogens that occur in the poultry supply chain. Therefore, this study analyzed the susceptibility of Salmonella [...] Read more.

The prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae varies worldwide, however, the incidence of ESBL-producing environmental Salmonella isolates is increasing. Salmonella is still one of the most important pathogens that occur in the poultry supply chain. Therefore, this study analyzed the susceptibility of Salmonella isolates collected from a poultry supply chain to β-lactam antibiotics, and examined the phenotypes of the isolates based on enzyme-inducible AmpC β-lactamase analysis. All analysis of the putative positive isolates in the current study confirmed that 27.02% (77/285 analysis) of all ESBL tests realized with the isolates produced a profile of resistance consistent with β-lactamase production. All isolates of S. Minnesota serotype had ESBL phenotype. Aztreonam resistance was the least common amongst the Salmonella isolates, followed by ceftazidime. The presence of inducible chromosomal ESBL was detected in 14 different isolates of the 19 serotypes investigated. These results are very indicatives of the presence of ESBL genes in Salmonella isolates from a broiler supply chain, reaffirming the growing global problem of ESBL resistance. Full article

(This article belongs to the Special Issue Antibiotic Resistant and Pathogenic Bacteria in the Food Production Environment: Epidemiological Evolution and Control)

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741 KiB

Open AccessArticle

How Has the Availability of Snus Influenced Cigarette Smoking in Norway?

by Ingeborg Lund and Karl Erik Lund

Int. J. Environ. Res. Public Health 2014, 11(11), 11705-11717; https://doi.org/10.3390/ijerph111111705 - 13 Nov 2014

Cited by 34 | Viewed by 14954

Abstract

Background: In Norway, low-nitrosamine smokeless tobacco (snus) is allowed to compete with cigarettes for market share. We aimed to study how the availability of snus influenced overall tobacco consumption, smoking initiation and smoking cessation. We discuss whether the Norwegian experience with snus [...] Read more.

Background: In Norway, low-nitrosamine smokeless tobacco (snus) is allowed to compete with cigarettes for market share. We aimed to study how the availability of snus influenced overall tobacco consumption, smoking initiation and smoking cessation. We discuss whether the Norwegian experience with snus can have any transfer value for e-cigarettes. Methods: We analysed consumption data from registered and unregistered supply sources of tobacco. We calculated quit-smoking ratios across snus use status in nine datasets comprising a total of 19,269 ever-smokers. Trends in snus use and smoking were derived from time-series of annual; cross-sectional; nationally representative surveys for the period 1985–2013. Results: The market share for snus increased from 4% in 1985 to 28% in 2012, but overall tobacco consumption decreased by 20.3% over this same period. Snus was the most common method for smoking cessation. Compared with smokers with no experience of using snus, the quit ratio for smoking was significantly higher for daily snus users in seven of the nine datasets analysed. Among young male adults, the prevalence of smoking (daily + occasional) was reduced from 50% in 1985 to 21% in 2013. Over the same period, use of snus increased from 9% to 33%. This negative correlation (r = −0.900, p < 0.001) was also observed among young females (r = −0.811, p < 0.001), but the trend shift in tobacco preferences occurred some years later. Conclusions: The experience with snus in Norway might indicate what will happen when alternative nicotine products––are allowed to compete with cigarettes in the nicotine market. Full article

(This article belongs to the Special Issue Electronic Cigarettes as a Tool in Tobacco Harm Reduction)

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670 KiB

Open AccessArticle

Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project

by Shannon Gravely, Geoffrey T. Fong, K. Michael Cummings, Mi Yan, Anne C. K. Quah, Ron Borland, Hua-Hie Yong, Sara C. Hitchman, Ann McNeill, David Hammond, James F. Thrasher, Marc C. Willemsen, Hong Gwan Seo, Yuan Jiang, Tania Cavalcante, Cristina Perez, Maizurah Omar and Karin Hummel

Int. J. Environ. Res. Public Health 2014, 11(11), 11691-11704; https://doi.org/10.3390/ijerph111111691 - 13 Nov 2014

Cited by 131 | Viewed by 18020 | Correction

Abstract

Background: In recent years, electronic cigarettes (e-cigarettes) have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, at present, little is known about awareness and use. This paper presents [...] Read more.

Background: In recent years, electronic cigarettes (e-cigarettes) have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, at present, little is known about awareness and use. This paper presents self-reported awareness, trial and current use of e-cigarettes in 10 countries surveyed between 2009 and 2013; for six of these countries, we present the first data on e-cigarettes from probability samples of adult smokers. Methods: A cross-sectional analysis of probability samples of adult (≥ 18 years) current and former smokers participating in the International Tobacco Control (ITC) surveys from 10 countries. Surveys were administered either via phone, face-to-face interviews, or the web. Survey questions included sociodemographic and smoking-related variables, and questions about e-cigarette awareness, trial and current use. Results: There was considerable cross-country variation by year of data collection and for awareness of e-cigarettes (Netherlands (2013: 88%), Republic of Korea (2010: 79%), United States (2010: 73%), Australia (2013: 66%), Malaysia (2011: 62%), United Kingdom (2010: 54%), Canada (2010: 40%), Brazil (2013: 35%), Mexico (2012: 34%), and China (2009: 31%)), in self-reports of ever having tried e-cigarettes (Australia, (20%), Malaysia (19%), Netherlands (18%), United States (15%), Republic of Korea (11%), United Kingdom (10%), Mexico (4%), Canada (4%), Brazil (3%), and China (2%)), and in current use (Malaysia (14%), Republic of Korea (7%), Australia (7%), United States (6%), United Kingdom (4%), Netherlands (3%), Canada (1%), and China (0.05%)). Conclusions: The cross-country variability in awareness, trial, and current use of e-cigarettes is likely due to a confluence of country-specific market factors, tobacco control policies and regulations (e.g., the legal status of e-cigarettes and nicotine), and the survey timing along the trajectory of e-cigarette awareness and trial/use in each country. These ITC results constitute an important snapshot of an early stage of what appears to be a rapid progression of global e-cigarette use. Full article

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Open AccessArticle

Liver δ-Aminolevulinate Dehydratase Activity is Inhibited by Neonicotinoids and Restored by Antioxidant Agents

by Elisa Sauer, Angela M. Moro, Natália Brucker, Sabrina Nascimento, Bruna Gauer, Rafael Fracasso, Adriana Gioda, Ruy Beck, José C. F. Moreira, Vera Lucia Eifler-Lima and Solange Cristina Garcia

Int. J. Environ. Res. Public Health 2014, 11(11), 11676-11690; https://doi.org/10.3390/ijerph111111676 - 13 Nov 2014

Cited by 21 | Viewed by 6273

Abstract

Neonicotinoids represent the most used class of insecticides worldwide, and their precursor, imidacloprid, is the most widely marketed. The aim of this study was to evaluate the effect of imidacloprid on the activity of hepatic δ-aminolevulinate dehydratase (δ-ALA-D), protective effect of potential antioxidants [...] Read more.

Neonicotinoids represent the most used class of insecticides worldwide, and their precursor, imidacloprid, is the most widely marketed. The aim of this study was to evaluate the effect of imidacloprid on the activity of hepatic δ-aminolevulinate dehydratase (δ-ALA-D), protective effect of potential antioxidants against this potential effect and presence of chemical elements in the constitution of this pesticide. We observed that δ-ALA-D activity was significantly inhibited by imidacloprid at all concentrations tested in a dose-dependent manner. The IC₅₀ value was obtained and used to evaluate the restoration of the enzymatic activity. δ-ALA-D inhibition was completely restored by addition of dithiotreitol (DTT) and partly by ZnCl_2, demonstrating that the inhibition occurs by oxidation of thiol groups and by displacement of the Zn (II), which can be explained by the presence of chemical elements found in the constitution of pesticides. Reduced glutathione (GSH) had the best antioxidant effect against to δ-ALA-D inhibition caused by imidacloprid, followed by curcumin and resveratrol. It is well known that inhibition of the enzyme δ-ALA-D may result in accumulation of its neurotoxic substrate (δ-ALA), in this line, our results suggest that further studies are needed to investigate the possible neurotoxicity induced by neonicotinoids and the involvement of antioxidants in cases of poisoning by neonicotinoids. Full article

(This article belongs to the Special Issue Proceedings of 1st Latin American Congress of Clinical and Laboratorial Toxicology (Toxi-Latin 2014))

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646 KiB

Open AccessDiscussion

Alcoholism Risk Reduction in France: A Modernised Approach Related to Alcohol Misuse Disorders

by Georges Brousse, Patrick Bendimerad, Ingrid De Chazeron, Pierre Michel Llorca, Pascal Perney and Maurice Dematteis

Int. J. Environ. Res. Public Health 2014, 11(11), 11664-11675; https://doi.org/10.3390/ijerph111111664 - 13 Nov 2014

Cited by 5 | Viewed by 5340

Abstract

During many years in France, risk reduction strategies for substance abuse concerned prevention strategies in the general population or interventions near users of illicit substances. In this spirit, the reduction of consumption only concerned opiate addicts. With regard to alcohol, the prevention messages [...] Read more.

During many years in France, risk reduction strategies for substance abuse concerned prevention strategies in the general population or interventions near users of illicit substances. In this spirit, the reduction of consumption only concerned opiate addicts. With regard to alcohol, the prevention messages relative to controlled consumption were difficult to transmit because of the importance of this product in the culture of the country. In addition, methods of treatment of alcoholism rested on the dogma of abstinence. Several factors have recently led to an evolution in the treatment of alcohol use disorders integrating the reduction of consumption in strategies. Strategies for reducing consumption should aim for consumption below recommended thresholds (two drinks per day for women, three for the men) or, at least, in that direction. It must also be supported by pharmacotherapy and psychotherapy, which offer possibilities. Failure to manage reduction will allow the goals to be revisited and to reconsider abstinence. Finally this evolution or revolution is a new paradigm carried in particular by a pragmatic approach of the disease and new treatments. The aims of this article are to give elements of comprehension relating to the evolution of the practices in France in prevention and treatment of alcohol use disorders and in particular with regard to the reduction of consumption. Full article

(This article belongs to the Special Issue Alcohol Abuse: Newer Approaches to an Old Problem)

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Open AccessArticle

Community-Based Lifestyle Intervention for Reducing Blood Pressure and Glucose among Middle-Aged and Older Adults in China: A Pilot Study

by Aihua Lin, Guanrong Zhang, Zhiting Liu, Jing Gu, Weiqing Chen and Futian Luo

Int. J. Environ. Res. Public Health 2014, 11(11), 11645-11663; https://doi.org/10.3390/ijerph111111645 - 13 Nov 2014

Cited by 13 | Viewed by 6156

Abstract

Although evidence suggests that lifestyle interventions can reduce blood pressure (BP) and glucose levels, there is little information about the feasibility of such interventions when implemented in community settings. This study evaluated the effectiveness of a community-based lifestyle intervention on BP and glucose [...] Read more.

Although evidence suggests that lifestyle interventions can reduce blood pressure (BP) and glucose levels, there is little information about the feasibility of such interventions when implemented in community settings. This study evaluated the effectiveness of a community-based lifestyle intervention on BP and glucose in the middle-aged and older Chinese population. By using a cluster randomisation approach, 474 participants from two communities were assigned to the intervention group which received intensive health education and behavioural intervention, or the control group which received conventional education. Linear mixed models were used to compare between-group differences on change in BP and fasting glucose after 6, 12 and 24 months. At the 12-month follow-up, the intervention group experienced significantly reductions in systolic BP (−4.9 vs. 2.4 mmHg; mean difference [MD] −7.3 mmHg; p < 0.001), diastolic BP (−1.9 vs. 1.9 mmHg; MD −3.8 mmHg; p < 0.001) and fasting glucose (−0.59 vs. 0.08 mmol/L; MD −0.67 mmol/L; p < 0.001). These differences were sustained at the 24-month follow-up. With only two communities, it was not possible to adjust for potential clustering by site. This approach of lifestyle interventions conducted through primary care services may be a potential solution for combating hypertension and diabetes in a resource-limited country context in China. Full article

(This article belongs to the Special Issue Preventive Medicine)

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Open AccessArticle

Association of Weekly Suicide Rates with Temperature Anomalies in Two Different Climate Types

by P. Grady Dixon, Mark Sinyor, Ayal Schaffer, Anthony Levitt, Christa R. Haney, Kelsey N. Ellis and Scott C. Sheridan

Int. J. Environ. Res. Public Health 2014, 11(11), 11627-11644; https://doi.org/10.3390/ijerph111111627 - 13 Nov 2014

Cited by 51 | Viewed by 11737

Abstract

Annual suicide deaths outnumber the total deaths from homicide and war combined. Suicide is a complex behavioral endpoint, and a simple cause-and-effect model seems highly unlikely, but relationships with weather could yield important insight into the biopsychosocial mechanisms involved in suicide deaths. This [...] Read more.

Annual suicide deaths outnumber the total deaths from homicide and war combined. Suicide is a complex behavioral endpoint, and a simple cause-and-effect model seems highly unlikely, but relationships with weather could yield important insight into the biopsychosocial mechanisms involved in suicide deaths. This study has been designed to test for a relationship between air temperature and suicide frequency that is consistent enough to offer some predictive abilities. Weekly suicide death totals and anomalies from Toronto, Ontario, Canada (1986–2009) and Jackson, Mississippi, USA (1980–2006) are analyzed for relationships by using temperature anomaly data and a distributed lag nonlinear model. For both analysis methods, anomalously cool weeks show low probabilities of experiencing high-end suicide totals while warmer weeks are more likely to experience high-end suicide totals. This result is consistent for Toronto and Jackson. Weekly suicide totals demonstrate a sufficient association with temperature anomalies to allow some prediction of weeks with or without increased suicide frequency. While this finding alone is unlikely to have immediate clinical implications, these results are an important step toward clarifying the biopsychosocial mechanisms of suicidal behavior through a more nuanced understanding of the relationship between temperature and suicide. Full article

(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)

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Open AccessArticle

Influence of Daily Individual Meteorological Parameters on the Incidence of Acute Coronary Syndrome

by Mirjam Ravljen, Marjan Bilban, Lučka Kajfež-Bogataj, Tomaž Hovelja and Damjan Vavpotič

Int. J. Environ. Res. Public Health 2014, 11(11), 11616-11626; https://doi.org/10.3390/ijerph111111616 - 12 Nov 2014

Cited by 17 | Viewed by 5419

Abstract

Background: A nationwide study was conducted to explore the short term association between daily individual meteorological parameters and the incidence of acute coronary syndrome (ACS) treated with coronary emergency catheter interventions in the Republic of Slovenia, a south-central European country. Method: [...] Read more.

Background: A nationwide study was conducted to explore the short term association between daily individual meteorological parameters and the incidence of acute coronary syndrome (ACS) treated with coronary emergency catheter interventions in the Republic of Slovenia, a south-central European country. Method: We linked meteorological data with daily ACS incidence for the entire population of Slovenia, for the population over 65 years of age and for the population under 65 years of age. Data were collected daily for a period of 4 years from 1 January 2008 to 31 December 2011. In line with existing studies, we used a main effect generalized linear model with a log-link-function and a Poisson distribution of ACS. Results and Conclusions: Three of the studied meteorological factors (daily average temperature, atmospheric pressure and relative humidity) all have relevant and significant influences on ACS incidences for the entire population. However, the ACS incidence for the population over 65 is only affected by daily average temperature, while the ACS incidence for the population under 65 is affected by daily average pressure and humidity. In terms of ambient temperature, the overall findings of our study are in line with the findings of the majority of contemporary European studies, which also note a negative correlation. The results regarding atmospheric pressure and humidity are less in line, due to considerable variations in results. Additionally, the number of available European studies on atmospheric pressure and humidity is relatively low. The fourth studied variable—season—does not influence ACS incidence in a statistically significant way. Full article

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Open AccessArticle

A Novel Socioeconomic Measure Using Individual Housing Data in Cardiovascular Outcome Research

by Duk Won Bang, Sheila M. Manemann, Yariv Gerber, Veronique L. Roger, Christine M. Lohse, Jennifer Rand-Weaver, Elizabeth Krusemark, Barbara P. Yawn and Young J. Juhn

Int. J. Environ. Res. Public Health 2014, 11(11), 11597-11615; https://doi.org/10.3390/ijerph111111597 - 12 Nov 2014

Cited by 26 | Viewed by 5537

Abstract

Background: To assess whether the individual housing-based socioeconomic status (SES) measure termed HOUSES was associated with post-myocardial infarction (MI) mortality. Methods: The study was designed as a population-based cohort study, which compared post-MI mortality among Olmsted County, Minnesota, USA, residents with [...] Read more.

Background: To assess whether the individual housing-based socioeconomic status (SES) measure termed HOUSES was associated with post-myocardial infarction (MI) mortality. Methods: The study was designed as a population-based cohort study, which compared post-MI mortality among Olmsted County, Minnesota, USA, residents with different SES as measured by HOUSES using Cox proportional hazards models. Subjects’ addresses at index date of MI were geocoded to real property data to formulate HOUSES (a z-score for housing value, square footage, and numbers of bedrooms and bathrooms). Educational levels were used as a comparison for the HOUSES index. Results: 637 of the 696 eligible patients with MI (92%) were successfully geocoded to real property data. Post-MI survival rates were 60% (50–72), 78% (71–85), 72% (60–87), and 87% (81–93) at 2 years for patients in the first (the lowest SES), second, third, and fourth quartiles of HOUSES, respectively (p < 0.001). HOUSES was associated with post-MI all-cause mortality, controlling for all variables except age and comorbidity (p = 0.036) but was not significant after adjusting for age and comorbidity (p = 0.24). Conclusions: Although HOUSES is associated with post-MI mortality, the differential mortality rates by HOUSES were primarily accounted for by age and comorbid conditions. HOUSES may be useful for health disparities research concerning cardiovascular outcomes, especially in overcoming the paucity of conventional SES measures in commonly used datasets. Full article

(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)

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Int. J. Environ. Res. Public Health, Volume 11, Issue 11 (November 2014) – 64 articles , Pages 11028-12087

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