International Journal of Environmental Research and Public Health

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Open AccessArticle

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

by Savina Ditommaso, Monica Giacomuzzi, Elisa Ricciardi and Carla M. Zotti

Int. J. Environ. Res. Public Health 2016, 13(7), 745; https://doi.org/10.3390/ijerph13070745 - 22 Jul 2016

Cited by 20 | Viewed by 6114

Abstract

This study was designed to examine the in vitro bactericidal activity of hydrogen peroxide against Legionella. We tested hydrogen peroxide (Peroxy Ag⁺) at 600 ppm to evaluate Legionella survival in a simulated dental treatment water system equipped with Water Hygienization [...] Read more.

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

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364 KiB

Open AccessReview

Exploring Global Exposure Factors Resources for Use in Consumer Exposure Assessments

by Rosemary T. Zaleski, Peter P. Egeghy and Pertti J. Hakkinen

Int. J. Environ. Res. Public Health 2016, 13(7), 744; https://doi.org/10.3390/ijerph13070744 - 22 Jul 2016

Cited by 16 | Viewed by 6717

Abstract

This publication serves as a global comprehensive resource for readers seeking exposure factor data and information relevant to consumer exposure assessment. It describes the types of information that may be found in various official surveys and online and published resources. The relevant exposure [...] Read more.

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

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Open AccessReview

Environmental Risk Factors in Psoriasis: The Point of View of the Nutritionist

by Luigi Barrea, Francesca Nappi, Carolina Di Somma, Maria Cristina Savanelli, Andrea Falco, Anna Balato, Nicola Balato and Silvia Savastano

Int. J. Environ. Res. Public Health 2016, 13(7), 743; https://doi.org/10.3390/ijerph13070743 - 22 Jul 2016

Cited by 85 | Viewed by 12798

Abstract

Psoriasis is a common, chronic, immune-mediated skin disease with systemic pro-inflammatory activation, where both environmental and genetic factors contribute to its pathogenesis. Among the risk factors for psoriasis, evidence is accumulating that nutrition plays a major role, per se, in psoriasis pathogenesis. In [...] Read more.

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

(This article belongs to the Special Issue Environmental Diseases)

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Open AccessArticle

DNA Damage in Euonymus japonicus Leaf Cells Caused by Roadside Pollution in Beijing

by Tianxin Li, Minjie Zhang, Ke Gu, Uwizeyimana Herman, John Crittenden and Zhongming Lu

Int. J. Environ. Res. Public Health 2016, 13(7), 742; https://doi.org/10.3390/ijerph13070742 - 22 Jul 2016

Cited by 5 | Viewed by 4768

Abstract

The inhalable particles from vehicle exhaust can cause DNA damage to exposed organisms. Research on DNA damage is primarily focused on the influence of specific pollutants on certain species or the effect of environmental pollution on human beings. To date, little research has [...] Read more.

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

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Open AccessArticle

Contamination and Risk Assessment of Heavy Metals in Lake Bed Sediment of a Large Lake Scenic Area in China

by Li Wan, Liang Xu and Yongsheng Fu

Int. J. Environ. Res. Public Health 2016, 13(7), 741; https://doi.org/10.3390/ijerph13070741 - 21 Jul 2016

Cited by 15 | Viewed by 4797

Abstract

The exposure of heavy metals to lake bed sediment of scenic areas may pose risks on aquatic ecosystems and human health, however very few studies on risk assessment have been reported for scenic areas. Accordingly, this study determined concentration levels, and assessed contamination [...] Read more.

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

(This article belongs to the Special Issue Environmental Systems Engineering)

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Open AccessArticle

Parent-Child Relationship of Pedometer-Assessed Physical Activity and Proxy-Reported Screen Time in Czech Families with Preschoolers

by Erik Sigmund, Petr Badura, Jana Vokacova and Dagmar Sigmundová

Int. J. Environ. Res. Public Health 2016, 13(7), 740; https://doi.org/10.3390/ijerph13070740 - 21 Jul 2016

Cited by 11 | Viewed by 5036

Abstract

This study focuses on determining the relationship between parents’ step count (SC) and screen time (ST) and children’s SC and ST on weekdays and at weekends. The participants (278 parents aged 30–45 and their 194 children aged 4–7) were recruited from 10 randomly [...] Read more.

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

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Open AccessArticle

How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis

by Ting-Min Hsieh, Tsung-Cheng Tsai, Yueh-Wei Liu and Ching-Hua Hsieh

Int. J. Environ. Res. Public Health 2016, 13(7), 739; https://doi.org/10.3390/ijerph13070739 - 21 Jul 2016

Cited by 10 | Viewed by 4561

Abstract

Background: High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of [...] Read more.

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

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Open AccessCommunication

Geographic Elevation, Car Driving, and Depression among Elderly Residents in Rural Areas: The Shimane CoHRE Study

by Tsuyoshi Hamano, Miwako Takeda, Kristina Sundquist and Toru Nabika

Int. J. Environ. Res. Public Health 2016, 13(7), 738; https://doi.org/10.3390/ijerph13070738 - 21 Jul 2016

Cited by 5 | Viewed by 4111

Abstract

Given that public transportation networks are often worse in rural areas than in urban areas, it is difficult for elderly non-drivers to access health-promoting goods, services, and resources related to mental health. Moreover, geographical location, assessed by elevation, could modify this association in [...] Read more.

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

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Open AccessArticle

Microbial Contamination and Hygiene of Fresh Cow’s Milk Produced by Smallholders in Western Zambia

by Theodore J.D. Knight-Jones, M. Bernard Hang’ombe, Mwansa M. Songe, Yona Sinkala and Delia Grace

Int. J. Environ. Res. Public Health 2016, 13(7), 737; https://doi.org/10.3390/ijerph13070737 - 21 Jul 2016

Cited by 28 | Viewed by 8284

Abstract

A field study was performed to assess safety of smallholder fresh cow’s milk around Mongu, Western Province, Zambia. This involved observation and sampling of milk along the value chain from milking to point-of-sale and storage. Samples were collected from 86 cows, from 9 [...] Read more.

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

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Open AccessArticle

Measurements of Volatile Organic Compounds in a Newly Built Daycare Center

by Miyuki Noguchi, Atsushi Mizukoshi, Yukio Yanagisawa and Akihiro Yamasaki

Int. J. Environ. Res. Public Health 2016, 13(7), 736; https://doi.org/10.3390/ijerph13070736 - 21 Jul 2016

Cited by 23 | Viewed by 5971

Abstract

We measured temporal changes in concentrations of total volatile organic compounds (TVOCs) and individual volatile organic compounds in a newly built daycare center. The temporal changes of the TVOC concentrations were monitored with a photo ionization detector (PID), and indoor air was sampled [...] Read more.

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

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Open AccessArticle

Perception of Air Pollution in the Jinchuan Mining Area, China: A Structural Equation Modeling Approach

by Zhengtao Li, Henk Folmer and Jianhong Xue

Int. J. Environ. Res. Public Health 2016, 13(7), 735; https://doi.org/10.3390/ijerph13070735 - 21 Jul 2016

Cited by 25 | Viewed by 7235

Abstract

Studies on the perception of air pollution in China are very limited. The aim of this paper is to help to fill this gap by analyzing a cross-sectional dataset of 759 residents of the Jinchuan mining area, Gansu Province, China. The estimations suggest [...] Read more.

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

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Open AccessArticle

Infection Rates by Dengue Virus in Mosquitoes and the Influence of Temperature May Be Related to Different Endemicity Patterns in Three Colombian Cities

by Víctor Hugo Peña-García, Omar Triana-Chávez, Ana María Mejía-Jaramillo, Francisco J. Díaz, Andrés Gómez-Palacio and Sair Arboleda-Sánchez

Int. J. Environ. Res. Public Health 2016, 13(7), 734; https://doi.org/10.3390/ijerph13070734 - 21 Jul 2016

Cited by 32 | Viewed by 7346

Abstract

Colombia is an endemic country for dengue fever where the four serotypes of virus dengue (DENV1–4) circulate simultaneously, and all types are responsible for dengue cases in the country. The control strategies are guided by entomological surveillance. However, heterogeneity in aedic indices is [...] Read more.

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

(This article belongs to the Special Issue Mosquito Control Innovations into The 21st Century)

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Graphical abstract

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Open AccessArticle

A Meta-Analysis of the Efficacy of Interferon Monotherapy or Combined with Different Nucleos(t)ide Analogues for Chronic Hepatitis B

by Jialing Zhou, Xiaoning Wu, Wei Wei, Hong You, Jidong Jia and Yuanyuan Kong

Int. J. Environ. Res. Public Health 2016, 13(7), 730; https://doi.org/10.3390/ijerph13070730 - 21 Jul 2016

Cited by 7 | Viewed by 4713

Abstract

Background: The aim of the present study was to compare the efficacy of interferon (IFN) with or without different nucleos(t)ide analogues (NAs). Methods: The PubMed, Wan Fang and CNKI databases were searched to identify relevant trials up to May 2015. Meta-analysis was performed [...] Read more.

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

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Open AccessArticle

Quantitative Microbial Risk Assessment in Occupational Settings Applied to the Airborne Human Adenovirus Infection

by Annalaura Carducci, Gabriele Donzelli, Lorenzo Cioni and Marco Verani

Int. J. Environ. Res. Public Health 2016, 13(7), 733; https://doi.org/10.3390/ijerph13070733 - 20 Jul 2016

Cited by 48 | Viewed by 6321

Abstract

Quantitative Microbial Risk Assessment (QMRA) methodology, which has already been applied to drinking water and food safety, may also be applied to risk assessment and management at the workplace. The present study developed a preliminary QMRA model to assess microbial risk that is [...] Read more.

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

(This article belongs to the Special Issue Occupational Safety and Related Impacts on Health and the Environment)

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Open AccessArticle

The Relation of Moderate Alcohol Consumption to Hyperuricemia in a Rural General Population

by Zhao Li, Xiaofan Guo, Yamin Liu, Ye Chang, Yingxian Sun, Guangshuo Zhu and Maria Roselle Abraham

Int. J. Environ. Res. Public Health 2016, 13(7), 732; https://doi.org/10.3390/ijerph13070732 - 20 Jul 2016

Cited by 20 | Viewed by 5318

Abstract

Background: although alcohol abuse is known to increase serum uric acid, the relation between moderate drinking and uric acid have remained poorly understood. We performed this study to evaluate whether different alcohol consumption level has different effects on the risk of hyperuricemia based [...] Read more.

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

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Open AccessReview

Understanding the Influence of Environment on Adults’ Walking Experiences: A Meta-Synthesis Study

by Sara Dadpour, Jahanshah Pakzad and Hamidreza Khankeh

Int. J. Environ. Res. Public Health 2016, 13(7), 731; https://doi.org/10.3390/ijerph13070731 - 20 Jul 2016

Cited by 20 | Viewed by 5877

Abstract

The environment has an important impact on physical activity, especially walking. The relationship between the environment and walking is not the same as for other types of physical activity. This study seeks to comprehensively identify the environmental factors influencing walking and to show [...] Read more.

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

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Open AccessArticle

Spatial Distribution, Sources Apportionment and Health Risk of Metals in Topsoil in Beijing, China

by Chunyuan Sun, Wenji Zhao, Qianzhong Zhang, Xue Yu, Xiaoxia Zheng, Jiayin Zhao and Ming Lv

Int. J. Environ. Res. Public Health 2016, 13(7), 727; https://doi.org/10.3390/ijerph13070727 - 20 Jul 2016

Cited by 17 | Viewed by 5145

Abstract

In order to acquire the pollution feature and regularities of distribution of metals in the topsoil within the sixth ring road in Beijing, a total of 46 soil samples were collected, and the concentrations of twelve elements (Nickel, Ni, Lithium, Li, Vanadium, V, [...] Read more.

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

(This article belongs to the Special Issue Remote Sensing, Crowd Sensing, and Geospatial Technologies for Public Health)

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Geographical Inequalities in Surgical Treatment for Localized Female Breast Cancer, Queensland, Australia 1997–2011: Improvements over Time but Inequalities Remain

by Peter D. Baade, Paramita Dasgupta, Philippa H. Youl, Christopher Pyke and Joanne F. Aitken

Int. J. Environ. Res. Public Health 2016, 13(7), 729; https://doi.org/10.3390/ijerph13070729 - 19 Jul 2016

Cited by 17 | Viewed by 5411

Abstract

The uptake of breast conserving surgery (BCS) for early stage breast cancer varies by where women live. We investigate whether these geographical patterns have changed over time using population-based data linkage between cancer registry records and hospital inpatient episodes. The study cohort consisted [...] Read more.

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

(This article belongs to the Special Issue Geographical Variation in Breast Cancer Outcomes)

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Open AccessArticle

Association by Spatial Interpolation between Ozone Levels and Lung Function of Residents at an Industrial Complex in South Korea

by Soon-Won Jung, Kyoungho Lee, Yong-Sung Cho, Ji-Hee Choi, Wonho Yang, Tack-Shin Kang, Choonghee Park, Geun-Bae Kim, Seung-Do Yu and Bu-Soon Son

Int. J. Environ. Res. Public Health 2016, 13(7), 728; https://doi.org/10.3390/ijerph13070728 - 19 Jul 2016

Cited by 13 | Viewed by 4759

Abstract

Spatial interpolation is employed to improve exposure estimates and to assess adverse health effects associated with environmental risk factors. Since various studies have reported that high ozone (O₃) concentrations can give rise to adverse effects on respiratory symptoms and lung function, [...] Read more.

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

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Open AccessArticle

Shisha Smoking Practices, Use Reasons, Attitudes, Health Effects and Intentions to Quit among Shisha Smokers in Malaysia

by Li Ping Wong, Haridah Alias, Nasrin Aghamohammadi, Sima Aghazadeh and Victor Chee Wai Hoe

Int. J. Environ. Res. Public Health 2016, 13(7), 726; https://doi.org/10.3390/ijerph13070726 - 19 Jul 2016

Cited by 27 | Viewed by 8831

Abstract

Despite its popularity, shisha smoking practices, reasons for its use, attitudes, detrimental health effects and intention to quit among shisha users in Malaysia have never been investigated. A total of 503 shisha users responded to a cross-sectional study conducted between July 2015 and [...] Read more.

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

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Open AccessArticle

A Survey of Jellyfish Sting Knowledge among Naval Personnel in Northeast China

by Ting Kan, Li Gui, Wenwen Shi, Yan Huang, Shuang Li and Chen Qiu

Int. J. Environ. Res. Public Health 2016, 13(7), 725; https://doi.org/10.3390/ijerph13070725 - 19 Jul 2016

Cited by 4 | Viewed by 4300

Abstract

Background: Jellyfish envenomation is common along the coastal area, and can cause severe consequences. Naval personnel are among the high-risk population for this injury. The aim of this study was to assess knowledge regarding jellyfish envenomation among naval personnel in a navy unit [...] Read more.

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

(This article belongs to the Special Issue Occupational Safety and Related Impacts on Health and the Environment)

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Open AccessEditorial

Environment and Health: Not Only Cancer

by Annamaria Colao, Giovanna Muscogiuri and Prisco Piscitelli

Int. J. Environ. Res. Public Health 2016, 13(7), 724; https://doi.org/10.3390/ijerph13070724 - 19 Jul 2016

Cited by 34 | Viewed by 7393

Abstract

The Hippocratic tradition emphasized environmental causes of diseases and the need for harmony between the individual and the natural environment as the right philosophy to maintain a good health status. Public awareness and scientific attention concerning environmental pollution is usually focused on the [...] Read more.

The Hippocratic tradition emphasized environmental causes of diseases and the need for harmony between the individual and the natural environment as the right philosophy to maintain a good health status. Public awareness and scientific attention concerning environmental pollution is usually focused on the consequent increased risk of developing cancer. Air pollution has been recognized by the World Health Organization (WHO) to cause cardiovascular and respiratroy diseases, as well as lung cancer, after acute/chronic exposure to fine particulates (PM_2.5 and PM₁₀) even at concentrations which are 50% lower than those accepted as legal limits in many developed countries. An increase of 10 µg/m³ of PM_2.5 produces a +4%–6% of overall mortality, a +10% of cardiovascular disease prevalence (arithmyas, acute myocardial infarctions, and heart failure) and a +22% of lung cancer prevalence. In addition to these chronic effects, acute hospitalizations are also affected, especially among susceptible populations such as children and diabetic patients. Water and soil contamination also have an additional detrimental effect on people’s health. Other issues concerning environment contamination and human health include male/female fertility, metabolic and thyroid conditions, but also professional exposures resulting in occupational diseases. Moreover, in the perspective of “gender medicine”, different acute or chronic effects of environmental pollution should be specifically assessed both in men and in women. This special issue on “Environmental Diseases” is aimed at providing a global overview about different threats to human health possibily originating from environmental contamination. Full article

(This article belongs to the Special Issue Environmental Diseases)

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

by Eugene Leibovitz, Nuphar David, Haya Ribitzky-Eisner, Mouner Abo Madegam, Said Abuabed, Gabriel Chodick, Michal Maimon and Yariv Fruchtman

Int. J. Environ. Res. Public Health 2016, 13(7), 723; https://doi.org/10.3390/ijerph13070723 - 19 Jul 2016

Cited by 4 | Viewed by 4445

Abstract

We described the occult bacteremia (OB) and bacteremia with diagnosed focus (BwF) picture among children managed as outpatients at the pediatric emergency room (PER) in southern Israel, before and after the introduction of pneumococcal conjugate vaccines (PCVs) introduction in a retrospective study enrolling [...] Read more.

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

(This article belongs to the Special Issue Pediatric Infectious Diseases)

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The Short-Term Effect of Ambient Temperature on Mortality in Wuhan, China: A Time-Series Study Using a Distributed Lag Non-Linear Model

by Yunquan Zhang, Cunlu Li, Renjie Feng, Yaohui Zhu, Kai Wu, Xiaodong Tan and Lu Ma

Int. J. Environ. Res. Public Health 2016, 13(7), 722; https://doi.org/10.3390/ijerph13070722 - 18 Jul 2016

Cited by 63 | Viewed by 6600

Abstract

Less evidence concerning the association between ambient temperature and mortality is available in developing countries/regions, especially inland areas of China, and few previous studies have compared the predictive ability of different temperature indictors (minimum, mean, and maximum temperature) on mortality. We assessed the [...] Read more.

Less evidence concerning the association between ambient temperature and mortality is available in developing countries/regions, especially inland areas of China, and few previous studies have compared the predictive ability of different temperature indictors (minimum, mean, and maximum temperature) on mortality. We assessed the effects of temperature on daily mortality from 2003 to 2010 in Jiang’an District of Wuhan, the largest city in central China. Quasi-Poisson generalized linear models combined with both non-threshold and double-threshold distributed lag non-linear models (DLNM) were used to examine the associations between different temperature indictors and cause-specific mortality. We found a U-shaped relationship between temperature and mortality in Wuhan. Double-threshold DLNM with mean temperature performed best in predicting temperature-mortality relationship. Cold effect was delayed, whereas hot effect was acute, both of which lasted for several days. For cold effects over lag 0–21 days, a 1 °C decrease in mean temperature below the cold thresholds was associated with a 2.39% (95% CI: 1.71, 3.08) increase in non-accidental mortality, 3.65% (95% CI: 2.62, 4.69) increase in cardiovascular mortality, 3.87% (95% CI: 1.57, 6.22) increase in respiratory mortality, 3.13% (95% CI: 1.88, 4.38) increase in stroke mortality, and 21.57% (95% CI: 12.59, 31.26) increase in ischemic heart disease (IHD) mortality. For hot effects over lag 0–7 days, a 1 °C increase in mean temperature above the hot thresholds was associated with a 25.18% (95% CI: 18.74, 31.96) increase in non-accidental mortality, 34.10% (95% CI: 25.63, 43.16) increase in cardiovascular mortality, 24.27% (95% CI: 7.55, 43.59) increase in respiratory mortality, 59.1% (95% CI: 41.81, 78.5) increase in stroke mortality, and 17.00% (95% CI: 7.91, 26.87) increase in IHD mortality. This study suggested that both low and high temperature were associated with increased mortality in Wuhan, and that mean temperature had better predictive ability than minimum and maximum temperature in the association between temperature and mortality. Full article

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Effect of Yoga Exercise on Premenstrual Symptoms among Female Employees in Taiwan

by Su-Ying Tsai

Int. J. Environ. Res. Public Health 2016, 13(7), 721; https://doi.org/10.3390/ijerph13070721 - 16 Jul 2016

Cited by 36 | Viewed by 14245

Abstract

Yoga classes designed for women with premenstrual syndrome are available, but their efficacy is unclear. We investigated the effects of 12 weeks’ yoga exercise (yoga intervention) on premenstrual symptoms in menstruating females in Taiwan. Sixty-four subjects completed the yoga intervention, and before and [...] Read more.

Yoga classes designed for women with premenstrual syndrome are available, but their efficacy is unclear. We investigated the effects of 12 weeks’ yoga exercise (yoga intervention) on premenstrual symptoms in menstruating females in Taiwan. Sixty-four subjects completed the yoga intervention, and before and after the intervention filled out a structured self-report questionnaire about their demographics, personal lifestyle, menstrual status, baseline menstrual pain scores, premenstrual symptoms, and health-related quality of life. Of 64 subjects, 90.6% reported experiencing menstrual pain during menstruation. After the yoga intervention, subjects reported decreased use of analgesics during menstruation (p = 0.0290) and decreased moderate or severe effects of menstrual pain on work (p = 0.0011). The yoga exercise intervention was associated with the improvement of the scale of physical function (p = 0.0340) and bodily pain (p = 0.0087) of the SF-36, and significantly decreased abdominal swelling (p = 0.0011), breast tenderness (p = 0.0348), abdominal cramps (p = 0.0016), and cold sweats (p = 0.0143). Menstrual pain mitigation after yoga exercise correlated with improvement in six scales of the SF-36 (physical function, bodily pain, general health perception, vitality/energy, social function, mental health). Employers can educate female employees about the benefits of regular exercise such as yoga, which may decrease premenstrual distress and improve female employee health. Full article

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The Role of Stress Management in the Relationship between Purpose in Life and Self-Rated Health in Teachers: A Mediation Analysis

by Fei Li, Jieyu Chen, Lin Yu, Yuan Jing, Pingping Jiang, Xiuqiong Fu, Shengwei Wu, Xiaomin Sun, Ren Luo, Hiuyee Kwan, Xiaoshan Zhao and Yanyan Liu

Int. J. Environ. Res. Public Health 2016, 13(7), 719; https://doi.org/10.3390/ijerph13070719 - 16 Jul 2016

Cited by 7 | Viewed by 6984

Abstract

Background: To examine whether stress management mediates the relationship between purpose in life and self-rated health status (SRH). Methods: A cross-sectional survey was conducted among 6840 teachers in 2013 in Guangzhou, China. Purpose in life was assessed through the Purpose in [...] Read more.

Background: To examine whether stress management mediates the relationship between purpose in life and self-rated health status (SRH). Methods: A cross-sectional survey was conducted among 6840 teachers in 2013 in Guangzhou, China. Purpose in life was assessed through the Purpose in Life Subscale of the Psychological Well-being Scale. Stress management was assessed using the eight-item questionnaire adapted from the Health-promoting Lifestyle Profile II. SRH was assessed by the Suboptimal Health Measurement Scale Version 1.0. The mediation hypothesis was tested by the structural equation model for path analysis. Results: It was found that purpose in life had direct and indirect effects on SRH. The path analysis showed the total effect (β = 0.563) of purpose in life on SRH was comprised of a direct effect (β = 0.319) and an indirect effect (β = 0.244), which was mediated by stress management. Conclusions: By supporting the mediation hypothesis, our results indicate that stress management mediated the effect of purpose in life on SRH. Enhancement of teachers’ purpose in life and improvement of training skills of stress management should be incorporated in the strategy of improving teachers’ health. Full article

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Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

by Alvin Cong Wei Ong, Sher Guan Low and Farhad Fakhrudin Vasanwala

Int. J. Environ. Res. Public Health 2016, 13(7), 718; https://doi.org/10.3390/ijerph13070718 - 16 Jul 2016

Cited by 10 | Viewed by 7131

Abstract

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood [...] Read more.

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary. Full article

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Open AccessArticle

Staff Training in Autism: The One-Eyed Wo/Man…

by Karola Dillenburger, Lyn McKerr, Julie-Ann Jordan and Mickey Keenan

Int. J. Environ. Res. Public Health 2016, 13(7), 716; https://doi.org/10.3390/ijerph13070716 - 16 Jul 2016

Cited by 32 | Viewed by 15350

Abstract

Having well-trained staff is key to ensuring good quality autism services, especially since people affected with autism generally tend to have higher support needs than other populations in terms of daily living, as well as their mental and physical health. Poorly-trained staff can [...] Read more.

Having well-trained staff is key to ensuring good quality autism services, especially since people affected with autism generally tend to have higher support needs than other populations in terms of daily living, as well as their mental and physical health. Poorly-trained staff can have detrimental effects on service provision and staff morale and can lead to staff burn-out, as well as increased service user anxiety and stress. This paper reports on a survey with health, social care, and education staff who work within the statutory autism services sector in the UK that explored their knowledge and training with regards to autism. Interview data obtained from staff and service users offer qualitative illustrations of survey findings. Overall, the findings expose an acute lack of autism-specific training that has detrimental impacts. At best, this training was based on brief and very basic awareness raising rather than on in-depth understanding of issues related to autism or skills for evidence-based practice. Service users were concerned with the effects that the lack of staff training had on the services they received. The paper concludes with a discussion of policy routes to achieving quality staff training based on international best practice. The focus is on improving the quality of life and mental health for services users and staff, as well as making potentially significant cost-savings for governments. Full article

(This article belongs to the Special Issue Mental Healthcare and Autism)

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Open AccessArticle

Medication Literacy in a Cohort of Chinese Patients Discharged with Acute Coronary Syndrome

by Zhuqing Zhong, Feng Zheng, Yuna Guo and Aijing Luo

Int. J. Environ. Res. Public Health 2016, 13(7), 720; https://doi.org/10.3390/ijerph13070720 - 15 Jul 2016

Cited by 13 | Viewed by 4293

Abstract

This study aims at investigating medication literacy of discharged patients with acute coronary syndrome (ACS) in China, and the important determinants of medication literacy among them. For this purpose, we conducted a prospective cohort study. Patient’s demographic and clinical data were retrieved from [...] Read more.

This study aims at investigating medication literacy of discharged patients with acute coronary syndrome (ACS) in China, and the important determinants of medication literacy among them. For this purpose, we conducted a prospective cohort study. Patient’s demographic and clinical data were retrieved from hospital charts and medication literacy was measured by instructed interview using the Chinese version of Medication Literacy Questionnaire on Discharged Patient between 7 and 30 days after the patient was discharged from the hospital. The results show that medication literacy for the surveyed patients was insufficient: >20% did not have adequate knowledge on the types of drugs and the frequency that they need to take the drugs, >30% did not know the name of and the dosage of the drugs they are taking, and >70% did not have adequate knowledge on the effects and side effects of the drugs they are taking. Our research indicated that medication literacy scores decreased with age but increased with education. The number of medicines the discharged patient took with them and days between discharge and interview were not associated with medication literacy levels. Full article

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Open AccessArticle

Phthalate Metabolites, Consumer Habits and Health Effects

by Peter Wallner, Michael Kundi, Philipp Hohenblum, Sigrid Scharf and Hans-Peter Hutter

Int. J. Environ. Res. Public Health 2016, 13(7), 717; https://doi.org/10.3390/ijerph13070717 - 15 Jul 2016

Cited by 25 | Viewed by 6103

Abstract

Phthalates are multifunctional chemicals used in a wide variety of consumer products. The aim of this study was to investigate whether levels of urinary phthalate metabolites in urine samples of Austrian mothers and their children were associated with consumer habits and health indicators. [...] Read more.

Phthalates are multifunctional chemicals used in a wide variety of consumer products. The aim of this study was to investigate whether levels of urinary phthalate metabolites in urine samples of Austrian mothers and their children were associated with consumer habits and health indicators. Within an Austrian biomonitoring survey, urine samples from 50 mother-child pairs of five communities (two-stage random stratified sampling) were analysed. The concentrations of 14 phthalate metabolites were determined, and a questionnaire was administered. Monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP), mono-(5-carboxy-2-ethylpentyl) phthalate (5cx-MEPP), and 3-carboxy-mono-propyl phthalate (3cx-MPP) could be quantified in the majority of samples. Significant correlations were found between the use of hair mousse, hair dye, makeup, chewing gum, polyethylene terephthalate (PET) bottles and the diethyl phthalate (DEP) metabolite MEP. With regard to health effects, significant associations of MEP in urine with headache, repeated coughing, diarrhoea, and hormonal problems were observed. MBzP was associated with repeated coughing and MEHP was associated with itching. Full article

(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)

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Int. J. Environ. Res. Public Health, Volume 13, Issue 7 (July 2016) – 121 articles

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