International Journal of Environmental Research and Public Health

26 pages, 4385 KiB

Open AccessArticle

Combined Effects of Aircraft, Rail, and Road Traffic Noise on Total Noise Annoyance—A Cross-Sectional Study in Innsbruck

by Christoph Lechner, David Schnaiter and Stephan Bose-O’Reilly

Int. J. Environ. Res. Public Health 2019, 16(18), 3504; https://doi.org/10.3390/ijerph16183504 - 19 Sep 2019

Cited by 19 | Viewed by 3203

Abstract

Noise legislation in Austria does not provide an assessment of the cumulative effect of noise from different sources. The desire of citizens for a total noise assessment is getting stronger. Within the pilot project “Gesamtlärmbetrachtung” (Total Noise Investigation) Innsbruck, data from 1031 face-to-face [...] Read more.

Noise legislation in Austria does not provide an assessment of the cumulative effect of noise from different sources. The desire of citizens for a total noise assessment is getting stronger. Within the pilot project “Gesamtlärmbetrachtung” (Total Noise Investigation) Innsbruck, data from 1031 face-to-face interviews were correlated with exposure data from road, rail and air traffic noise. The interviews were selected in clusters according to the exposure combinations of these three sources. In addition to exposure-response relationships, it has also been found that the annoyance response to air and rail traffic noise is independent of the background noise from road traffic. The total noise annoyance response shows a cumulative effect in each source considered. From the source specific exposure-response relationships, a total noise assessment model based on the annoyance equivalents model was developed. This model is more suitable than the dominant source model and thus also considerable for legal application. Full article

(This article belongs to the Section Environmental Health)

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19 pages, 2870 KiB

Open AccessArticle

Factors Influencing Microbiological Biodiversity of Human Foot Skin

by Aleksandra Steglińska, Anita Jachowicz, Justyna Szulc, Justyna Adamiak, Anna Otlewska, Katarzyna Pielech-Przybylska and Beata Gutarowska

Int. J. Environ. Res. Public Health 2019, 16(18), 3503; https://doi.org/10.3390/ijerph16183503 - 19 Sep 2019

Cited by 9 | Viewed by 3635

Abstract

The aim of the study was to analyze the microbiological biodiversity of human foot skin with respect to factors such as age, gender, frequency of foot washing and physical activity, and to select indicator species to be considered when designing textile materials with [...] Read more.

The aim of the study was to analyze the microbiological biodiversity of human foot skin with respect to factors such as age, gender, frequency of foot washing and physical activity, and to select indicator species to be considered when designing textile materials with antimicrobial properties used for sock and insole production. The experiment was carried out on a group of 40 people. The number of microorganisms was determined using culture-dependent methods. Biodiversity was determined using culture followed by genetic identification based on 16S rRNA gene sequencing (bacteria), ITS region (fungi), or using Illumina next-generation sequencing (in a group of eight selected individuals). The total bacterial number on women’s feet was on average 1.0 × 10⁶ CFU/cm², and was not statistically significantly different than that of men’s feet (mean 1.2 × 10⁵ CFU/cm²). The number of bacteria, in most cases, decreased with age and with increased frequency of physical activity. The number of bacteria increased with diminishing feet-washing frequency; however, statistically significant differences were found between groups. The number of fungi was not significantly different amongst groups. Bacteria belonging to the phyla Firmicutes, Proteobacteria and Actinobacteria constituted the main microorganisms of the foot skin. Ascomycota and Basidiomycota predominated amongst the fungi. The presence of specific species varied in groups depending on the factors mentioned above. Two of the species identified were classified as pathogens (Neisseria flavescens and Aspergillus fumigatus). These findings suggest that it is necessary to extend the list of microorganisms tested on textiles with respect to hygienic properties. Full article

(This article belongs to the Special Issue Environmental Microbiology and Urban Health)

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28 pages, 371 KiB

Open AccessReview

Early Autism Screening: A Comprehensive Review

by Fadi Thabtah and David Peebles

Int. J. Environ. Res. Public Health 2019, 16(18), 3502; https://doi.org/10.3390/ijerph16183502 - 19 Sep 2019

Cited by 66 | Viewed by 12502

Abstract

Autistic spectrum disorder (ASD) refers to a neurodevelopmental condition associated with verbal and nonverbal communication, social interactions, and behavioural complications that is becoming increasingly common in many parts of the globe. Identifying individuals on the spectrum has remained a lengthy process for the [...] Read more.

Autistic spectrum disorder (ASD) refers to a neurodevelopmental condition associated with verbal and nonverbal communication, social interactions, and behavioural complications that is becoming increasingly common in many parts of the globe. Identifying individuals on the spectrum has remained a lengthy process for the past few decades due to the fact that some individuals diagnosed with ASD exhibit exceptional skills in areas such as mathematics, arts, and music among others. To improve the accuracy and reliability of autism diagnoses, many scholars have developed pre-diagnosis screening methods to help identify autistic behaviours at an early stage, speed up the clinical diagnosis referral process, and improve the understanding of ASD for the different stakeholders involved, such as parents, caregivers, teachers, and family members. However, the functionality and reliability of those screening tools vary according to different research studies and some have remained questionable. This study evaluates and critically analyses 37 different ASD screening tools in order to identify possible areas that need to be addressed through further development and innovation. More importantly, different criteria associated with existing screening tools, such as accessibility, the fulfilment of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specifications, comprehensibility among the target audience, performance (specifically sensitivity, specificity, and accuracy), web and mobile availability, and popularity have been investigated. Full article

(This article belongs to the Special Issue Machine Learning and Analytics for Medical Care and Health Service)

14 pages, 631 KiB

Open AccessArticle

Nature-Based Interventions for Mental Health Care: Social Network Analysis as a Tool to Map Social Farms and their Response to Social Inclusion and Community Engagement

by Marta Borgi, Mario Marcolin, Paolo Tomasin, Cinzia Correale, Aldina Venerosi, Alberto Grizzo, Roberto Orlich and Francesca Cirulli

Int. J. Environ. Res. Public Health 2019, 16(18), 3501; https://doi.org/10.3390/ijerph16183501 - 19 Sep 2019

Cited by 14 | Viewed by 3671

Abstract

Social farming represents a hybrid governance model in which public bodies, local communities, and economic actors act together to promote health and social inclusion in rural areas. Although relational variables are crucial to foster social farm performance, the relational system in which farms [...] Read more.

Social farming represents a hybrid governance model in which public bodies, local communities, and economic actors act together to promote health and social inclusion in rural areas. Although relational variables are crucial to foster social farm performance, the relational system in which farms are embedded has still not been fully described. Using social network analysis, here we map the nature of the links of a selected sample of social farms operating in Northern Italy. We also explore possible network variations following specific actions taken to potentiate local social farming initiatives. The results show a certain degree of variability in terms of the extension and features of the examined networks. Overall, the actions taken appear to be significant to enlarge and diversify farms’ networks. Social farming has the potential to provide important benefits to society and the environment and to contrast vulnerability in rural areas. Being able to create social and economic networks of local communities, social farming may also represent an innovative way to respond to the cultural shift from institutional psychiatry to community-based mental health care. This study emphasizes the critical role played by network facilitation in diversifying actors, promoting heterogeneous relationships, and, in turn, system complexity. Full article

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11 pages, 480 KiB

Open AccessArticle

Air Pollution in a Nationally Representative Sample: Findings from the National Adult Tobacco Survey of Lao PDR

by Glorietta Hurd-Kundeti, Anne Berit Petersen, Khamphithoun Somsamouth and Pramil N. Singh

Int. J. Environ. Res. Public Health 2019, 16(18), 3500; https://doi.org/10.3390/ijerph16183500 - 19 Sep 2019

Cited by 2 | Viewed by 2776

Abstract

In Southeast Asia, household air pollution (HAP) from solid fuel use is the leading cause of disability-adjusted life years (DALYs), a risk which is compounded by exposure to other sources of indoor and outdoor air pollution including secondhand tobacco smoke (SHS). The purpose [...] Read more.

In Southeast Asia, household air pollution (HAP) from solid fuel use is the leading cause of disability-adjusted life years (DALYs), a risk which is compounded by exposure to other sources of indoor and outdoor air pollution including secondhand tobacco smoke (SHS). The purpose of this study was to measure the individual and combined prevalence of exposure to household and community sources of air pollution in a national sample of adults in Lao PDR. We analyzed data from the 2012 National Adult Tobacco Survey (NATSL) of Lao PDR—a multi-stage stratified cluster sample of 9706 subjects from 2822 households located in all 17 provinces. Our findings indicate a high prevalence of exposure to household air pollution from cooking fires (78%) and SHS exposure in the home (74.5%). More than a third (32.8%) reported exposure to both inside the home. Exposure to outdoor sources of smoke from cooking, trash, and crop fires was substantial (30.1% to 56.0%). The aggregation of exposures from multiple sources of household air pollution raises the need for initiatives that establish programmatic linkages in the health, environmental, and agricultural sectors to provide a comprehensive strategy to reduce risk factors for respiratory disease in Lao PDR and the region. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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16 pages, 1846 KiB

Open AccessArticle

Comprehensive Evaluation and Spatial Difference Analysis of Regional Ecological Carrying Capacity: A Case Study of the Yangtze River Urban Agglomeration

by Yuanyuan Wang, Benhong Peng, Guo Wei and Ehsan Elahi

Int. J. Environ. Res. Public Health 2019, 16(18), 3499; https://doi.org/10.3390/ijerph16183499 - 19 Sep 2019

Cited by 40 | Viewed by 3271

Abstract

Ecological carrying capacity is an important factor of sustainable development for cities, and a critical part of achieving the coordinated development of the social economic and ecological environment for urban agglomerations. In order to evaluate the regional ecological carrying capacity and provide a [...] Read more.

Ecological carrying capacity is an important factor of sustainable development for cities, and a critical part of achieving the coordinated development of the social economic and ecological environment for urban agglomerations. In order to evaluate the regional ecological carrying capacity and provide a basis for decision-making for regional sustainable development, this paper constructs an ecological carrying capacity model for the urban agglomeration from two dimensions: ecological carrying elastic force and ecological carrying pressure. The analytic hierarchy process is utilized to determine the weights of nine indices in these two dimensions. For the Yangtze River urban agglomeration, the comprehensive index of its ecological carrying capacity is investigated quantitatively, and the spatial distribution map of its comprehensive index measuring ecological carrying capacity is computed. The results show that Nanjing, Yangzhou, Taizhou, and Changzhou are in the stage of high load carrying; Suzhou, Wuxi, Nantong, and Zhenjiang are in the stage of low load carrying. In addition, the environmental protection investment has the greatest impact on ecological carrying elastic force, followed by the proportion of the tertiary industry; wastewater discharge has the greatest impact on ecological carrying pressure. The level of ecological carrying capacity varies within the region. It is necessary to take measures to increase the ecological carrying elastic force and reduce the ecological carrying pressure according to the actual conditions in each region. Meanwhile, exchanges and cooperation between different regions should be strengthened to stimulate the coordinated and sustainable development. Full article

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17 pages, 604 KiB

Open AccessArticle

Levels of Physical Activity in Children and Adolescents with Type 1 Diabetes in Relation to the Healthy Comparators and to the Method of Insulin Therapy Used

by Ewelina Czenczek-Lewandowska, Justyna Leszczak, Joanna Baran, Aneta Weres, Justyna Wyszyńska, Bogumił Lewandowski, Mariusz Dąbrowski and Artur Mazur

Int. J. Environ. Res. Public Health 2019, 16(18), 3498; https://doi.org/10.3390/ijerph16183498 - 19 Sep 2019

Cited by 31 | Viewed by 3655

Abstract

Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between [...] Read more.

Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between children with T1D (n = 215) and healthy controls (n = 115) and to assess the physical activity of the study group in relation to the applied method of insulin therapy, i.e., the use of insulin pen vs. insulin pump. The level of physical activity was assessed with a hip-worn tri-axial accelerometer (ActiGraph GT3X+) used by the subjects for an uninterrupted period of seven days. Children with T1D had significantly lower median values of total time of moderate (213.3 vs. 272.1 min), vigorous (135.3 vs. 19.6 min) and moderate-to-vigorous (347.4 vs. 467.4 min) physical activity compared to healthy peers respectively, (p < 0.001) in all cases. In addition, the total median number of steps was significantly lower (53,631 vs. 67,542 steps), (p < 0.001). The method of insulin therapy was not associated with significant differences in physical activity level (p > 0.001). The level of physical activity in children and adolescents with T1D is lower than in their healthy peers and does not depend on the insulin therapy method. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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12 pages, 23410 KiB

Open AccessArticle

Using Geostatistical Gaussian Simulation for Designing and Interpreting Soil Surface Magnetic Susceptibility Measurements

by Piotr Fabijańczyk and Jarosław Zawadzki

Int. J. Environ. Res. Public Health 2019, 16(18), 3497; https://doi.org/10.3390/ijerph16183497 - 19 Sep 2019

Cited by 3 | Viewed by 2089

Abstract

This paper presents a new approach to the assessment of the uncertainty of using geostatistical Gaussian simulation in soil magnetometry. In the study area, numerous measurements of soil magnetic susceptibility were made, and spatial distributions of soil magnetic susceptibility were simulated. The parameters [...] Read more.

This paper presents a new approach to the assessment of the uncertainty of using geostatistical Gaussian simulation in soil magnetometry. In the study area, numerous measurements of soil magnetic susceptibility were made, and spatial distributions of soil magnetic susceptibility were simulated. The parameters of variograms of soil magnetic susceptibility measured in the study area were determined and compared with those of simulated soil magnetic susceptibility. Regardless of the measurement scheme used, reproducibility of the original semivariograms of soil magnetic susceptibility was satisfactorily achieved when applying simulated values. A nugget effect, a sill, and a range of correlations of variograms of simulated values of soil magnetic susceptibility were similar to those of measured values. When the input data for the geostatistical simulation were averaged, the measured values of soil magnetic susceptibility and simulated spatial distributions were characterized by slightly lower standard deviations in comparison with the result of simulations based on the non-averaged, measured ones. At the same time, however, local variability of soil magnetic susceptibility was reproduced less. The accuracy of the calculations of point parameters and spatial distributions—based on the averaged values of soil magnetic susceptibility—were satisfactory, but when using geostatistical methods, it is recommended to use non-averaged magnetic susceptibility measurements. Full article

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20 pages, 5339 KiB

Open AccessArticle

Wood and Its Impact on Humans and Environment Quality in Health Care Facilities

by Veronika Kotradyova, Erik Vavrinsky, Barbora Kalinakova, Dominik Petro, Katarina Jansakova, Martin Boles and Helena Svobodova

Int. J. Environ. Res. Public Health 2019, 16(18), 3496; https://doi.org/10.3390/ijerph16183496 - 19 Sep 2019

Cited by 28 | Viewed by 6922

Abstract

The paper presents the application of natural materials, especially wood, which are relevant for human well-being in built environments of health, social, and day care facilities. These properties were tested by a complex methodology in a case study in the wooden waiting room [...] Read more.

The paper presents the application of natural materials, especially wood, which are relevant for human well-being in built environments of health, social, and day care facilities. These properties were tested by a complex methodology in a case study in the wooden waiting room at National Oncology Institute in Bratislava. In this space, experimental tests of physiological responses were further executed on 50 volunteers moving in the waiting room for 20 min. In this article, the EEG (electroencephalograph) (four persons) and emotions from the faces of all our volunteers before entering and after a stay in a wooden waiting room were recorded. Specifically, the ECG (electrocardiograph), heart rate (HR), and respiration activity were measured by using our own designed ECG holter (40 persons), and also blood pressure and cortisol levels were observed. The usage of wooden materials verifies their regenerative and positive impact on the human nervous system, through the appealing aesthetics (color, texture, and structures), high contact comfort, pleasant smell, possibility to regulate air humidity, volatile organic compound emissions (VOC-emissions), and acoustic well-being in the space. Full article

(This article belongs to the Special Issue Quality of Life: The Interplay between Human Behaviour, Technology and the Environment)

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16 pages, 866 KiB

Open AccessArticle

Effects of Traditional vs. iPad-Enhanced Aerobic Exercise on Wayfinding Efficacy and Cognition: A Pilot Randomized Controlled Trial

by Daniel Palac, Tiffany Bullard, Jason D. Cohen, Lydia T. Nguyen, Raksha A. Mudar and Sean P. Mullen

Int. J. Environ. Res. Public Health 2019, 16(18), 3495; https://doi.org/10.3390/ijerph16183495 - 19 Sep 2019

Cited by 4 | Viewed by 3837

Abstract

The purpose of this pilot study was to test the feasibility and efficacy of an iPad-enhanced aerobic exercise intervention designed to enhance wayfinding efficacy and performance and relevant cognitive functioning among middle-aged adults at risk for cognitive impairment. Twenty-seven low active adults (21 [...] Read more.

The purpose of this pilot study was to test the feasibility and efficacy of an iPad-enhanced aerobic exercise intervention designed to enhance wayfinding efficacy and performance and relevant cognitive functioning among middle-aged adults at risk for cognitive impairment. Twenty-seven low active adults (21 females) aged 45 to 62 years (51.22 ± 5.20) participated in a ten-week randomized controlled trial. Participants were randomized to an iPad-enhanced aerobic exercise group (experimental group) or an aerobic exercise-only group (control group) following baseline assessment. Both groups exercised at 50% to 75% of age-predicted heart rate maximum for 30 to 50 min/d, 2 d/wk for 10 weeks. During aerobic exercise, the experimental group engaged in virtual tours delivered via iPad. Baseline and post-intervention assessments of wayfinding self-efficacy, wayfinding task performance, cognitive functioning, electroencephalogram (EEG), and psychosocial questionnaires were administered. The results suggest that ten weeks of iPad-enhanced, moderately intense aerobic exercise had specific effects on wayfinding self-efficacy; however, no statistical differences were found between groups on the behavioral wayfinding task or spatial memory performance at follow-up. Performance scores on an inhibitory attentional-control cognitive assessment revealed significant differences between groups, favoring the experimental group (p < 0.05). Virtual reality-enhanced aerobic exercise may prove to be an effective method for improving cognitive function and increasing confidence to navigate real-world scenarios among individuals at risk of cognitive impairment. Full article

(This article belongs to the Special Issue Digital Health Interventions in Everyday Settings)

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13 pages, 1799 KiB

Open AccessArticle

The Relationships between High School Subjects in terms of School Satisfaction and Academic Performance in Mexican Adolescents

by Raúl Baños, Antonio Baena-Extremera and Antonio Granero-Gallegos

Int. J. Environ. Res. Public Health 2019, 16(18), 3494; https://doi.org/10.3390/ijerph16183494 - 19 Sep 2019

Cited by 11 | Viewed by 3918

Abstract

Adolescents’ academic performance and the way it is related to their subjective wellbeing are issues of great interest across educational systems. The purpose of this study was to ascertain how satisfaction with high school subjects can predict school satisfaction and academic performance in [...] Read more.

Adolescents’ academic performance and the way it is related to their subjective wellbeing are issues of great interest across educational systems. The purpose of this study was to ascertain how satisfaction with high school subjects can predict school satisfaction and academic performance in Mexican students. The sample consisted of 457 high school students in the Baja California and Nuevo León states in Mexico (247 boys, 210 girls); their mean age being 14.10 (SD = 0.84). We used a questionnaire featuring a subject satisfaction scale, an intrinsic school satisfaction scale, and one related to academic grades. We used descriptive analyses, correlations, and structural regression models. In terms of results, the high satisfaction and academic performance levels in physical education, Spanish and English are worth highlighting. Geography and history are the most relevant predictors of academic grades, while Spanish predicts school satisfaction and physical education predicts boredom. In conclusion, satisfaction with mathematics, Spanish, and English are strong predictors of satisfaction (SATF), and the latter in turn predicts Mexican high school students’ academic performance. Full article

(This article belongs to the Section Children's Health)

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13 pages, 1161 KiB

Open AccessArticle

The Role of Rural Infrastructure in Reducing Production Costs and Promoting Resource-Conserving Agriculture

by Qinghua Wu, Xiaoliang Guan, Jun Zhang and Yang Xu

Int. J. Environ. Res. Public Health 2019, 16(18), 3493; https://doi.org/10.3390/ijerph16183493 - 19 Sep 2019

Cited by 17 | Viewed by 3264

Abstract

The development of rural infrastructure plays an essential role in improving rural livelihoods and enhancing sustainable and environmentally friendly agricultural production. However, little is known about whether rural infrastructure enables the promotion of resource-conserving agriculture and reduces production costs. Understanding the relationship between [...] Read more.

The development of rural infrastructure plays an essential role in improving rural livelihoods and enhancing sustainable and environmentally friendly agricultural production. However, little is known about whether rural infrastructure enables the promotion of resource-conserving agriculture and reduces production costs. Understanding the relationship between rural infrastructure and production costs can provide significant information for policy-makers in their efforts to promote resource-saving agriculture that is beneficial to environmental performance. This study contributes to the literature by analyzing the heterogeneous effects of irrigation infrastructure and standard and substandard roads on agricultural production costs, using an unconditional quantile regression model and provincial data from China for the period 1995–2017. The empirical results show that the effects of rural infrastructure on production costs are mixed. In particular, irrigation infrastructure affects production costs positively in the lower quantiles, but it negatively affects production costs in the higher quantiles. In the higher 80th and 90th quantiles, standard and substandard roads affect production costs both negatively and significantly. Our findings suggest that improving rural infrastructure enables the promotion of resource-conserving agriculture and enhances environmental performance, especially for those paying high production costs. Full article

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11 pages, 315 KiB

Open AccessArticle

Older People Living in Nursing Homes: An Oral Health Screening Survey in Florence, Italy

by Fabrizio Chiesi, Maddalena Grazzini, Maddalena Innocenti, Barbara Giammarco, Enrico Simoncini, Giuseppe Garamella, Patrizio Zanobini, Caterina Perra, Lorenzo Baggiani, Chiara Lorini and Guglielmo Bonaccorsi

Int. J. Environ. Res. Public Health 2019, 16(18), 3492; https://doi.org/10.3390/ijerph16183492 - 19 Sep 2019

Cited by 17 | Viewed by 3971

Abstract

The oral health state plays an important role in the concept of ‘elderly frailty’, since institutionalized older people are prone to suffering from bad oral conditions. The aim of this study is to assess the state of oral health in the older residents [...] Read more.

The oral health state plays an important role in the concept of ‘elderly frailty’, since institutionalized older people are prone to suffering from bad oral conditions. The aim of this study is to assess the state of oral health in the older residents of nursing homes and to measure its potential association with the cognitive state, the degree of functional autonomy, and the malnutrition risk. Methods: We enrolled 176 subjects from 292 residents in five nursing homes in Florence. For each subject, we performed the Malnutrition Universal Screening Tool, the Pfeiffer test, the Minimum Data Set—Long Form, a dental examination, and the Geriatric Oral Health Assessment Index questionnaire. The results show that the oral condition was poor in 43.8% of cases, medium in 38.1%, and good in 18.2%. A worse oral health state was significantly associated (p < 0.05) with a worse cognitive state and with a higher dependency in daily living activities. The malnutrition score among the older people was unrelated to the oral health condition (p = 0.128). It can be concluded that the oral health condition in older institutionalized subjects is an open challenge for the public healthcare system, since the maintenance of adequate good oral health is an essential element of good physical as well as cognitive and psychological health. Full article

(This article belongs to the Special Issue Community Dental Care)

9 pages, 909 KiB

Open AccessArticle

The Relationship between Scabies and Stroke: A Population-Based Nationwide Study

by Meng-Huan Wu, Chien-Yu Li, Huichin Pan and Yu-Chieh Lin

Int. J. Environ. Res. Public Health 2019, 16(18), 3491; https://doi.org/10.3390/ijerph16183491 - 19 Sep 2019

Cited by 4 | Viewed by 2997

Abstract

Background: Scabies is a commonly occurring infectious skin infestation that substantially impacts the quality of life, while stroke, which consists of a neurological deficit resulting from a lack of blood flow to the brain, carries sizable economic costs. The pathophysiologic mechanisms underlying both [...] Read more.

Background: Scabies is a commonly occurring infectious skin infestation that substantially impacts the quality of life, while stroke, which consists of a neurological deficit resulting from a lack of blood flow to the brain, carries sizable economic costs. The pathophysiologic mechanisms underlying both diseases involve inflammatory processes that are mediated by the immune system; however, no prior research has been conducted to explore the relationship between the two conditions. Methods: This population-based nationwide study utilized data from the National Health Insurance Research Database (NHIRD) of Taiwan for a total of 6628 scabies patients, who comprised a scabies group, and a randomly selected cohort of 26,509 matching patients, who served as a control group. More specifically, the medical records for the patients in both groups were checked for seven years to identify any new cases of stroke within that seven-year follow-up period. The hazard ratio (HR) of stroke for the follow-up period was then calculated using Cox proportional hazards regressions, while comorbidities and demographic characteristics were likewise analyzed. Results: During the follow-up period, 2892 patients, or 8.7%, of the overall total of 33,137 patients included in the study were newly diagnosed with a stroke. Of those newly diagnosed stroke patients, 833 were from the scabies group, and 2059 were from the control group, accounting for 12.6% and 7.8%, respectively, of the individuals in each group. With a crude hazard ratio of 1.67, the patients in the scabies group had a significantly higher risk of subsequent stroke than those in the control group, although the adjusted hazard ratio (aHR) for the scabies patients, which was determined by adjusting for covariates, was only 1.32 (95% confidence interval (CI): 1.21–1.43). Conclusions: The results of the study indicated an elevated risk of stroke among scabies patients, an association that might be contributed to by immunopathological factors. This information could serve as a reminder to clinicians to remain alert to any indications of neurological impairment in patients previously infected with scabies. Full article

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21 pages, 1506 KiB

Open AccessArticle

Optimal Coordination Strategy for International Production Planning and Pollution Abating under Cap-and-Trade Regulations

by Baogui Xin, Wei Peng and Minghe Sun

Int. J. Environ. Res. Public Health 2019, 16(18), 3490; https://doi.org/10.3390/ijerph16183490 - 19 Sep 2019

Cited by 10 | Viewed by 2514

Abstract

Because both pollution emissions and production policies often are international in scope, it is necessary to find optimal coordination strategies for international production planning and pollution abating. Differential game models are developed for multiple neighboring countries to reach optimal decisions on their production [...] Read more.

Because both pollution emissions and production policies often are international in scope, it is necessary to find optimal coordination strategies for international production planning and pollution abating. Differential game models are developed for multiple neighboring countries to reach optimal decisions on their production planning and pollution abating under cap-and-trade regulations. Non-cooperative and cooperative differential games are presented to depict the optimal tradeoffs between production planning and pollution abating. Hamilton-Jacobi-Bellman (HJB) equations are then employed to analyze the asymmetric and symmetric feedback solutions. Numerical simulations are used to illustrate the results. Five different dividends are also discussed. With the proposed strategies, more improvement will be directed toward production supplies and environmental issues than ever before. Full article

(This article belongs to the Section Environmental Science and Engineering)

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19 pages, 2137 KiB

Open AccessArticle

Effects of Phthalate Esters on Ipomoea aquatica Forsk. Seedlings and the Soil Microbial Community Structure under Different Soil Conditions

by Tingting Ma, Linwei Liu, Wei Zhou, Like Chen and Peter Christie

Int. J. Environ. Res. Public Health 2019, 16(18), 3489; https://doi.org/10.3390/ijerph16183489 - 19 Sep 2019

Cited by 9 | Viewed by 2779

Abstract

Phthalate acid esters (PAEs) are the most frequently utilized synthetic chemical compounds worldwide. They are typical emergent contaminants and are currently attracting considerable concern due to their risks to plants, animals, and public health. Determining the vital environmental factors that affect the toxicity [...] Read more.

Phthalate acid esters (PAEs) are the most frequently utilized synthetic chemical compounds worldwide. They are typical emergent contaminants and are currently attracting considerable concern due to their risks to plants, animals, and public health. Determining the vital environmental factors that affect the toxicity of target pollutants in soil is important for vegetable production and the maintenance and control of soil productivity. We investigated the influence of di-n-butyl phthalate (DBP) and bis(2-ethylhexyl) phthalate (DEHP) under different soil conditions on physiological changes in water spinach (Ipomoea aquatic Forsk.) seedlings and the rhizosphere soil microbial community. Supported by our former experiments in which we determined the representative concentrations that caused the most pronounced toxic effects, three experimental concentrations were studied including control soils without PAEs and spiked soils with either 20 mg DBP or DEHP kg⁻¹ soil. The soil at all the three PAE concentrations was then adjusted to test two soil pH values, three levels of soil organic matter (SOM) content, and three levels of soil moisture content; thus, we completed 12 treatments or conditions simulating different soil environment conditions in greenhouses. After 30 days of cultivation, we analyzed the toxicity effects of two target PAEs on plant growth and physiological factors, and on soil microbial community characteristics. The toxicity of soil DBP and DEHP to the physiology of water spinach was found to be most affected by the soil pH value, then by SOM content, and least of all by soil moisture. The results of the 454 high-throughput sequencing analysis of the soil microbial community indicated that the toxicity of target PAEs to soil microorganisms was most affected by SOM content and then by soil moisture, and no clear relationship was found with soil pH. Under different soil conditions, declines in leaf biomass, chlorophyll a content, and carotenoid content—as well as increases in free amino acid (FAA) content, superoxide anion free radical activity, and hydroxyl radical activity—occurred in response to DBP or DEHP. Heavy use of chemical fertilizer, organic fertilizer, and high humidity led to the special environmental conditions of greenhouse soil, constituting the main conditions considered in this study. The results indicate that under the special highly intensive production systems of greenhouses, soil conditions may directly influence the effects of pollutant phytotoxicity and may thus endanger the yield, nutrient content, and food safety of vegetables. The combined studies of the impacts on plants and rhizosphere microorganisms give a more detailed picture of the toxic effects of the pollutants under different soil conditions. Full article

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11 pages, 1219 KiB

Open AccessReview

Perspectives on Disability and Non-Communicable Diseases in Low- and Middle-Income Countries, with a Focus on Stroke and Dementia

by Josephine E. Prynn and Hannah Kuper

Int. J. Environ. Res. Public Health 2019, 16(18), 3488; https://doi.org/10.3390/ijerph16183488 - 19 Sep 2019

Cited by 26 | Viewed by 9631

Abstract

Non-communicable diseases (NCD) and disability are both common, and increasing in magnitude, as a result of population ageing and a shift in disease burden towards chronic conditions. Moreover, disability and NCDs are strongly linked in a two-way association. People living with NCDs may [...] Read more.

Non-communicable diseases (NCD) and disability are both common, and increasing in magnitude, as a result of population ageing and a shift in disease burden towards chronic conditions. Moreover, disability and NCDs are strongly linked in a two-way association. People living with NCDs may develop impairments, which can cause activity limitations and participation restriction in the absence of supportive personal and environmental factors. In other words, NCDs may lead to disabilities. At the same time, people with disabilities are more vulnerable to NCDs, because of their underlying health condition, and vulnerability to poverty and exclusion from healthcare services. NCD programmes must expand their focus beyond prevention and treatment to incorporate rehabilitation for people living with NCDs, in order to maximize their functioning and well-being. Additionally, access to healthcare needs to be improved for people with disabilities so that they can secure their right to preventive, curative and rehabilitation services. These changes may require new innovations to overcome existing gaps in healthcare capacity, such as an increasing role for mobile technology and task-sharing. This perspective paper discusses these issues, using a particular focus on stroke and dementia in order to clarify these relationships. Full article

(This article belongs to the Special Issue Disabilities, Health and Well-being)

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12 pages, 318 KiB

Open AccessArticle

Neighborhood Walkability Is Not Associated with Adults’ Sedentary Behavior in the Residential Setting: Evidence from Breda, The Netherlands

by Menno Luijkx and Marco Helbich

Int. J. Environ. Res. Public Health 2019, 16(18), 3487; https://doi.org/10.3390/ijerph16183487 - 19 Sep 2019

Cited by 7 | Viewed by 2557

Abstract

Sedentary behavior has negative health effects. It is assumed that the walkability of the living environment is related to the amount of time spent on sedentary behavior in the residential setting. However, evidence on such a relation is still scarce, and results are [...] Read more.

Sedentary behavior has negative health effects. It is assumed that the walkability of the living environment is related to the amount of time spent on sedentary behavior in the residential setting. However, evidence on such a relation is still scarce, and results are contradictory. Therefore, we examined to what extent residential neighborhood walkability is associated with a variety of sedentary behaviors that frequently occur in the residential setting among adults. We carried out a cross-sectional survey using the domain-specific sedentary behavior questionnaire among adults in Breda, the Netherlands. Respondents’ walkability of the living environment was assessed objectively by means of road network buffers. We employed gamma generalized linear regressions to assess correlations between multiple sedentary behaviors and neighborhood walkability. We found no significant associations between residential neighborhood walkability and sedentary behavior levels. The lack of correlations was consistent across buffer sizes. Our models showed that adults with a higher education, a job, and a driver’s license spent significantly less time on sedentary behaviors. Our findings suggest that person-level characteristics should be targeted when developing intervention strategies to counteract sedentary time, rather than intervening in the walkability of the residential living environment. Full article

(This article belongs to the Section Environmental Health)

13 pages, 1005 KiB

Open AccessFeature PaperArticle

The Role of Built Environment on Health of Older Adults in Korea: Obesity and Gender Differences

by Mi Namgung, B. Elizabeth Mercado Gonzalez and Seungwoo Park

Int. J. Environ. Res. Public Health 2019, 16(18), 3486; https://doi.org/10.3390/ijerph16183486 - 19 Sep 2019

Cited by 5 | Viewed by 2780

Abstract

This study examines the effect of the built environment on obesity in older adults, taking into consideration gender difference. In this regard, we ask two questions: (1) How does the built environment affect obesity in older adults? (2) Is there a gender difference [...] Read more.

This study examines the effect of the built environment on obesity in older adults, taking into consideration gender difference. In this regard, we ask two questions: (1) How does the built environment affect obesity in older adults? (2) Is there a gender difference in the effect of the built environment? To examine the research questions, this study uses the 2015 Korean National Health and Nutrition Survey and geographically weighted regression (GWR) analysis. The empirical analyses show that environmental factors have stronger effects on local obesity rates for older men than for older women, which indicates a gender difference in obesity. Based on these findings, we suggest that public health policies for obesity should consider the built environment as well as gender difference. Full article

(This article belongs to the Section Environmental Health)

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15 pages, 3898 KiB

Open AccessArticle

Analysis of Waste Generation Characteristics during New Apartment Construction—Considering the Construction Phase

by Young-Chan Kim, Yuan-Long Zhang, Won-Jun Park, Gi-Wook Cha, Jung-Wan Kim and Won-Hwa Hong

Int. J. Environ. Res. Public Health 2019, 16(18), 3485; https://doi.org/10.3390/ijerph16183485 - 19 Sep 2019

Cited by 5 | Viewed by 2877

Abstract

The waste generation rate (WGR) is used to predict the generation of construction and demolition waste (C&DW) and has become a prevalent tool for efficient waste management systems. Many studies have focused on deriving the WGR, but most focused on demolition waste rather [...] Read more.

The waste generation rate (WGR) is used to predict the generation of construction and demolition waste (C&DW) and has become a prevalent tool for efficient waste management systems. Many studies have focused on deriving the WGR, but most focused on demolition waste rather than construction waste (CW). Moreover, previous studies have used theoretical databases and thus were limited in showing changes in the generated CW during the construction period of actual sites. In this study, CW data were collected for recently completed apartment building sites through direct measurement, and the WGR was calculated by CW type for the construction period. The CW generation characteristics by type were analyzed, and the results were compared with those of previous studies. In this study, CW was classified into six types: Waste concrete, waste asphalt concrete, waste wood, waste synthetic resin, waste board, and mixed waste. The amount of CW generated was lowest at the beginning of the construction period. It slowly increased over time and then decreased again at the end. In particular, waste concrete and mixed waste were generated throughout the construction period, while other CWs were generated in the middle of the construction period or towards the end. The research method and results of this study are significant in that the construction period was considered, which has been neglected in previous studies on the WGR. These findings are expected to contribute to the development of efficient CW management systems. Full article

(This article belongs to the Collection Environmental Risk Assessment)

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9 pages, 2667 KiB

Open AccessArticle

Selective Removal of Malachite Green Dye from Aqueous Solutions by Supported Liquid Membrane Technology

by Mohammad Waqar Ashraf, Nidal Abulibdeh and Abdus Salam

Int. J. Environ. Res. Public Health 2019, 16(18), 3484; https://doi.org/10.3390/ijerph16183484 - 19 Sep 2019

Cited by 12 | Viewed by 2729

Abstract

A lab-scale study on the application of supported liquid membranes (SLM) has been conducted for recovery and selective removal of Malachite Green dye from wastewater. Naturally occurring non-toxic vegetable oils have been used as membrane liquids. Polyvinylidene fluoride (PVDF) films have been used [...] Read more.

A lab-scale study on the application of supported liquid membranes (SLM) has been conducted for recovery and selective removal of Malachite Green dye from wastewater. Naturally occurring non-toxic vegetable oils have been used as membrane liquids. Polyvinylidene fluoride (PVDF) films have been used as supports for the liquid membrane. Various parameters affecting the dye permeation such as initial dye concentration, pH, stripping acid concentration, oil viscosity and membrane stability have been investigated. The highest flux value (1.65 × 10⁻⁵ mg/cm²/sec) was obtained with a sunflower oil supported membrane at pH 11 in the feed and 0.25 M HCl in the stripping solution. The membrane showed good stability under optimum conditions and maximum transport was achieved in 8 h of permeation time. Full article

(This article belongs to the Special Issue Water Quality Improvement and Ecological Restoration)

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16 pages, 321 KiB

Open AccessArticle

Combining Social Science and Environmental Health Research for Community Engagement

by Alissa Cordner, Grace Poudrier, Jesse DiValli and Phil Brown

Int. J. Environ. Res. Public Health 2019, 16(18), 3483; https://doi.org/10.3390/ijerph16183483 - 19 Sep 2019

Cited by 16 | Viewed by 3892

Abstract

Social science-environmental health (SS-EH) research takes many structural forms and contributes to a wide variety of topical areas. In this article we discuss the general nature of SS-EH contributions and offer a new typology of SS-EH practice that situates this type of research [...] Read more.

Social science-environmental health (SS-EH) research takes many structural forms and contributes to a wide variety of topical areas. In this article we discuss the general nature of SS-EH contributions and offer a new typology of SS-EH practice that situates this type of research in a larger transdisciplinary sensibility: (1) environmental health science influenced by social science; (2) social science studies of environmental health; and (3) social science-environmental health collaborations. We describe examples from our own and others’ work and we discuss the central role that research centers, training programs, and conferences play in furthering SS-EH research. We argue that the third form of SS-EH research, SS-EH collaborations, offers the greatest potential for improving public and environmental health, though such collaborations come with important challenges and demand constant reflexivity on the part of researchers. Full article

(This article belongs to the Special Issue New Directions in Environmental Communication Research)

11 pages, 6134 KiB

Open AccessArticle

Occurrence of Cortical Arousal at Recovery from Respiratory Disturbances during Deep Propofol Sedation

by Ryuma Urahama, Masaya Uesato, Mizuho Aikawa, Reiko Kunii, Shiroh Isono and Hisahiro Matsubara

Int. J. Environ. Res. Public Health 2019, 16(18), 3482; https://doi.org/10.3390/ijerph16183482 - 18 Sep 2019

Cited by 2 | Viewed by 2997

Abstract

Recent evidences suggest that non-arousal mechanisms can restore and stabilize breathing in sleeping patients with obstructive sleep apnea. This possibility can be examined under deep sedation which increases the cortical arousal threshold. We examined incidences of cortical arousal at termination of apneas and [...] Read more.

Recent evidences suggest that non-arousal mechanisms can restore and stabilize breathing in sleeping patients with obstructive sleep apnea. This possibility can be examined under deep sedation which increases the cortical arousal threshold. We examined incidences of cortical arousal at termination of apneas and hypopneas in elderly patients receiving propofol sedation which increases the cortical arousal threshold. Ten elderly patients undergoing advanced endoscopic procedures under propofol-sedation were recruited. Standard polysomnographic measurements were performed to assess nature of breathing, consciousness, and occurrence of arousal at recovery from apneas and hypopneas. A total of 245 periodic apneas and hypopneas were identified during propofol-induced sleep state. Cortical arousal only occurred in 55 apneas and hypopneas (22.5%), and apneas and hypopneas without arousal and desaturation were most commonly observed (65.7%) regardless of the types of disordered breathing. Chi-square test indicated that incidence of no cortical arousal was significantly associated with occurrence of no desaturation. Higher dose of propofol was associated with a higher apnea hypopnea index (r = 0.673, p = 0.033). In conclusion, even under deep propofol sedation, apneas and hypopneas can be terminated without cortical arousal. However, extensive suppression of the arousal threshold can lead to critical hypoxemia suggesting careful respiratory monitoring. Full article

(This article belongs to the Special Issue Sleep Apnea Syndrome)

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31 pages, 841 KiB

Open AccessReview

Practical Guidance for Interventions in Adults with Metabolic Syndrome: Diet and Exercise vs. Changes in Body Composition

by Enrique Albert Pérez, Marina Poveda González, Rosa María Martínez-Espinosa, Mariola D Molina Vila and Manuel Reig García-Galbis

Int. J. Environ. Res. Public Health 2019, 16(18), 3481; https://doi.org/10.3390/ijerph16183481 - 18 Sep 2019

Cited by 22 | Viewed by 5187

Abstract

(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this [...] Read more.

(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this systematic review of randomized clinical trials (RCT) is based on the guidelines recommended by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Criteria of selection: ≥18 years of age; patients diagnosed with MS; intervention programs including diet, physical exercise and/or modifications in the style of life as treatment, as well as the magnitude of changes in body composition (BC); randomized clinical trial published between 2004 and 2018. (3) Results: the multidisciplinary interventions describe major changes in BC, and the recurring pattern in these clinical trials is an energy reduction and control in the percentage of intake of macronutrients along with the performance of regularly structured exercise; the most analyzed parameter was waist circumference (88.9% of the trials), followed by body weight (85.2%), BMI (77.8%) and body fat (55.6%). (4) Conclusions: The analysis of the information here reported sheds light for the design of future clinical trials in adults with MS. The best anthropometric parameters and units of measurement to monitor the interventions are related to dietary and physical exercise interventions. A list of practical advice that is easy to implement in daily practice in consultation is here proposed in order to guarantee the best results in changes of body composition. Full article

(This article belongs to the Special Issue Community Nutrition, Physical Activity and Health Promotion: Current Perspectives in Public Health Nutrition)

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23 pages, 1979 KiB

Open AccessArticle

Spatiotemporal Dynamics of Ecological Total-Factor Energy Efficiency and Their Drivers in China at the Prefecture Level

by Guangdong Li

Int. J. Environ. Res. Public Health 2019, 16(18), 3480; https://doi.org/10.3390/ijerph16183480 - 18 Sep 2019

Cited by 11 | Viewed by 2402

Abstract

Improvement of ecological total-factor energy efficiency (ETFEE) is crucial for transformation of China’s economic growth pattern, energy conservation and emissions abatement. Here we combined the epsilon-based measure (EBM) and the Global Malmquist-Luenberger (GML) productivity index to evaluate ETFEE and ecological total-factor energy productivity [...] Read more.

Improvement of ecological total-factor energy efficiency (ETFEE) is crucial for transformation of China’s economic growth pattern, energy conservation and emissions abatement. Here we combined the epsilon-based measure (EBM) and the Global Malmquist-Luenberger (GML) productivity index to evaluate ETFEE and ecological total-factor energy productivity (ETFEP) and its decompositions for 283 prefecture-level cities in China between 2003 and 2013. A spatial econometric model is used to investigate factors influencing ETFEE and ETFEP. Results indicated that ETFEE, ETFEP and corresponding trends differ significantly depending on whether environmental constraints are considered. No convergence trend was found in ETFEE between prefecture-level cities. Technical progress plays the largest role in increasing ETFEP growth. Pure efficiency change and scale efficiency change, however, are the main hindering factors. Boosting cumulative technological progress, cumulative scale efficiency growth rate and cumulative pure efficiency growth rate are important means of increasing ETFEP. I also found that areas with high levels of economic development do not completely overlap with areas of high ETFEE. Surprisingly, the fiscal expenditure on scientific undertakings and technological spillover effects from foreign direct investment (FDI) have not substantially increased ETFEE. Whereas increased industrialization hinders the improvement of ETFEE. Furthermore, reducing per capita energy consumption help boost ETFEE. In addition, endowment advantages of factors of production have a positive overall effect on improving ETFEE. Lastly, important policy implications are inferred. Full article

(This article belongs to the Section Environmental Science and Engineering)

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23 pages, 2203 KiB

Open AccessArticle

Healthcare Supply Chain Network Coordination Through Medical Insurance Strategies with Reference Price Effect

by Lingyu Gao and Xiaoli Wang

Int. J. Environ. Res. Public Health 2019, 16(18), 3479; https://doi.org/10.3390/ijerph16183479 - 18 Sep 2019

Cited by 4 | Viewed by 3170

Abstract

China has established the universal medical insurance system and individual out of pocket costs have decreased, however, the average healthcare expenditure of the Chinese population and the expenses of the whole society have increased substantially. One major challenge which impedes the progress of [...] Read more.

China has established the universal medical insurance system and individual out of pocket costs have decreased, however, the average healthcare expenditure of the Chinese population and the expenses of the whole society have increased substantially. One major challenge which impedes the progress of attaining sustainable development of the social healthcare system in China is that the number of hospital admissions is disproportionate. Superior hospitals are overcrowded, whereas subordinate hospitals are experiencing low admissions. In this paper, we apply the game theory model to coordinate the healthcare supply chain network, which is composed of the government, medical insurance fund, superior hospitals, subordinate hospitals and patients. Especially by taking the reference price effect into account, this paper analyzes different medical insurance reimbursement strategies and their influence on patient choice and the healthcare supply chain network. The result shows that the reference price effect increases the leverage of medical insurance, guides patients’ choice, optimizes the allocation of medical resources and reduces the medical expends. In comparison to a decentralized decision- making strategy, a centralized decision- making strategy can stimulate both superior hospital and subordinate hospital’s cooperative intentions which benefits the social healthcare system. Full article

(This article belongs to the Special Issue Network Analytics in Healthcare Decision Making)

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27 pages, 849 KiB

Open AccessReview

Evaluation of Public Health Emergency Management in China: A Systematic Review

by Jia Wang, Beibei Yuan, Zhengmao Li and Zhifeng Wang

Int. J. Environ. Res. Public Health 2019, 16(18), 3478; https://doi.org/10.3390/ijerph16183478 - 18 Sep 2019

Cited by 21 | Viewed by 5579

Abstract

To summarize the present status of health emergency management assessment in China, a comprehensive search of Chinese databases for research that explicitly mention health emergency assessment indicators and indicator systems was performed. Studies were evaluated using the Ekman quality assessment tool, and data [...] Read more.

To summarize the present status of health emergency management assessment in China, a comprehensive search of Chinese databases for research that explicitly mention health emergency assessment indicators and indicator systems was performed. Studies were evaluated using the Ekman quality assessment tool, and data were extracted with an original extraction form. Sixty-one studies were included. There are many types and methods of health emergency management assessment in China, and the dimensions and the indicators involved are complex. Legal, regulatory, and policy bases for such assessment need to be further strengthened. The relevance of the entire assessment process and its practical application should be enhanced. In the occupational practice, appropriate evaluation methods should be selected according to respective evaluation purposes, evaluation objects, and contents. Laws, regulations, and policies in the evaluation of health emergency management should be improved. Finally, further correlational research on health emergency management evaluation system processes should be explored and improved. Full article

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11 pages, 1024 KiB

Open AccessArticle

Occupational Class Differences in Long-Term Sickness Absence Due to Breast Cancer during 2005–2013: A Population-Based Study among Finnish Women

by Johanna Suur-Uski, Johanna Pekkala, Jenni Blomgren, Olli Pietiläinen, Ossi Rahkonen and Minna Mänty

Int. J. Environ. Res. Public Health 2019, 16(18), 3477; https://doi.org/10.3390/ijerph16183477 - 18 Sep 2019

Cited by 2 | Viewed by 2827

Abstract

Breast cancer is the most common cancer among women in Western countries with clear socioeconomic differences. Higher occupational class is associated with higher breast cancer incidence but with better survival from the disease, whereas lower occupational class is associated with higher risk of [...] Read more.

Breast cancer is the most common cancer among women in Western countries with clear socioeconomic differences. Higher occupational class is associated with higher breast cancer incidence but with better survival from the disease, whereas lower occupational class is associated with higher risk of sickness absence. We are not aware of previous studies examining changes over time in occupational class differences in sickness absence due to breast cancer. This paper focuses on occupational class differences in the incidence and duration of sickness absence due to breast cancer over the period of 2005–2013. Age-adjusted occupational class differences in the cumulative incidence and duration of sickness absence due to breast cancer were calculated utilising a nationally representative 70% random sample of employed Finnish women aged 35–64 years (yearly N varying between 499,778 and 519,318). The results show that higher occupational class was associated with higher annual cumulative incidence of sickness absence due to breast cancer. Lower occupational class was associated with longer duration of absence. Occupational class differences in both cumulative incidence and duration of absence remained broadly stable. As a conclusion, these results suggest that measures should be targeted particularly to promotion of work capacity among employees with breast cancer in lower occupational classes. Full article

(This article belongs to the Special Issue Workplace Health and Wellbeing 2019)

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18 pages, 2524 KiB

Open AccessArticle

Using Improved Principal Component Analysis to Explore Construction Accident Situations from the Multi-Dimensional Perspective: A Chinese Study

by Bo Shao, Zhigen Hu and Dawei Liu

Int. J. Environ. Res. Public Health 2019, 16(18), 3476; https://doi.org/10.3390/ijerph16183476 - 18 Sep 2019

Cited by 8 | Viewed by 2548

Abstract

The improvement of the macro-level accident situation in the Chinese construction industry is currently an urgent task for the government due to the high accident rate. This study intends to use improved principal component analysis to explore the accident situations in the Chinese [...] Read more.

The improvement of the macro-level accident situation in the Chinese construction industry is currently an urgent task for the government due to the high accident rate. This study intends to use improved principal component analysis to explore the accident situations in the Chinese construction industry from a multi-dimensional perspective, aiming at providing targeted direction on the improvement of the accident situation for the government. Six composite indicators that can quantify the accident situation are firstly selected based on a wide review of the literature and interviews with safety experts, with the original data collected from China institutions. The classical principal component analysis is then improved to examine the correlations between indicators, and further to evaluate accident situations in China provinces. Finally, the features of accident situations are explored and analyzed from a multi-dimensional perspective. The findings show that the improved principal component analysis can retain more dispersion degree information of the original data. Meanwhile, three principal components including the accident frequency, trend, and severity were extracted to quantify the accident situation, and a hierarchical indicator system for the comprehensive evaluation of the accident situation was constructed to deeper understand multi-dimensional characteristics of China’s accident situations. Furthermore, there exist great regional differences of accident situations in Chinese provinces. From the overall perspective, the accident situation shows a declining trend from the western backward region to the highly developed eastern coastal region. This study provides a multi-dimensional perspective for the government to formulate safety regulations and improve the accident situation. Full article

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9 pages, 1585 KiB

Open AccessArticle

Bactericidal Activity of Ready-To-Use Alcohol-Based Commercial Wipes According to EN 16615 Carrier Standard

by Patryk Tarka, Agnieszka Chojecka, Olga Paduch, Aneta Nitsch-Osuch, Krzysztof Kanecki and Anna Kierzkowska

Int. J. Environ. Res. Public Health 2019, 16(18), 3475; https://doi.org/10.3390/ijerph16183475 - 18 Sep 2019

Cited by 4 | Viewed by 4423

Abstract

Background: The effectiveness of ready-to-use disinfectant wipes was previously assessed in standardized suspension tests, which were inadequate because they ignored that the wipes are rubbed against a surface. Thus, we assessed the effectiveness of commercially available disinfectant wipes impregnated with an alcoholic solution [...] Read more.

Background: The effectiveness of ready-to-use disinfectant wipes was previously assessed in standardized suspension tests, which were inadequate because they ignored that the wipes are rubbed against a surface. Thus, we assessed the effectiveness of commercially available disinfectant wipes impregnated with an alcoholic solution according to the 16615 standard, which includes a test with mechanical action. Methods: According to the EN 16615 standard, under clean conditions, four squares (5 cm × 5 cm), placed next to one another, were marked on a test surface. Enterococcus hirae, Pseudomonas aeruginosa, and Staphylococcus aureus were inoculated on the leftmost square, and a wipe impregnated with an alcoholic solution was placed to the left of that square. Then, the wipe was pressed with a 2.5 kg weight and moved to the right and back to the left. After contact times of 1, 5, 10, or 15 min, we measured the reduction in bacterial load. Results: Alcohol-based ready-to-use commercial wipes did not show sufficient bactericidal activity at the contact times of 1, 5, 10 and 15 min. Wipes containing propan-1-ol and a mixture of propan-1-ol and propan-2-ol were active against Pseudomonas aeruginosa at the contact times of 1 min and 15 min. None of the examined wipes were active against Enterococcus hirae or Staphylococcus aureus. Conclusion: Bactericidal parameters of ready-to-use disinfectant wipes should be determined in surface tests, in addition to suspension tests, because suspension tests do not simulate the conditions under which disinfectant wipes are used in practice. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Int. J. Environ. Res. Public Health, Volume 16, Issue 18 (September-2 2019) – 278 articles

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