Int. J. Environ. Res. Public Health, Volume 12, Issue 4 (April 2015) – 67 articles , Pages 3406-4480

The purpose of this study is to examine the impact of the introduction of the Free Swimming Programme (FSP) in a local community (not identified to preserve anonymity) in the South East of England. The question has been approached in a variety of ways: by using primary quantitative data from leisure centres and logistic regressions based on the Active People Survey (APS). Problems are identified related to the introduction of the FSP in this community and suggestions are made for future policy. A brief examination of swimming participation in England enables researchers to place this community into a national context. The problems and policies of sport organisation developed in this community are not dissimilar to a more general application reflecting the English experience; in this sense it is anticipated that the findings will enable managers of sport organisations, along with public health policy makers, to focus more effectively on raising sport participation. The unique selling points of this article are the examination of FSP for adult participants, the local analysis of junior and senior participation, and the overall assessment of the policy based on APS. Full article

Communities of practice (CoP) can facilitate collaboration between people who share a common interest, but do not usually work together. A CoP was initiated and developed including stakeholders from clinical, research, community and governmental backgrounds involved in a large multidisciplinary and multi-sectorial project: the Rehabilitation Living Lab in a Mall (RehabMaLL). This study aimed to evaluate the structure, process and outcomes of this CoP. A single case-study, using mixed-methods, evaluated the RehabMaLL CoP initiative after one year, based on Donabedian’s conceptual evaluation model. Forty-three participants took part in the RehabMaLL CoP with 60.5% (n = 26) participating at least once on the online platform where 234 comments were posted. Four in-person meetings were held. Members expressed satisfaction regarding the opportunity to share knowledge with people from diverse backgrounds and the usefulness of the CoP for the RehabMaLL project. Collaboration led to concrete outcomes, such as a sensitization activity and a research project. Common challenges included lack of time and difficulty finding common objectives. A CoP can be a useful strategy to facilitate knowledge sharing on disability issues. Future research is necessary to determine strategies of increasing knowledge creation between members. Full article

Objective: In Brazil, demographic, socioeconomic and epidemiological changes over time have led to a transition in nutritional standards, resulting in a gradual reduction of malnutrition and an increased prevalence of overweight and obese individuals, similar to the situation in developed countries in previous decades. This study assessed the body mass index (BMI) and the prevalence of an overweight status and obesity, adjusted for various factors, in a population in northeastern Brazil including all age groups. Methods: This is a cross-sectional population-based epidemiological study using single sampling procedure composed of levels. Given the heterogeneity of the variable “income” and the relationship between income, prevalence of diseases and nutrition, a stratified sampling on blocks in the first level was used. In this, city districts were classified by income into 10 strata, according to information obtained from IBGE. A systematic sampling was applied on randomly selected blocks in order to choose the residences that would be part of the sample (second level), including 1165 participants from all age groups. Results and Discussion: The prevalence of an overweight status or obesity was adjusted for demographic, socioeconomic and lifestyle variables. When the Chi-square test was applied, a relationship was observed between the prevalence of an overweight status or obesity and the age group, gender, educational level and income of the participants. Regarding lifestyle parameters, only smoking was associated with the prevalence of an overweight status or obesity, in both adults and in the total sample. The results for the following groups were significant (p < 0.05): the age group from 20 to 59 years, when the individual presented an educational level greater than or equal to high school; and the age group ≥ 60 years, when the individual was female. It is noteworthy that educational level and being female were significant in adjusting for the total population as major factors influencing an increased BMI, followed by the variables physical activity and family income. Conclusions: The adjusted results justify the adoption of intervention and prevention policies to combat these clinical conditions for the study population as a whole, particularly directed toward adults with higher education level as well as elderly females. Full article

Recently we have reported that intermediate-frequency magnetic field (IF-MF) exposure transiently altered the mRNA expression levels of memory function-related genes in the hippocampi of adult male mice. However, the effects of IF-MF exposure during brain development on neurological biomarkers have not yet been clarified. In the present study, we investigated the effect of IF-MF exposure during development on neurological and immunological markers in the mouse hippocampus in 3- and 7-week-old male mice. Pregnant C57BL/6J mice were exposed to IF-MF (21 kHz, 3.8 mT) for one hour per day from organogenesis period day 7 to 17. At adolescence, some IF-MF-exposed mice were further divided into exposure, recovery, and sham-exposure groups. The adolescent-exposure groups were exposed again to IF-MF from postnatal day 27 to 48. The expression of mRNA in the hippocampi was examined using a real-time RT-PCR method, and microglia activation was examined by immunohistochemical analysis. The expression levels of NR1 and NR2B as well as transcription factors (CaMKIV, CREB1), inflammatory mediators (COX2, IL-1 b,TNF-α), and the oxidative stress marker heme-oxygenase (HO)-1 were significantly increased in the IF-MF-exposed mice, compared with the control group, in the 7-week-old mice, but not in the 3-week-old mice. Microglia activation was not different between the control and other groups. This study provides the first evidence that early exposure to IF-MF reversibly affects the NMDA receptor, its related signaling pathways, and inflammatory mediators in the hippocampus of young adult mice; these changes are transient and recover after termination of exposure without histopathological changes. Full article

Objective: To explore potential risk factors of isolated diastolic hypertension (IDH) among young and middle-aged Chinese. Methods: A community-based cross-sectional study was conducted among 338 subjects, aged 25 years and above, using random sampling technique. There were 68 cases of IDH, 46 cases of isolated systolic hypertension (ISH), 89 cases of systolic and diastolic hypertension (SDH), and 135 of subjects with normal blood pressure. Cases and controls were matched on sex by frequency matching. Demographic characteristics, blood pressure and other relevant information were collected. Results: Compared with controls, patients with IDH and ISH had significant higher level of triglyceride, high density lipoprotein, blood glucose and body mass index (BMI) (p < 0.05); while patients with SDH had significantly higher level of total cholesterol, triglyceride, glucose and BMI (p < 0.05). Linear mixed effects model showed that drinking tea, family history of hypertension (FHH), higher blood glucose, triglyceride and low density lipoprotein were related with elevated diastolic blood pressure (DBP) (p < 0.01); HFH, blood glucose, creatinine and BMI have positive effect on systolic blood pressure (SBP) (p < 0.05). Conclusions: Drinking tea, FHH, high levels of triglyceride, high density lipoprotein, blood glucose and BMI are associated with IDH among young and middle-aged Chinese. Full article

This project examined the lifestyle, health habits and risk factors of young adults at Qatar University. It explored the clustering and differences in dietary habits, body mass index (BMI) and physical activity (PA) amongst male and female students, both Qatari and non-Qatari. Seven hundred thirty two students aged 18–25 years completed a self-reported questionnaire and an objective measure of BMI. Males and females had a high prevalence of being overweight and obesity and low levels of PA, according to well-established international standards. Three clusters were identified based on the students’ lifestyle and dietary habits. Cluster 1 (high risk factors) included those who engaged the least in healthy dietary practices and consumed the most unhealthy foods, participated in less PA and had the highest BMI. Cluster 2 (moderate risk factors) included those with considerably more habits falling into the moderate category, engagement in the most PA, the least TV and computer viewing time and had the lowest BMI. Cluster 3 (low risk factors) included those who engaged the most with the four healthy dietary practices, the least with the four unhealthy dietary practices and participated in moderate PA per week. This project provides valuable data that could be used by policy makers to address issues concerning student’s health. Full article

Many studies conducted during the last decade suggest the mental health benefits of green and blue spaces. We aimed to systematically review the available literature on the long-term mental health benefits of residential green and blue spaces by including studies that used standardized tools or objective measures of both the exposures and the outcomes of interest. We followed the PRISMA statement guidelines for reporting systematic reviews and meta-analysis. In total 28 studies were included in the systematic review. We found limited evidence for a causal relationship between surrounding greenness and mental health in adults, whereas the evidence was inadequate in children. The evidence was also inadequate for the other exposures evaluated (access to green spaces, quality of green spaces, and blue spaces) in both adults and children. The main limitation was the limited number of studies, together with the heterogeneity regarding exposure assessment. Given the increase in mental health problems and the current rapid urbanization worldwide, results of the present systematic review should be taken into account in future urban planning. However, further research is needed to provide more consistent evidence and more detailed information on the mechanisms and the characteristics of the green and blue spaces that promote better mental health. We provide recommendations for future studies in order to provide consistent and evidence-based recommendations for policy makers. Full article

Objective: Prolonged office sitting time adversely affects neuromuscular and cardiovascular health parameters. As a consequence, the present study investigated the effects of prompting the use of height-adjustable working desk (HAWD) on occupational sitting and standing time, neuromuscular outcomes and concentration in office workers. Methods: A single-blinded randomized controlled trial (RCT) with parallel group design was conducted. Thirty-eight office workers were supplied with HAWDs and randomly assigned (Strata: physical activity (PA), BMI, gender, workload) to a prompt (INT) or non-prompt (CON) group. INT received three daily screen-based prompts within 12 weeks. CON was only instructed once concerning the benefits of using HAWDs prior to the start of the study. Sitting and standing times were objectively assessed as primary outcomes for one entire working week using the ActiGraph wGT3X-BT at baseline (pre), after 6 (mid) and 12 weeks (post). Concentration (d2-test), postural sway during upright stance (under single, dual and triple task) and lower limb strength endurance (heel-rise) were collected as secondary outcomes. Results: With large but not statistically significant within group effects from pre to post, INT increased weekly standing time at work by 9% (p = 0.22, d = 0.8) representing an increase from 7.2 h (4.8) to 9.7 (6.6) h (p = 0.07). Concentration and neuromuscular performance did not change from pre to post testing (0.23 < p < 0.95; 0.001 < η_p² < 0.05). Conclusion: Low-frequent and low cost screen-based point of choice prompts (3 per day within 12 weeks) already result in notable increases of occupational standing time of approx. daily 30 min. These stimuli, however, did not relevantly affect neuromuscular outcomes. Full article

Traditional healing remains an important aspect of many people’s engagement with healthcare and, in this, responses to the treatment of HIV/AIDS are no different. However, given the gravity of the global HIV/AIDS pandemic, there has been much debate as to the value of traditional healing in this respect. Accordingly, this paper explores the extent to which meaningful accommodation between the biomedical and traditional sectors is possible (and/or even desirable). It does this through a consideration of Native American and South African experiences, looking at how the respective groups, in which medical pluralism is common, have addressed the issue of HIV/AIDS. The paper points to the importance of developing “culturally appropriate” forms of treatment that emphasise complementary rather than adversarial engagement between the traditional and biomedical systems and how policymakers can best facilitate this. Full article

Considering the wide growth of the wind turbine market over the last decade as well as their increasing power size, more and more potential conflicts have arisen in society due to the noise radiated by these plants. Our goal was to determine whether the annoyance caused by wind farms is related to aspects other than noise. To accomplish this, an auditory experiment on the recognition of wind turbine noise was conducted to people with long experience of wind turbine noise exposure and to people with no previous experience to this type of noise source. Our findings demonstrated that the trend of the auditory recognition is the same for the two examined groups, as far as the increase of the distance and the decrease of the values of sound equivalent levels and loudness are concerned. Significant differences between the two groups were observed as the distance increases. People with wind turbine noise experience showed a higher tendency to report false alarms than people without experience. Full article

Changes in ecological vulnerability were analyzed for Northern Shaanxi, China using a geographic information system (GIS). An evaluation model was developed using a spatial principal component analysis (SPCA) model containing land use, soil erosion, topography, climate, vegetation and social economy variables. Using this model, an ecological vulnerability index was computed for the research region. Using natural breaks classification (NBC), the evaluation results were divided into five types: potential, slight, light, medium and heavy. The results indicate that there is greater than average optimism about the conditions of the study region, and the ecological vulnerability index (EVI) of the southern eight counties is lower than that of the northern twelve counties. From 1997 to 2011, the ecological vulnerability index gradually decreased, which means that environmental security was gradually enhanced, although there are still some places that have gradually deteriorated over the past 15 years. In the study area, government and economic factors and precipitation are the main reasons for the changes in ecological vulnerability. Full article

Sub-Saharan Africa is experiencing rapid urbanisation and many urban residents use groundwater where piped supplies are intermittent or unavailable. This study aimed to investigate long-term changes in groundwater contamination hazards and hand-dug well water quality in two informal settlements in Kisumu city, Kenya. Buildings, pit latrines, and wells were mapped in 1999 and 2013–2014. Sanitary risk inspection and water quality testing were conducted at 51 hand-dug wells in 2002 to 2004 and 2014. Pit latrine density increased between 1999 and 2014, whilst sanitary risk scores for wells increased between 2002 to 2004 and 2014 (n = 37, Z = −1.98, p = 0.048). Nitrate levels dropped from 2004 to 2014 (n = 14, Z = −3.296, p = 0.001), but multivariate analysis suggested high rainfall in 2004 could account for this. Thermotolerant coliform counts dropped between 2004 and 2014, with this reduction significant in one settlement. Hand-dug wells had thus remained an important source of domestic water between 1999 and 2014, but contamination risks increased over this period. Water quality trends were complex, but nitrate levels were related to both sanitary risks and rainfall. Given widespread groundwater use by the urban poor in sub-Saharan Africa, the study protocol could be further refined to monitor contamination in hand-dug wells in similar settings. Full article

Background: An established relationship exists between public transportation (PT) use and physical activity. However, there is limited literature that examines the link between PT use and active commuting (AC) behavior. This study examines this link to determine if PT users commute more by active modes. Methods: A volunteer, convenience sample of adults (n = 748) completed an online survey about AC/PT patterns, demographic, psychosocial, community and environmental factors. t-test compared differences between PT riders and non-PT riders. Binary logistic regression analyses examined the effect of multiple factors on AC and a full logistic regression model was conducted to examine AC. Results: Non-PT riders (n = 596) reported less AC than PT riders. There were several significant relationships with AC for demographic, interpersonal, worksite, community and environmental factors when considering PT use. The logistic multivariate analysis for included age, number of children and perceived distance to work as negative predictors and PT use, feelings of bad weather and lack of on-street bike lanes as a barrier to AC, perceived behavioral control and spouse AC were positive predictors. Conclusions: This study revealed the complex relationship between AC and PT use. Further research should investigate how AC and public transit use are related. Full article

There is a significant positive relationship between exposure to forest environments and physical and mental health. However, there are individual differences within these responses, and this phenomenon has posed questions in various fields. Here, we show that the physiological effect of a forest environment can differ depending on a subject’s initial values and that forests have a physiological adjustment effect close to an appropriate level. Subjects with high initial blood pressure and pulse rate showed a decrease in these values after walking in a forested area, whereas those with low initial values showed an increase. There was no physiological adjustment effect observed in an urban area; thus, these effects are specific to a forest environment. Full article

Background: Antimicrobial resistance in microorganisms are on the increase worldwide and are responsible for substantial cases of therapeutic failures. Resistance of species of Enterococcus to antibiotics is linked to their ability to acquire and disseminate antimicrobial resistance determinants in nature, and wastewater treatment plants (WWTPs) are considered to be one of the main reservoirs of such antibiotic resistant bacteria. We therefore determined the antimicrobial resistance and virulence profiles of some common Enterococcus spp that are known to be associated with human infections that were recovered from hospital wastewater and final effluent of the receiving wastewater treatment plant in Alice, Eastern Cape. Methods: Wastewater samples were simultaneously collected from two sites (Victoria hospital and final effluents of a municipal WWTP) in Alice at about one to two weeks interval during the months of July and August 2014. Samples were screened for the isolation of enterococci using standard microbiological methods. The isolates were profiled molecularly after targeted generic identification and speciation for the presence of virulence and antibiotic resistance genes. Results: Out of 66 presumptive isolates, 62 were confirmed to belong to the Enterococcus genusof which 30 were identified to be E. faecalis and 15 E. durans. The remaining isolates were not identified by the primers used in the screening procedure. Out of the six virulence genes that were targeted only three of them; ace, efaA, and gelE were detected. There was a very high phenotypic multiple resistance among the isolates and these were confirmed by genetic analyses. Conclusions: Analyses of the results obtained indicated that hospital wastewater may be one of the sources of antibiotic resistant bacteria to the receiving WWTP. Also, findings revealed that the final effluent discharged into the environment was contaminated with multi-resistant enterococci species thus posing a health hazard to the receiving aquatic environment as these could eventually be transmitted to humans and animals that are exposed to it. Full article

Polyacrylamide (PAM) is a water-soluble polymer that is widely used as a flocculant in sewage treatment. The accumulation of PAM affects the formation of dewatered sludge and potentially produces hazardous monomers. In the present study, the bacterial strain HI47 was isolated from dewatered sludge. This strain could metabolize PAM as its sole nutrient source and was subsequently identified as Pseudomonas putida. The efficiency of PAM degradation was 31.1% in 7 days and exceeded 45% under optimum culture condition (pH 7.2, 39 °C and 100 rpm). The addition of yeast extract and glucose improved the bacterial growth and PAM degradation. The degraded PAM samples were analyzed by gel-filtration chromatography, Fourier transform infrared and high-performance liquid chromatography. The results showed that high-molecular-weight PAM was partly cleaved to small molecular oligomer derivatives and part of the amide groups of PAM had been converted to carboxyl groups. The biodegradation did not accumulate acrylamide monomers. Based on the SDS-PAGE and N-terminal sequencing results, the PAM amide groups were converted into carboxyl groups by a PAM-induced extracellular enzyme from the aliphatic amidase family. Full article

The dissemination of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) from food-producing animals to the surrounding environment has attracted much attention. To determine the emissions of ESBL-producing E. coli from pig farms to the surrounding environment, fecal and environmental samples from six pig farms were collected. In total, 119 ESBL-producing E. coli were isolated from feces, air samples, water, sludge and soil samples. Antibiotic susceptibility testing showed that the ESBL-producing isolates were resistant to multiple antibiotics and isolates of different origin within the same farm showed similar resistance phenotypes. Both CTX-M and TEM ESBL-encoding genes were detected in these isolates. CTX-M-14 and CTX-M-15 were the predominant ESBL genes identified. ESBL producers from feces and environmental samples within the same farm carried similar CTX-M types. The results indicated that the ESBL-producing E. coli carrying multidrug resistance could readily disseminate to the surrounding environment. Full article

In the UK, 20% of people with spinal cord injury (SCI) are discharged from rehabilitation into an elderly care home. Despite this, and knowledge that the home is central to health and wellbeing, little research has examined the impact of being in care homes on the health and wellbeing of people with SCI. The purpose of this study was to address this gap. Twenty adults who lived in care homes or had done so recently for over two years were interviewed in-depth. Qualitative data were analyzed using inductive thematic analysis. Analyses revealed that living in a care home environment severely damages quality of life, physical health and psychological wellbeing in the short and long-term. Reasons why quality of life, health, and wellbeing were damaged are identified. These included a lack of freedom, control, and flexibility, inability to participate in community life, inability to sustain relationships, safety problems, restricted participation in work and leisure time physical activity, lack of meaning, self-expression, and a future, loneliness, difficulties with the re-housing process, depression, and suicidal thoughts and actions. It is concluded that for people with SCI, the care home environment violates social dignity, is oppressive, and denies human rights. Implications for housing and health care policies are also offered. Full article

Respiratory diseases mainly spread through interpersonal contact. Class suspension is the most direct strategy to prevent the spread of disease through elementary or secondary schools by blocking the contact network. However, as university students usually attend courses in different buildings, the daily contact patterns on a university campus are complicated, and once disease clusters have occurred, suspending classes is far from an efficient strategy to control disease spread. The purpose of this study is to propose a methodological framework for generating campus location networks from a routine administration database, analyzing the community structure of the network, and identifying the critical links and nodes for blocking respiratory disease transmission. The data comes from the student enrollment records of a major comprehensive university in Taiwan. We combined the social network analysis and spatial interaction model to establish a geo-referenced community structure among the classroom buildings. We also identified the critical links among the communities that were acting as contact bridges and explored the changes in the location network after the sequential removal of the high-risk buildings. Instead of conducting a questionnaire survey, the study established a standard procedure for constructing a location network on a large-scale campus from a routine curriculum database. We also present how a location network structure at a campus could function to target the high-risk buildings as the bridges connecting communities for blocking disease transmission. Full article

Cigarette smoking is an important risk factor for hypertension. However, the effects on hypertension of the interaction between smoking and the genotype of the nicotinic acetylcholine receptor gene are unclear. The purpose of this study is to determine whether the CHRNA3 rs6495308 genotype affects the association between daily cigarette consumption and hypertension. We recruited 947 male smokers in southern China and used a questionnaire administered in face to face interviews to obtain information on their socio-demographic characteristics and smoking behavior. Blood samples were collected to test for CHRNA3 rs6495308 genotype variations. Three blood-pressure measurements were taken for each participant, and the average values recorded. We found that, compared with light smoking (<15 cigarettes per day), heavy smoking (≥15 cigarettes per day) yielded a greater risk of hypertension. We also observed that the interaction between daily cigarette consumption and the CHRNA3 rs6495308 genotype may affect hypertension. Heavy smokers with the homozygous mutant CHRNA3 rs6495308 genotype exhibited a significantly greater risk of hypertension than light smokers with wild-type CHRNA3 rs6495308 genotypes. The positive interaction between heavy smoking and the homozygous mutant CHRNA3 rs6495308 genotype was found to affect the likelihood of hypertension in Chinese male smokers. Full article

The xenoestrogens nonylphenol (NP) and bisphenol A (BPA) are regarded as endocrine disrupting chemicals (EDCs) which have widespread occurrence in our daily life. In the present study, the purpose was to analyze the combined effects of NP and BPA on the human prostate epithelial cell line RWPE-1 using two mathematical models based on the Loewe additivity (LA) theory and the Bliss independence (BI) theory. RWPE-1 cells were treated with NP (0.01–100 µM) and BPA (1–5000 µM) in either a single or a combined format. A cell viability assay and lactate dehydrogenase (LDH) leakage rate assay were employed as endpoints. As predicted by the two models and based on the cell viability assay, significant synergism between NP and BPA were observed. However, based on the LDH assay, the trends were reversed. Given that environmental contaminants are frequently encountered simultaneously, these data indicated that there were potential interactions between NP and BPA, and the combined effects of the chemical mixture might be stronger than the additive values of individual chemicals combined, which should be taken into consideration for the risk assessment of EDCs. Full article

Surface water has been a source of domestic water due to shortage of potable water in most rural areas. This study was carried out to evaluate the level of contamination of Mvudi River in South Africa by measuring turbidity, electrical conductivity (EC), pH, concentrations of nitrate, fluoride, chloride, and sulphate. E. coli and Enterococci were analysed using membrane filtration technique. Average pH, EC and Turbidity values were in the range of 7.2–7.7, 10.5–16.1 mS/m and 1.3–437.5 NTU, respectively. The mean concentrations of fluoride, chloride, nitrate and sulphate for both the wet and the dry seasons were 0.11 mg/L and 0.27 mg/L, 9.35 mg/L and 14.82 mg/L, 3.25 mg/L and 6.87 mg/L, 3.24 mg/L and 0.70 mg/L, respectively. E. coli and Enterococci counts for both the wet and the dry seasons were 4.81 × 10³ (log = 3.68) and 5.22 × 10³ (log = 3.72), 3.4 × 10³ (log = 3.53) and 1.22 × 10³ (log = 3.09), per 100 mL of water, respectively. The count of E. coli for both seasons did not vary significantly (p > 0.05) but Enterococci count varied significantly (p < 0.001). All the physico-chemical parameters obtained were within the recommended guidelines of the Department of Water Affairs and Forestry of South Africa and the World Health Organization for domestic and recreational water use for both seasons except turbidity and nitrates. The microbiological parameters exceeded the established guidelines. Mvudi River is contaminated with faecal organisms and should not be used for domestic purposes without proper treatment so as to mitigate the threat it poses to public health. Full article

The purpose of this study is to compare traumatic brain injuries (TBI) and spinal cord injuries (SCI) patients’ function and disability by using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0); and to clarify the factors that contribute to disability. We analyzed data available between September 2012 and August 2013 from Taiwan’s national disability registry which is based on the International Classification of Functioning, Disability, and Health (ICF) framework. Of the 2664 cases selected for the study, 1316 pertained to TBI and 1348 to SCI. A larger percentage of patients with TBI compared with those with SCI exhibited poor cognition, self-care, relationships, life activities, and participation in society (all p < 0.001). Age, sex, injury type, socioeconomic status, place of residence, and severity of impairment were determined as factors that independently contribute to disability (all p < 0.05). The WHODAS 2.0 is a generic assessment instrument which is appropriate for assessing the complex and multifaceted disability associated with TBI and SCI. Further studies are needed to validate the WHODAS 2.0 for TBI and SCI from a multidisciplinary perspective. Full article

Diesel fuel is known to emit pollutants that have a negative impact on environmental and human health. In developing countries like South Africa, attendants are employed to pump fuel for customers at service stations. Attendants refuel vehicles with various octane unleaded fuel, lead-replacement petrol and diesel fuel, on a daily basis. Attendants are at risk to adverse health effects associated with the inhalation of volatile organic compounds released from these fuels. The pollutants released include benzene, toluene, ethylbenzene and xylenes (BTEX), which are significant due to their high level of toxicity. In this study, a risk assessment of BTEX was conducted at a diesel service station for public buses. Using Radiello passive samplers, it was found that benzene concentrations were above recommended international standards. Due to poor ventilation and high exposure duration, the average benzene concentration over the sampling campaign exceeded the US Environmental Protection Agency’s chronic inhalation exposure reference concentration. Lifetime cancer risk estimation showed that on average there is a 3.78 × 10⁻⁴ cancer risk, corresponding to an average chronic daily intake of 1.38 × 10⁻³ mg/kg/day of benzene exposure. Additionally, there were incidences where individuals were at potential hazard risk of benzene and toluene that may pose non-carcinogenic effects to employees. Full article

Racial and ethnic minority communities, including American Indian and Alaska Natives, have been disproportionately impacted by environmental pollution and contamination. This includes siting and location of point sources of pollution, legacies of contamination of drinking and recreational water, and mining, military and agricultural impacts. As a result, both quantity and quality of culturally important subsistence resources are diminished, contributing to poor nutrition and obesity, and overall reductions in quality of life and life expectancy. Climate change is adding to these impacts on Native American communities, variably causing drought, increased flooding and forced relocation affecting tribal water resources, traditional foods, forests and forest resources, and tribal health. This article will highlight several extramural research projects supported by the United States Environmental Protection Agency (USEPA) Science to Achieve Results (STAR) tribal environmental research grants as a mechanism to address the environmental health inequities and disparities faced by tribal communities. The tribal research portfolio has focused on addressing tribal environmental health risks through community based participatory research. Specifically, the STAR research program was developed under the premise that tribal populations may be at an increased risk for environmentally-induced diseases as a result of unique subsistence and traditional practices of the tribes and Alaska Native villages, community activities, occupations and customs, and/or environmental releases that significantly and disproportionately impact tribal lands. Through a series of case studies, this article will demonstrate how grantees—tribal community leaders and members and academic collaborators—have been addressing these complex environmental concerns by developing capacity, expertise and tools through community-engaged research. Full article

Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153) in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107) completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39%) strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%). Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR. Full article

Volcanic ash contributed significantly to particulate matter (PM) in Iceland following the eruptions in Eyjafjallajökull 2010 and Grímsvötn 2011. This study aimed to investigate the association between different PM sources and emergency hospital visits for cardiorespiratory causes from 2007 to 2012. Indicators of PM₁₀ sources; “volcanic ash”, “dust storms”, or “other sources” (traffic, fireworks, and re-suspension) on days when PM₁₀ exceeded the daily air quality guideline value of 50 µg/m³ were entered into generalized additive models, adjusted for weather, time trend and co-pollutants. The average number of daily emergency hospital visits was 10.5. PM₁₀ exceeded the air quality guideline value 115 out of 2191 days; 20 days due to volcanic ash, 14 due to dust storms (two days had both dust storm and ash contribution) and 83 due to other sources. High PM₁₀ levels from volcanic ash tended to be significantly associated with the emergency hospital visits; estimates ranged from 4.8% (95% Confidence Interval (CI): 0.6, 9.2%) per day of exposure in unadjusted models to 7.3% (95% CI: −0.4, 15.5%) in adjusted models. Dust storms were not consistently associated with daily emergency hospital visits and other sources tended to show a negative association. We found some evidence indicating that volcanic ash particles were more harmful than particles from other sources, but the results were inconclusive and should be interpreted with caution. Full article

Background: Exposure to the particulate matter produced in underground railway systems is arousing increasing scientific interest because of its health effects. The aim of our study was to evaluate the airborne concentrations of PM₁₀ and three sub-fractions of PM_2.5 in an underground railway system environment in proximity to platforms and in underground commercial areas within the system, and to compare these with the outdoor airborne concentrations. We also evaluated the metal components, the cytotoxic properties of the various fractions of particulate matter (PM) and their capacity to induce oxidative stress. Method: We collected the coarse fraction (5–10 µm) and the fine fractions (1–2.5 µm; 0.5–1 µm; 0.25–0.5 µm). Chemical characterisation was determined by means of spectrometry. Cytotoxicity and oxidative stress were evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and Reactive Oxygen Species (ROS) assessment. Results: The concentrations of both PM₁₀ and PM_2.5 proved to be similar at the three sampling sites. Iron and other transition metals displayed a greater concentration at the subway platform than at the other two sites. The 2.5–10 µm and 1–2.5 µm fractions of PM from all three sampling sites determined a greater increase in ROS; the intensity of oxidative stress progressively declined as particle diameter diminished. Moreover, ROS concentrations were correlated with the concentrations of some transition metals, namely Mn, Cr, Ti, Fe, Cu, Zn, Ni and Mo. All particulate matter fractions displayed lower or similar ROS values between platform level and the outdoor air. Conclusions: The present study revealed that the underground railway environment at platform level, although containing higher concentrations of some particularly reactive metallic species, did not display higher cytotoxicity and oxidative stress levels than the outdoor air. Full article

Purpose: The primary objective of this study was to examine whether exergames could help children reach the recommendations for PA and cardiorespiratory fitness regarding exercise intensity. Differences in perceived physical exertion, EE, VO₂, and HR between normal weight (NW) and overweight (OW) children participating in exergames were also examined. Methods: Twenty-one children (age: 10.45 ± 0.88) were assessed for EE, VO₂ and HR during rest, in a maximal treadmill test, and while playing different exergames. Ratings of perceived exertion (RPE) (category range: 0 to 10) were also measured during exergaming. Three types of exergames were examined: running, table tennis, and dancing. These games were either performed on a Chinese game console, I-Dong, or another well-developed Western game console (Sony PlayStation 3 or Nintendo Wii). Results: Exergaming resulted in EE (kcal/min) from 2.05–5.14, VO₂ (mL/kg/min) from 9.98–25.54, and HR (beats per minute) from 98.05–149.66. Children reported RPE ranging from 1.29 to 5.29. The Chinese exergame, I-Dong Running, was the only game in which children reached a moderate intensity and met the recommended minimum VO₂reserve (50%) for cardiorespiratory fitness. Conclusion: Exergames could provide alternative opportunities to enhance children’s physical activity. They could be used as light-to-moderate PA, and with exergames, children can even reach the recommended intensity for developing and maintaining cardiorespiratory fitness. Full article

Background: This review aimed to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution with early childhood respiratory disease. Methods: We carried out a systematic literature search of peer-reviewed epidemiological studies undertaken in “westernized” countries that have assessed exposure to indoor pollutants and asthma and wheeze from infancy up to the age of 5. Results: The search, between January 2004 and February 2014 yielded 1840 studies for consideration. Following application of eligibility criteria to titles and abstracts 22 independent studies were deemed relevant for further review. Two additional studies were next identified through examination of the references’ lists of these studies. Of these 24 selected studies, 16 adopted a prospective cohort design and 8 were case-control studies. Fourteen studies assessed exposure to bio-aerosols, 8 studies assessed exposure to specific air chemicals and two studies assessed exposure to bio-aerosols and air chemicals. Furthermore, 11 studies examined the association of exposure with asthma and 16 with wheeze. Findings indicate that existing studies have reported contradictory effects of indoor pollutants levels and occurrence of asthma/wheeze. Conclusion: Additional research to establish causality and evaluate interventions to prevent disease onset is needed. Full article