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Int. J. Environ. Res. Public Health, Volume 14, Issue 1 (January 2017)

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Editorial

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Open AccessEditorial Acknowledgement to Reviewers of IJERPH in 2016
Int. J. Environ. Res. Public Health 2017, 14(1), 65; doi:10.3390/ijerph14010065
Received: 11 January 2017 / Revised: 11 January 2017 / Accepted: 11 January 2017 / Published: 11 January 2017
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Abstract The editors of IJERPH would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2016.[...] Full article

Research

Jump to: Editorial, Review, Other

Open AccessArticle Hotspot Identification for Shanghai Expressways Using the Quantitative Risk Assessment Method
Int. J. Environ. Res. Public Health 2017, 14(1), 20; doi:10.3390/ijerph14010020
Received: 31 August 2016 / Revised: 12 December 2016 / Accepted: 20 December 2016 / Published: 27 December 2016
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Abstract
Hotspot identification (HSID) is the first and key step of the expressway safety management process. This study presents a new HSID method using the quantitative risk assessment (QRA) technique. Crashes that are likely to happen for a specific site are treated as the
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Hotspot identification (HSID) is the first and key step of the expressway safety management process. This study presents a new HSID method using the quantitative risk assessment (QRA) technique. Crashes that are likely to happen for a specific site are treated as the risk. The aggregation of the crash occurrence probability for all exposure vehicles is estimated based on the empirical Bayesian method. As for the consequences of crashes, crashes may not only cause direct losses (e.g., occupant injuries and property damages) but also result in indirect losses. The indirect losses are expressed by the extra delays calculated using the deterministic queuing diagram method. The direct losses and indirect losses are uniformly monetized to be considered as the consequences of this risk. The potential costs of crashes, as a criterion to rank high-risk sites, can be explicitly expressed as the sum of the crash probability for all passing vehicles and the corresponding consequences of crashes. A case study on the urban expressways of Shanghai is presented. The results show that the new QRA method for HSID enables the identification of a set of high-risk sites that truly reveal the potential crash costs to society. Full article
(This article belongs to the Special Issue Traffic Safety and Injury Prevention)
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Open AccessArticle Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?
Int. J. Environ. Res. Public Health 2017, 14(1), 40; doi:10.3390/ijerph14010040
Received: 3 December 2016 / Revised: 23 December 2016 / Accepted: 28 December 2016 / Published: 3 January 2017
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Abstract
Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions)
[...] Read more.
Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads (n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria (p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed (p = 0.007), promotion (p = 0.017), location of food outlets (p = 0.027), and price (p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle A Study of Personal Health Record User’s Behavioral Model Based on the PMT and UTAUT Integrative Perspective
Int. J. Environ. Res. Public Health 2017, 14(1), 8; doi:10.3390/ijerph14010008
Received: 24 October 2016 / Revised: 19 December 2016 / Accepted: 19 December 2016 / Published: 23 December 2016
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Abstract
The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT)
[...] Read more.
The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Empirical Analysis and Modeling of Stop-Line Crossing Time and Speed at Signalized Intersections
Int. J. Environ. Res. Public Health 2017, 14(1), 9; doi:10.3390/ijerph14010009
Received: 25 August 2016 / Revised: 10 November 2016 / Accepted: 7 December 2016 / Published: 23 December 2016
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Abstract
In China, a flashing green (FG) indication of 3 s followed by a yellow (Y) indication of 3 s is commonly applied to end the green phase at signalized intersections. Stop-line crossing behavior of drivers during such a phase transition period significantly influences
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In China, a flashing green (FG) indication of 3 s followed by a yellow (Y) indication of 3 s is commonly applied to end the green phase at signalized intersections. Stop-line crossing behavior of drivers during such a phase transition period significantly influences safety performance of signalized intersections. The objective of this study is thus to empirically analyze and model drivers’ stop-line crossing time and speed in response to the specific phase transition period of FG and Y. High-resolution trajectories for 1465 vehicles were collected at three rural high-speed intersections with a speed limit of 80 km/h and two urban intersections with a speed limit of 50 km/h in Shanghai. With the vehicle trajectory data, statistical analyses were performed to look into the general characteristics of stop-line crossing time and speed at the two types of intersections. A multinomial logit model and a multiple linear regression model were then developed to predict the stop-line crossing patterns and speeds respectively. It was found that the percentage of stop-line crossings during the Y interval is remarkably higher and the stop-line crossing time is approximately 0.7 s longer at the urban intersections, as compared with the rural intersections. In addition, approaching speed and distance to the stop-line at the onset of FG as well as area type significantly affect the percentages of stop-line crossings during the FG and Y intervals. Vehicle type and stop-line crossing pattern were found to significantly influence the stop-line crossing speed, in addition to the above factors. The red-light-running seems to occur more frequently at the large intersections with a long cycle length. Full article
(This article belongs to the Special Issue Traffic Safety and Injury Prevention)
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Open AccessArticle Use of Electronic Nicotine Delivery Systems among Adults with Mental Health Conditions, 2015
Int. J. Environ. Res. Public Health 2017, 14(1), 10; doi:10.3390/ijerph14010010
Received: 31 October 2016 / Revised: 5 December 2016 / Accepted: 19 December 2016 / Published: 23 December 2016
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Abstract
Adults with mental health conditions (MHC) are especially likely to smoke and experience tobacco-related health disparities. Individuals with MHC may also use electronic nicotine delivery devices (ENDS) at disproportionately high rates. However, there is a relative dearth of knowledge regarding ENDS use among
[...] Read more.
Adults with mental health conditions (MHC) are especially likely to smoke and experience tobacco-related health disparities. Individuals with MHC may also use electronic nicotine delivery devices (ENDS) at disproportionately high rates. However, there is a relative dearth of knowledge regarding ENDS use among individuals with MHC. In a large representative sample of U.S. adults (n = 6051), associations between self-reported MHC diagnoses and ENDS use and susceptibility were examined, stratified by smoking status. Participants with MHC were approximately 1.5 times more likely to have used ENDS in their lifetime and almost twice as likely to currently use ENDS as those without MHC. MHC status was most strongly linked to higher ENDS use among former smokers, and former smokers with MHC were more likely to report using ENDS during past smoking quit attempts than those without MHC. Among participants who had not tried ENDS, former smokers with MHC were especially susceptible to future ENDS use. The potential advantage of ENDS for cessation purposes should be balanced with the risk of attracting former smokers with MHC to ENDS. Full article
(This article belongs to the Special Issue E-Cigarettes: Epidemiology, Policy and Public Health)
Open AccessArticle The Effects of Age, Period, and Cohort on Mortality from Ischemic Heart Disease in China
Int. J. Environ. Res. Public Health 2017, 14(1), 50; doi:10.3390/ijerph14010050
Received: 10 December 2016 / Revised: 10 December 2016 / Accepted: 22 December 2016 / Published: 7 January 2017
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Abstract
In contrast with most developed countries, mortality due to ischemic heart disease (IHD) continues to rise in China. We examined the effects of age, period, and cohort on IHD mortality in urban and rural populations from 1987 to 2013 to identify the drivers
[...] Read more.
In contrast with most developed countries, mortality due to ischemic heart disease (IHD) continues to rise in China. We examined the effects of age, period, and cohort on IHD mortality in urban and rural populations from 1987 to 2013 to identify the drivers of this trend. Region-specific data on annual IHD mortality among adults aged 20 to 84 years and corresponding population statistics were collected. We then tested for age, period, and cohort effects using the Intrinsic Estimator approach. Our results indicated that IHD mortality in China increased significantly over the three decades studied. There was a log-linear increase in the age effect on IHD mortality as those aged 80–84 showed 277 and 161 times greater IHD mortality risk than those aged 20–24 in urban and rural populations, respectively. While there was an upward trend in the period effect in both populations, the influence of the cohort effect on mortality decreased over time for those born from 1904 to 1993. The age, period, and cohort effects on mortality in China were generally comparable between urban and rural populations. The results suggest that population aging is a major driver behind the rapid rise in IHD mortality. Increased exposure to air pollution may also have played a role in driving the period effect Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Volatile Organic Compounds (VOCs) in Conventional and High Performance School Buildings in the U.S.
Int. J. Environ. Res. Public Health 2017, 14(1), 100; doi:10.3390/ijerph14010100
Received: 12 December 2016 / Revised: 13 January 2017 / Accepted: 17 January 2017 / Published: 21 January 2017
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Abstract
Exposure to volatile organic compounds (VOCs) has been an indoor environmental quality (IEQ) concern in schools and other buildings for many years. Newer designs, construction practices and building materials for “green” buildings and the use of “environmentally friendly” products have the promise of
[...] Read more.
Exposure to volatile organic compounds (VOCs) has been an indoor environmental quality (IEQ) concern in schools and other buildings for many years. Newer designs, construction practices and building materials for “green” buildings and the use of “environmentally friendly” products have the promise of lowering chemical exposure. This study examines VOCs and IEQ parameters in 144 classrooms in 37 conventional and high performance elementary schools in the U.S. with the objectives of providing a comprehensive analysis and updating the literature. Tested schools were built or renovated in the past 15 years, and included comparable numbers of conventional, Energy Star, and Leadership in Energy and Environmental Design (LEED)-certified buildings. Indoor and outdoor VOC samples were collected and analyzed by thermal desorption, gas chromatography and mass spectroscopy for 94 compounds. Aromatics, alkanes and terpenes were the major compound groups detected. Most VOCs had mean concentrations below 5 µg/m3, and most indoor/outdoor concentration ratios ranged from one to 10. For 16 VOCs, the within-school variance of concentrations exceeded that between schools and, overall, no major differences in VOC concentrations were found between conventional and high performance buildings. While VOC concentrations have declined from levels measured in earlier decades, opportunities remain to improve indoor air quality (IAQ) by limiting emissions from building-related sources and by increasing ventilation rates. Full article
(This article belongs to the Special Issue Indoor Air Quality and Health 2016)
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Open AccessArticle Perceptions of E-Cigarettes among Black Youth in California
Int. J. Environ. Res. Public Health 2017, 14(1), 60; doi:10.3390/ijerph14010060
Received: 12 November 2016 / Revised: 14 December 2016 / Accepted: 3 January 2017 / Published: 11 January 2017
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Abstract
Research suggests that Black youth are less likely to use e-cigarettes than their white counterparts, yet little is known as to why. We examined perceptions of e-cigarettes among Black young adults (ages 18–25) to explore the meanings these youth ascribe to e-cigarettes and
[...] Read more.
Research suggests that Black youth are less likely to use e-cigarettes than their white counterparts, yet little is known as to why. We examined perceptions of e-cigarettes among Black young adults (ages 18–25) to explore the meanings these youth ascribe to e-cigarettes and the role that identity plays in how these devices are viewed. Analysis of in-depth interviews with 36 Black smokers and non-smokers in the San Francisco Bay Area suggests that Black youth perceive e-cigarettes as serving distinct, yet overlapping roles: a utilitarian function, in that they are recognized as legitimate smoking cessation tools, and a social function, insofar as they serve to mark social identity, specifically a social identity from which our participants disassociated. Participants described e-cigarette users in highly racialized and classed terms and generally expressed disinterest in using e-cigarettes, due in part perhaps to the fact that use of these devices would signal alignment with a middle class, hipster identity. This analysis is discussed within a highly charged political and public health debate about the benefits and harms associated with e-cigarette use. Full article
(This article belongs to the Special Issue E-Cigarettes: Epidemiology, Policy and Public Health)
Open AccessArticle Transcriptome Profiling of the Lungs Reveals Molecular Clock Genes Expression Changes after Chronic Exposure to Ambient Air Particles
Int. J. Environ. Res. Public Health 2017, 14(1), 90; doi:10.3390/ijerph14010090
Received: 28 September 2016 / Revised: 10 January 2017 / Accepted: 13 January 2017 / Published: 18 January 2017
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Abstract
The symptoms of asthma, breathlessness, insomnia, etc. all have relevance to pulmonary rhythmic disturbances. Epidemiology and toxicology studies have demonstrated that exposure to ambient air particles can result in pulmonary dysfunction. However, there are no data directly supporting a link between air pollution
[...] Read more.
The symptoms of asthma, breathlessness, insomnia, etc. all have relevance to pulmonary rhythmic disturbances. Epidemiology and toxicology studies have demonstrated that exposure to ambient air particles can result in pulmonary dysfunction. However, there are no data directly supporting a link between air pollution and circadian rhythm disorder. In the present study, we found that breathing highly polluted air resulted in changes of the molecular clock genes expression in lung by transcriptome profiling analyses in a rodent model. Compared to those exposed to filtered air, in both pregnant and offspring rats in the unfiltered group, key clock genes (Per1, Per2, Per3, Rev-erbα and Dbp) expression level decreased and Bmal1 expression level increased. In both rat dams and their offspring, after continuous exposure to unfiltered air, we observed significant histologic evidence for both perivascular and peribronchial inflammation, increased tissue and systemic oxidative stress in the lungs. Our results suggest that chronic exposure to particulate matter can induce alterations of clock genes expression, which could be another important pathway for explaining the feedbacks of ambient particle exposure in addition to oxidative stress and inflammation. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Motivations and Limitations Associated with Vaping among People with Mental Illness: A Qualitative Analysis of Reddit Discussions
Int. J. Environ. Res. Public Health 2017, 14(1), 7; doi:10.3390/ijerph14010007
Received: 28 October 2016 / Revised: 27 November 2016 / Accepted: 19 December 2016 / Published: 22 December 2016
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Abstract
This study aims to understand the nature and significance of online lay discussions about e-cigarettes and mental illness. We systematically searched the website Reddit.com using keywords related to e-cigarettes and mental illness. We coded relevant posts into themes under the framework of motivations
[...] Read more.
This study aims to understand the nature and significance of online lay discussions about e-cigarettes and mental illness. We systematically searched the website Reddit.com using keywords related to e-cigarettes and mental illness. We coded relevant posts into themes under the framework of motivations for and limitations of vaping for people with mental illness. The thematic analysis included 3263 comments from 133 discussion threads. Six themes were classified as motivations to vape for people with mental illness: Self-medication; Quitting smoking; Freedom and control; Hobby; Social connectedness; and Motivation from caregivers and online communities. The limitations of vaping included: Unsatisfactory substitute for cigarettes and psychiatric medicines; Drug interactions; Nicotine addiction; Risks of e-liquid; Practical difficulties and Cost. People with mental illness; and their carers; use online discussion boards like Reddit to discuss the benefits and limitations of e-cigarettes for people with mental illness. Both positive and negative views exist. Media platforms like Reddit may shape the opinions of stakeholders and generate lay expertise about contentious health topics such as e-cigarettes. These findings have implications for policy and practice concerning assisting smokers with mental illness to reduce their health risk through switching to e-cigarettes. Full article
(This article belongs to the Special Issue E-Cigarettes: Epidemiology, Policy and Public Health)
Open AccessArticle Prospective Cohort Study to Elucidate the Correlation between Occupational Stress and Hypertension Risk in Oil Workers from Kelamayi City in the Xinjiang Uygur Autonomous Region of China
Int. J. Environ. Res. Public Health 2017, 14(1), 1; doi:10.3390/ijerph14010001
Received: 8 September 2016 / Revised: 14 December 2016 / Accepted: 15 December 2016 / Published: 22 December 2016
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Abstract
The purpose of this study was to assess the major risk factors for hypertension in oil workers, and investigate the effect of occupational stress on the incidence of hypertension after controlling for other risk factors. A prospective cohort approach was used following enrollment
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The purpose of this study was to assess the major risk factors for hypertension in oil workers, and investigate the effect of occupational stress on the incidence of hypertension after controlling for other risk factors. A prospective cohort approach was used following enrollment of 1354 oil workers. The occupational stress experienced by oil workers was higher than for the general population in China. By the end of the cohort study, 231 new cases of hypertension among the oil workers had been diagnosed. The cumulative incidence of hypertension was 17.06%. There were 44, 112, and 75 workers who developed hypertension in the low, intermediate, and high occupational stress groups, which represented a 12.0%, 15.6%, and 20.3% cumulative incidence, respectively (chi-square value = 9.812, p < 0.01). Multivariate Cox proportional hazard model analysis showed that type of work, cigarette smoking, excess body weight, and obesity were risk factors for hypertension (p < 0.05). After risk factors such as type of work, cigarette smoking, alcohol consumption, and body mass index (BMI) were controlled, the hypertension risk (hazard ratio, HR) in the high occupational stress group was 1.549 (1.072–2.236) compared to the low exposure group, and 2.337 (1.191–4.585) in female subjects. Our study indicated that an increase in occupational stress was associated with an increased risk of hypertension after other factors were adjusted. Full article
(This article belongs to the Special Issue Health Behavior and Public Health)
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Open AccessArticle Ecosystem Health Assessment at County-Scale Using the Pressure-State-Response Framework on the Loess Plateau, China
Int. J. Environ. Res. Public Health 2017, 14(1), 2; doi:10.3390/ijerph14010002
Received: 16 September 2016 / Revised: 17 November 2016 / Accepted: 9 December 2016 / Published: 22 December 2016
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Abstract
Assessing ecosystem health is helpful to determine reasonable eco-environmental restoration and resource management strategies. Based on a pressure-state-response (PSR) framework, a set of comprehensive indicators including natural, social and economic aspects was proposed and applied for assessing the ecosystem health of Yuanzhou County,
[...] Read more.
Assessing ecosystem health is helpful to determine reasonable eco-environmental restoration and resource management strategies. Based on a pressure-state-response (PSR) framework, a set of comprehensive indicators including natural, social and economic aspects was proposed and applied for assessing the ecosystem health of Yuanzhou County, Loess Plateau, Ningxia Province, China. The basic data used to calculate the values of the assessment indicators include Landsat TM image and socio-economic data, and remote sensing (RS) and the geographic information system (GIS) were used to process image data. The results showed that the ecosystem health conditions of most townships in Yuanzhou County were at the moderately healthy level, three townships were at the healthy level, and only two townships were at the unhelathy level; the areas (percentage) at the unhealthy, moderately healthy and healthy levels were 443.91 km2 (12.66%), 2438.75 km2 (69.54%) and 624.50 km2 (17.81%), respectively. The results could provide useful information for local residents and the government to take measures to improve the health conditions of their township ecosystem. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Exposure to Indoor Particulate Matter Worsens the Symptoms and Acute Exacerbations in Chronic Obstructive Pulmonary Disease Patients of Southwestern Taiwan: A Pilot Study
Int. J. Environ. Res. Public Health 2017, 14(1), 4; doi:10.3390/ijerph14010004
Received: 22 October 2016 / Revised: 30 November 2016 / Accepted: 19 December 2016 / Published: 22 December 2016
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Abstract
Ambient particulate matter (PM) can trigger adverse reactions in the respiratory system, but less is known about the effect of indoor PM. In this longitudinal study, we investigated the relationships between indoor PM and clinical parameters in patients with moderate to very severe
[...] Read more.
Ambient particulate matter (PM) can trigger adverse reactions in the respiratory system, but less is known about the effect of indoor PM. In this longitudinal study, we investigated the relationships between indoor PM and clinical parameters in patients with moderate to very severe chronic obstructive pulmonary disease (COPD). Indoor air quality (PM2.5 and PM10 levels) was monitored in the patients’ bedroom, kitchen, living room, and front door at baseline and every two months for one year. At each home visit, the patients were asked to complete spirometry and questionnaire testing. Exacerbations were assessed by chart review and questionnaires during home visits. Generalized estimating equation (GEE) analysis (n = 83) showed that the level of wheezing was significantly higher in patients whose living room and kitchen had abnormal (higher than ambient air quality standards in Taiwan) PM2.5 and PM10 levels. Patients who lived in houses with abnormal outdoor PM2.5 levels had higher COPD Assessment Test scores (physical domain), and those who lived in houses with abnormal PM10 levels in the living room and kitchen had higher London Chest Activity of Daily Living scores. Increased PM levels were associated with worse respiratory symptoms and increased risk of exacerbation in patients with moderate to very severe COPD. Full article
(This article belongs to the Section Environment Health)
Open AccessArticle Residential Proximity to Major Roadways and Risk of Type 2 Diabetes Mellitus: A Meta-Analysis
Int. J. Environ. Res. Public Health 2017, 14(1), 3; doi:10.3390/ijerph14010003
Received: 5 October 2016 / Revised: 12 December 2016 / Accepted: 12 December 2016 / Published: 22 December 2016
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Abstract
Research indicates that higher levels of traffic-related pollution exposure increase the risk of diabetes, but the association between road proximity and diabetes risk remains unclear. To assess and quantify the association between residential proximity to major roadways and type 2 diabetes, a systematic
[...] Read more.
Research indicates that higher levels of traffic-related pollution exposure increase the risk of diabetes, but the association between road proximity and diabetes risk remains unclear. To assess and quantify the association between residential proximity to major roadways and type 2 diabetes, a systematic review and meta-analysis was performed. Embase, Medline, and Web of Science were searched for eligible studies. Using a random-effects meta-analysis, the summary relative risks (RRs) were calculated. Bayesian meta-analysis was also performed. Eight studies (6 cohort and 2 cross-sectional) with 158,576 participants were finally included. The summary unadjusted RR for type 2 diabetes associated with residential proximity to major roadways was 1.24 (95% confidence interval [CI]: 1.07–1.44, p = 0.001, I2 = 48.1%). The summary adjusted RR of type 2 diabetes associated with residential proximity to major roadways was 1.12 (95% CI: 1.03–1.22, p = 0.01, I2 = 17.9%). After excluding two cross-sectional studies, the summary results suggested that residential proximity to major roadways could increase type 2 diabetes risk (Adjusted RR = 1.13; 95% CI: 1.02–1.27, p = 0.025, I2 = 36.6%). Bayesian meta-analysis showed that the unadjusted RR and adjusted RR of type 2 diabetes associated with residential proximity to major roadways were 1.22 (95% credibility interval: 1.06–1.55) and 1.13 (95% credibility interval: 1.01–1.31), respectively. The meta-analysis suggested that residential proximity to major roadways could significantly increase risk of type 2 diabetes, and it is an independent risk factor of type 2 diabetes. More well-designed studies are needed to further strengthen the evidence. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Hazard Assessment of Debris-Flow along the Baicha River in Heshigten Banner, Inner Mongolia, China
Int. J. Environ. Res. Public Health 2017, 14(1), 30; doi:10.3390/ijerph14010030
Received: 24 October 2016 / Revised: 19 December 2016 / Accepted: 23 December 2016 / Published: 29 December 2016
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Abstract
This study focused on a cloud model approach for considering debris-flow hazard assessment, in which the cloud model provided a model for transforming the qualitative and quantitative expressions. Additionally, the entropy method and analytical hierarchy process were united for calculating the parameters weights.
[...] Read more.
This study focused on a cloud model approach for considering debris-flow hazard assessment, in which the cloud model provided a model for transforming the qualitative and quantitative expressions. Additionally, the entropy method and analytical hierarchy process were united for calculating the parameters weights. The weighting method avoids the disadvantages inherent in using subjective or objective methods alone. Based on the cloud model and component weighting method, a model was established for the analysis of debris-flow hazard assessment. There are 29 debris-flow catchments around the pumped storage power station in the study area located near Zhirui (Inner Mongolia, China). Field survey data and 3S technologies were used for data collection. The results of the cloud model calculation process showed that of the 29 catchments, 25 had low debris-flow hazard assessment, three had moderate hazard assessment, and one had high hazard assessment. The widely used extenics method and field geological surveys were used to validate the proposed approach. This approach shows high potential as a useful tool for debris-flow hazard assessment analysis. Compared with other prediction methods, it avoids the randomness and fuzziness in uncertainty problems, and its prediction results are considered reasonable. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle The Impact of Heat Waves on Occurrence and Severity of Construction Accidents
Int. J. Environ. Res. Public Health 2017, 14(1), 70; doi:10.3390/ijerph14010070
Received: 18 October 2016 / Revised: 20 December 2016 / Accepted: 28 December 2016 / Published: 11 January 2017
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Abstract
The impact of heat stress on human health has been extensively studied. Similarly, researchers have investigated the impact of heat stress on workers’ health and safety. However, very little work has been done on the impact of heat stress on occupational accidents and
[...] Read more.
The impact of heat stress on human health has been extensively studied. Similarly, researchers have investigated the impact of heat stress on workers’ health and safety. However, very little work has been done on the impact of heat stress on occupational accidents and their severity, particularly in South Australian construction. Construction workers are at high risk of injury due to heat stress as they often work outdoors, undertake hard manual work, and are often project based and sub-contracted. Little is known on how heat waves could impact on construction accidents and their severity. In order to provide more evidence for the currently limited number of empirical investigations on the impact of heat stress on accidents, this study analysed 29,438 compensation claims reported during 2002–2013 within the construction industry of South Australia. Claims reported during 29 heat waves in Adelaide were compared with control periods to elicit differences in the number of accidents reported and their severity. The results revealed that worker characteristics, type of work, work environment, and agency of accident mainly govern the severity. It is recommended that the implementation of adequate preventative measures in small-sized companies and civil engineering sites, targeting mainly old age workers could be a priority for Work, Health and Safety (WHS) policies. Full article
(This article belongs to the Special Issue Effecting a Safe and Healthy Environment in Construction)
Open AccessArticle Spatial Analysis of Human Health Risk Due to Arsenic Exposure through Drinking Groundwater in Taiwan’s Pingtung Plain
Int. J. Environ. Res. Public Health 2017, 14(1), 81; doi:10.3390/ijerph14010081
Received: 28 October 2016 / Revised: 9 January 2017 / Accepted: 10 January 2017 / Published: 14 January 2017
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Abstract
Chronic arsenic (As) exposure continues to be a public health problem of major concern worldwide, affecting hundreds of millions of people. A long-term groundwater quality survey has revealed that 20% of the groundwater in southern Taiwan’s Pingtung Plain is clearly contaminated with a
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Chronic arsenic (As) exposure continues to be a public health problem of major concern worldwide, affecting hundreds of millions of people. A long-term groundwater quality survey has revealed that 20% of the groundwater in southern Taiwan’s Pingtung Plain is clearly contaminated with a measured As concentration in excess of the maximum level of 10 µg/L recommended by the World Health Organization. The situation is further complicated by the fact that more than half of the inhabitants in this area continue to use groundwater for drinking. Efforts to assess the health risk associated with the ingestion of As from the contaminated drinking water are required in order to determine the priorities for health risk management. The conventional approach to conducting a human health risk assessment may be insufficient for this purpose, so this study adopts a geostatistical Kriging method to perform a spatial analysis of the health risk associated with ingesting As through drinking groundwater in the Pingtung Plain. The health risk is assessed based on the hazard quotient (HQ) and target cancer risk (TR) established by the U.S. Environmental Protection Agency. The results show that most areas where the HQ exceeds 1 are in the southwestern part of the study area. In addition, the high-population density townships of Daliao, Linyuan, Donggang, Linbian, Jiadong, and Fangliao presently have exceedingly high TR values that are two orders of magnitude higher than the acceptable standard. Thus, the use of groundwater for drinking in these townships should be strictly avoided. A map that delineates areas with high TR values and high population densities is provided. The findings broaden the scope of the spatial analysis of human health risk and provide a basis for improving the decision-making process. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Ameliorative Effect of Curcumin-Encapsulated Hyaluronic Acid–PLA Nanoparticles on Thioacetamide-Induced Murine Hepatic Fibrosis
Int. J. Environ. Res. Public Health 2017, 14(1), 11; doi:10.3390/ijerph14010011
Received: 30 September 2016 / Revised: 21 November 2016 / Accepted: 15 December 2016 / Published: 24 December 2016
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Abstract
In this study, we developed curcumin-encapsulated hyaluronic acid–polylactide nanoparticles (CEHPNPs) to be used for liver fibrosis amelioration. CD44, the hyaluronic acid (HA) receptor, is upregulated on the surface of cancer cells and on activated hepatic stellate cells (aHSCs) rather than normal cells. CEHPNPs
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In this study, we developed curcumin-encapsulated hyaluronic acid–polylactide nanoparticles (CEHPNPs) to be used for liver fibrosis amelioration. CD44, the hyaluronic acid (HA) receptor, is upregulated on the surface of cancer cells and on activated hepatic stellate cells (aHSCs) rather than normal cells. CEHPNPs could bind to CD44 and be internalized effectively through endocytosis to release curcumin, a poor water-soluble liver protective agent. Thus, CEHPNPs were potentially not only improving drug efficiency, but also targeting aHSCs. HA and polylactide (PLA) were crosslinked by adipic acid dihydrazide (ADH). The synthesis of HA–PLA was monitored by Fourier-transform infrared (FTIR) and Nuclear Magnetic Resonance (NMR). The average particle size was approximately 60–70 nm as determined by dynamic light scattering (DLS) and scanning electron microscope (SEM). Zeta potential was around −30 mV, which suggested a good stability of the particles. This drug delivery system induced significant aHSC cell death without affecting quiescent HSCs, hepatic epithelial, and parenchymal cells. This system reduced drug dosage without sacrificing therapeutic efficacy. The cytotoxicity IC50 (inhibitory concentration at 50%) value of CEHPNPs was approximately 1/30 to that of the free drug treated group in vitro. Additionally, the therapeutic effects of CEHPNPs were as effective as the group treated with the same curcumin dose intensity in vivo. CEHPNPs significantly reduced serum aspartate transaminase/alanine transaminase (ALT/AST) significantly, and attenuated tissue collagen production and cell proliferation as revealed by liver biopsy. Conclusively, the advantages of superior biosafety and satisfactory therapeutic effect mean that CEHPNPs hold great potential for treating hepatic fibrosis. Full article
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Open AccessArticle Infection Dynamics and Antimicrobial Resistance Profile of Salmonella Paratyphi B d-tartrate Positive (Java) in a Persistently Infected Broiler Barn
Int. J. Environ. Res. Public Health 2017, 14(1), 101; doi:10.3390/ijerph14010101
Received: 9 November 2016 / Revised: 16 January 2017 / Accepted: 17 January 2017 / Published: 21 January 2017
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Abstract
The infection dynamics of S. Java were examined in three consecutive rearing periods on a broiler farm in Northwestern Germany which had been persistently infected with S. Java for more than five years. The barn was investigated for Salmonella occurrence after cleaning and
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The infection dynamics of S. Java were examined in three consecutive rearing periods on a broiler farm in Northwestern Germany which had been persistently infected with S. Java for more than five years. The barn was investigated for Salmonella occurrence after cleaning and disinfection to verify the persistent contamination of the broiler house with S. Java before the start of the first rearing cycle. Confirmation of Salmonella absence in day-old chicks (time-point 1) as well as early establishment of infection between days 5–7 (time-point 2) were confirmed by caecal swabs prepared for qPCR and classical microbiological methods. At three time-periods (between days 11–15 (time-point 3), days 25–28 (time-point 4), and days 38–40 (time-point 5)) caecal content was examined for colony forming units (CFU) Salmonella/g. In general, there was an increase in Salmonella Java load at time-point 4 compared to time-points 3 and 5. Therefore, we observed a bell-shaped course of infection resulting in higher rates of Salmonella CFU/g prior to prethinning than at final slaughter. The antimicrobial susceptibility testing revealed resistance to tetracycline, fluorquinolones, trimethoprim, and cefoxitin. Full article
(This article belongs to the Special Issue Emerging Infectious Diseases and Environmental Threats)
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Open AccessArticle Surveillance of Clostridium difficile Infections: Results from a Six-Year Retrospective Study in Nine Hospitals of a North Italian Local Health Authority
Int. J. Environ. Res. Public Health 2017, 14(1), 61; doi:10.3390/ijerph14010061
Received: 4 November 2016 / Revised: 2 January 2017 / Accepted: 6 January 2017 / Published: 10 January 2017
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Abstract
Clostridium difficile is an emerging cause of healthcare associated infections. In nine hospitals of an Italian Local Health Authority the episodes of C. difficile infection (CDI) were identified using the data registered by the centralized Laboratory Information System, from 2010 to 2015. CDI
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Clostridium difficile is an emerging cause of healthcare associated infections. In nine hospitals of an Italian Local Health Authority the episodes of C. difficile infection (CDI) were identified using the data registered by the centralized Laboratory Information System, from 2010 to 2015. CDI incidence (positive patients for A and/or B toxins per patients-days) was analysed per year, hospital, and ward. A number of cases approximately equivalent to the mean of identified cases per year were studied retrospectively to highlight the risk factors associated to CDI and their severity. Nine hundred and forty-two patients affected by CDI were identified. The overall incidence was 3.7/10,000 patients-days, with a stable trend across the six years and the highest rates observed in smaller and outlying hospitals (up to 17.8/10,000), where the admitted patients were older and the wards with the highest incidences (long-term-care: 7.6/10,000, general medicine: 5.7/10,000) were more represented. The mean age of patients in each hospital was correlated with CDI rates. Of the 101 cases selected for the retrospective study, 86.1% were healthcare associated, 10.9% community acquired; 9.1% met the criteria for recurrent case and 23.8% for severe case of CDI. The overall mortality rate was 28.7%. Comorbidity conditions occurred in 91.1%, previous exposure to antibiotics in 76.2%, and proton pump inhibitors in 77.2%. Recurrent and severe cases were significantly associated with renal insufficiency and creatinine levels ≥2 mg/dL. The survey based on the centralized laboratory data was useful to study CDI epidemiology in the different centres in order to identify possible weaknesses and plan control strategies, in particular the reinforcement of staff training, mainly targeted at compliance with contact precautions and hand hygiene. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle An Effect Analysis of Comprehensive Treatment of Groundwater Over-Exploitation in Cheng’an County, Hebei Province, China
Int. J. Environ. Res. Public Health 2017, 14(1), 41; doi:10.3390/ijerph14010041
Received: 16 October 2016 / Revised: 20 December 2016 / Accepted: 29 December 2016 / Published: 4 January 2017
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Abstract
The comprehensive treatment project of groundwater over-exploitation in Hebei Province has been implemented for more than a year, and the effect of exploitation restriction is in urgent need of evaluation. This paper deals with Cheng’an County of Hebei Province as the research subject.
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The comprehensive treatment project of groundwater over-exploitation in Hebei Province has been implemented for more than a year, and the effect of exploitation restriction is in urgent need of evaluation. This paper deals with Cheng’an County of Hebei Province as the research subject. Based on collected hydro-meteorological, socioeconomic, groundwater, and other related data, together with typical regional experimental research, this study generates the effective precipitation–groundwater exploitation (P-W) curve and accompanying research methods, and calculates the quantity of groundwater exploitation restriction. It analyzes the target completion status of groundwater exploitation restriction through water conservancy measures and agricultural practices of the groundwater over-exploitation comprehensive treatment project that was implemented in Cheng’an County in 2014. The paper evaluates the treatment effect of groundwater over-exploitation, as well as provides technical support for the effect evaluation of groundwater exploitation restriction of agricultural irrigation in Cheng’an County and relevant areas. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Driver Vision Based Perception-Response Time Prediction and Assistance Model on Mountain Highway Curve
Int. J. Environ. Res. Public Health 2017, 14(1), 31; doi:10.3390/ijerph14010031
Received: 30 August 2016 / Revised: 14 December 2016 / Accepted: 20 December 2016 / Published: 30 December 2016
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Abstract
To make driving assistance system more humanized, this study focused on the prediction and assistance of drivers’ perception-response time on mountain highway curves. Field tests were conducted to collect real-time driving data and driver vision information. A driver-vision lane model quantified curve elements
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To make driving assistance system more humanized, this study focused on the prediction and assistance of drivers’ perception-response time on mountain highway curves. Field tests were conducted to collect real-time driving data and driver vision information. A driver-vision lane model quantified curve elements in drivers’ vision. A multinomial log-linear model was established to predict perception-response time with traffic/road environment information, driver-vision lane model, and mechanical status (last second). A corresponding assistance model showed a positive impact on drivers’ perception-response times on mountain highway curves. Model results revealed that the driver-vision lane model and visual elements did have important influence on drivers’ perception-response time. Compared with roadside passive road safety infrastructure, proper visual geometry design, timely visual guidance, and visual information integrality of a curve are significant factors for drivers’ perception-response time. Full article
(This article belongs to the Special Issue Traffic Safety and Injury Prevention)
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Open AccessArticle Health Benefits of Urban Allotment Gardening: Improved Physical and Psychological Well-Being and Social Integration
Int. J. Environ. Res. Public Health 2017, 14(1), 71; doi:10.3390/ijerph14010071
Received: 20 October 2016 / Revised: 21 December 2016 / Accepted: 6 January 2017 / Published: 12 January 2017
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Abstract
With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here,
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With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here, we quantify the effects, if any, of participating in allotment gardening on physical, psychological and social health. A questionnaire survey of 332 people was performed in Tokyo, Japan. We compared five self-reported health outcomes between allotment gardeners and non-gardener controls: perceived general health, subjective health complaints, body mass index (BMI), mental health and social cohesion. Accounting for socio-demographic and lifestyle variables, regression models revealed that allotment gardeners, compared to non-gardeners, reported better perceived general health, subjective health complaints, mental health and social cohesion. BMI did not differ between gardeners and non-gardeners. Neither frequency nor duration of gardening significantly influenced reported health outcomes. Our results highlight that regular gardening on allotment sites is associated with improved physical, psychological and social health. With the recent escalation in the prevalence of chronic diseases, and associated healthcare costs, this study has a major implication for policy, as it suggests that urban allotments have great potential for preventative healthcare. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Are Cockroaches an Important Source of Indoor Endotoxins?
Int. J. Environ. Res. Public Health 2017, 14(1), 91; doi:10.3390/ijerph14010091
Received: 13 December 2016 / Revised: 13 January 2017 / Accepted: 16 January 2017 / Published: 18 January 2017
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Abstract
Endotoxins are common indoor biocontaminants. Their levels have been shown to link to many sources and factors. One of them is cockroach infestation but the role of cockroaches and contamination mechanisms are unclear. We hypothesized that not only is cockroach infestation a sign
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Endotoxins are common indoor biocontaminants. Their levels have been shown to link to many sources and factors. One of them is cockroach infestation but the role of cockroaches and contamination mechanisms are unclear. We hypothesized that not only is cockroach infestation a sign of poor hygiene, but it also contributes to indoor endotoxins via fecal contamination. In this study, different cockroach species were caught in homes. The endotoxin and allergen levels and their ratios in cockroach feces were determined. To estimate the amount of indoor endotoxins that originated from cockroaches, a new approach of using these new cockroach endotoxin and allergen ratios to compare with environmental data was employed. We found that Supella (S.) longipalpa, Periplaneta (P.) australasiae, and Blattella (B.) germanica were dominant in homes. On average, P. australasiae feces had a higher level but greater variation of endotoxins. B. germanica feces had the highest levels of allergens measured. Depending on environmental bacterial load and the type of cockroaches present, cockroach endotoxins in the environment may vary greatly. Cockroaches directly contribute to indoor endotoxins rather than just being a sign of poor hygiene. The type and extent of cockroach infestation should be taken into consideration when assessing and remediating indoor endotoxin contamination. Full article
(This article belongs to the Section Environment Health)
Open AccessArticle Antimicrobial Resistant Enteropathogenic Escherichia coli and Salmonella spp. in Houseflies Infesting Fish in Food Markets in Zambia
Int. J. Environ. Res. Public Health 2017, 14(1), 21; doi:10.3390/ijerph14010021
Received: 7 September 2016 / Revised: 2 December 2016 / Accepted: 19 December 2016 / Published: 28 December 2016
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Abstract
Diarrhea is one of the most common diseases and is a leading cause of death in developing countries. This is often caused by contaminated food. Poor food hygiene standards are exacerbated by the presence of flies which can transmit a variety of infectious
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Diarrhea is one of the most common diseases and is a leading cause of death in developing countries. This is often caused by contaminated food. Poor food hygiene standards are exacerbated by the presence of flies which can transmit a variety of infectious microorganisms, particularly through animal source foods. This fact becomes especially important in developing countries like Zambia, where fish is a highly valued source of protein. Our interest in this study was to identify if the flies that beset food markets in Zambia carry important pathogenic bacteria on their bodies, and subsequently if these bacteria carry resistance genes to commonly used antibiotics, which would indicate problems in eradicating these pathogens. The present study took into account fish vendors’ and consumers’ perception of flies and interest in interventions to reduce their numbers. We conducted semi-structured interviews with (1) traders (comprised of randomly selected males and females) and (2) consumers (including randomly selected males and females). Thereafter, we collected flies found on fish in markets in Mongu and Lusaka districts of Zambia. For the entire study, a total of 418 fly samples were analyzed in the laboratory and Salmonella spp. and enteropathogenic Escherichia coli were isolated from the flies. Further laboratory screening revealed that overall, 17.2% (72/418) (95% CI; 43.2%–65.5%) of total samples analyzed contained Extended-Spectrum Beta-Lactamase (ESBL)-producing E. coli. These significant findings call for a strengthening of the antibiotic administering policy in Zambia and the development of sustainable interventions to reduce fly numbers in food markets and improve food safety and hygiene. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle A Case Study of Upper-Room UVGI in Densely-Occupied Elementary Classrooms by Real-Time Fluorescent Bioaerosol Measurements
Int. J. Environ. Res. Public Health 2017, 14(1), 51; doi:10.3390/ijerph14010051
Received: 4 October 2016 / Revised: 19 December 2016 / Accepted: 30 December 2016 / Published: 8 January 2017
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Abstract
Recently, the requirement to continuously collect bioaerosol samples using shorter response times has called for the use of real-time detection. The decreased cost of this technology makes it available for a wider application than military use, and makes it accessible to pharmaceutical and
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Recently, the requirement to continuously collect bioaerosol samples using shorter response times has called for the use of real-time detection. The decreased cost of this technology makes it available for a wider application than military use, and makes it accessible to pharmaceutical and academic research. In this case study, real-time bioaerosol monitors (RBMs) were applied in elementary school classrooms—a densely occupied environment—along with upper-room ultraviolet germicidal irradiation (UVGI) devices. The classrooms were separated into a UVGI group and a non-UVGI control group. Fluorescent bioaerosol counts (FBCs) were monitored on 20 visiting days over a four-month period. The classroom with upper-room UVGI showed significantly lower concentrations of fine size (<3 μm) and total FBCs than the control classroom during 13 of the 20 visiting days. The results of the study indicate that the upper-room UVGI could be effective in reducing FBCs in the school environment, and RBMs may be applicable in reflecting the transient conditions of the classrooms due to the dynamic activity levels of the students and teachers. Full article
(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)
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Open AccessArticle Comparison of Gastric versus Gastrointestinal PBET Extractions for Estimating Oral Bioaccessibility of Metals in House Dust
Int. J. Environ. Res. Public Health 2017, 14(1), 92; doi:10.3390/ijerph14010092
Received: 24 November 2016 / Revised: 23 December 2016 / Accepted: 13 January 2017 / Published: 18 January 2017
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Abstract
Oral bioaccessibility estimates for six metals which are prevalent as contaminants in Canada (zinc, lead, cadmium, copper, nickel, and chromium) are investigated for house dust using the simple gastric phase versus the two-phase physiologically-based extraction technique (PBET). The purpose is to determine whether
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Oral bioaccessibility estimates for six metals which are prevalent as contaminants in Canada (zinc, lead, cadmium, copper, nickel, and chromium) are investigated for house dust using the simple gastric phase versus the two-phase physiologically-based extraction technique (PBET). The purpose is to determine whether a complete gastrointestinal (GI) assay yields a more conservative (i.e., higher) estimate of metal bioaccessibility in house dust than the gastric phase alone (G-alone). The study samples include household vacuum dust collected from 33 homes in Montreal, Canada, plus four certified reference materials (NIST 2583, NIST 2584, NIST 2710 and NIST 2710a). Results indicate that percent bioaccessibilities obtained using G-alone are generally greater than or equivalent to those obtained using the complete GI simulation for the six studied metals in house dust. Median bioaccessibilities for G-alone/GI in household vacuum dust samples (n = 33) are 76.9%/19.5% for zinc, 50.4%/6.2% for lead, 70.0%/22.4% for cadmium, 33.9%/30.5% for copper and 28.5%/20.7% for nickel. Bioaccessible chromium is above the detection limit in only four out of 33 samples, for which G-alone results are not significantly different from GI results (p = 0.39). It is concluded that, for the six studied metals, a simple G-alone extraction provides a conservative and cost-effective approach for estimating oral bioaccessibility of metals in house dust. Full article
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Open AccessArticle A Brief Report: Lessons Learned and Preliminary Findings of Progreso en Salud, an HIV Risk Reduction Intervention for Latina Seasonal Farmworkers
Int. J. Environ. Res. Public Health 2017, 14(1), 32; doi:10.3390/ijerph14010032
Received: 15 September 2016 / Revised: 21 December 2016 / Accepted: 23 December 2016 / Published: 30 December 2016
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Abstract
Throughout the past decade, HIV rates in Florida—particularly South Florida, where many Latina seasonal farmworkers reside and work—have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV
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Throughout the past decade, HIV rates in Florida—particularly South Florida, where many Latina seasonal farmworkers reside and work—have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV prevention intervention Progreso en Salud (Progress in Health). Among the 114 Latina seasonal farmworker participants, there were significant increases from baseline to 6-month follow-up in the percentages of overall condom use, HIV testing, HIV/AIDS-related communications with friends, HIV knowledge, condom use self-efficacy, and correct use of condoms. Lessons learned from this study can be used to inform future HIV intervention strategies to improve the adoption and maintenance of HIV risk reduction behaviors among high-risk Latina seasonal workers and other high-risk underserved populations. Future research is needed to support our findings. Full article
(This article belongs to the Special Issue Cultural Determinants of HIV, Substance Abuse and Addiction)
Open AccessArticle The Trend of Voluntary Warnings in Electronic Nicotine Delivery System Magazine Advertisements
Int. J. Environ. Res. Public Health 2017, 14(1), 62; doi:10.3390/ijerph14010062
Received: 30 October 2016 / Revised: 27 December 2016 / Accepted: 5 January 2017 / Published: 10 January 2017
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Abstract
Some manufacturers of electronic nicotine delivery systems (ENDS) voluntarily carried health warnings in their advertisements. This study examined these voluntary warnings in magazine ads and plotted their trends between 2012 and early 2015. ENDS magazine ads were obtained through Kantar media and warnings
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Some manufacturers of electronic nicotine delivery systems (ENDS) voluntarily carried health warnings in their advertisements. This study examined these voluntary warnings in magazine ads and plotted their trends between 2012 and early 2015. ENDS magazine ads were obtained through Kantar media and warnings were collected from the Chicago Public Library or the Trinkets and Trash surveillance system. The prevalence of voluntary warnings, warnings with the specific capitalized word “WARNING”, and MarkTen warnings were examined after being weighted using factors related to exposure between January 2012 and March 2015. Five brands (MarkTen, NJOY, MISTIC, and some Blu) carried warnings during the study period. The prevalence of warnings post 2012 that contained a description of nicotine did not significantly increase until the launch of MarkTen, which also happened several months before April 2014 when the U.S. food and drug administration (FDA) published its proposed deeming rule. In addition, none of these warnings met the criteria required by the FDA in the final rules. Voluntary warnings, particularly MarkTen warnings, significantly increased in ENDS magazine ads between 2014 and 2015. It is important to monitor how ENDS manufacturers will comply with the FDA regulation related to warnings and how this regulation will ultimately impact ENDS risk perceptions and use. Full article
(This article belongs to the Special Issue E-Cigarettes: Epidemiology, Policy and Public Health)
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Open AccessArticle Effects of Ambient Fine Particles PM2.5 on Human HaCaT Cells
Int. J. Environ. Res. Public Health 2017, 14(1), 72; doi:10.3390/ijerph14010072
Received: 3 October 2016 / Revised: 23 December 2016 / Accepted: 2 January 2017 / Published: 12 January 2017
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Abstract
The current study was conducted to observe the effects of fine particulate matter (PM2.5) on human keratinocyte cell line (HaCaT) cells. The potential mechanism linking PM2.5 and skin was explored. HaCaT cells were cultured and then accessed in plate with
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The current study was conducted to observe the effects of fine particulate matter (PM2.5) on human keratinocyte cell line (HaCaT) cells. The potential mechanism linking PM2.5 and skin was explored. HaCaT cells were cultured and then accessed in plate with PM2.5. Cell viability was tested by Cell Counting Kit-8. The mRNA and protein expression of Filaggrin, Loricrin, Involucrin, and Repetin were analyzed. The levels of Granulocyte-macrophage Colony Stimulating Factor, Thymic Stromal Lymphopoietin, Tumor Necrosis Factor-α, Interleukin-1α, and Interleukin-8 were detected in the supernatant of the HaCaT cell with enzyme-linked immunosorbent assay kits. Cell viability decreased with the increase in PM2.5. Compared with the control group, the protein expression of Filaggrin, Repetin, Involucrin, and Loricrin showed different expression patterns in PM2.5 treatment groups. The level of Tumor Necrosis Factor-α, Thymic Stromal Lymphopoietin, Interleukin-1α, and Interleukin-8 significantly increased in the cells treated with PM2.5. Ambient PM2.5 may increase the risk of eczema and other skin diseases. The relative mechanism may be associated with the impairment of the skin barrier and the elevation of inflammatory responses. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Impact of The Real Cost Campaign on Adolescents’ Recall, Attitudes, and Risk Perceptions about Tobacco Use: A National Study
Int. J. Environ. Res. Public Health 2017, 14(1), 42; doi:10.3390/ijerph14010042
Received: 20 October 2016 / Accepted: 30 November 2016 / Published: 4 January 2017
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Abstract
The Food and Drug Administration’s (FDA) The Real Cost campaign advertisements (ads) have targeted U.S. youth with messages designed to prevent and reduce tobacco use. This study examined exposure to The Real Cost campaign, including ad and slogan recall, and associations with attitudes
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The Food and Drug Administration’s (FDA) The Real Cost campaign advertisements (ads) have targeted U.S. youth with messages designed to prevent and reduce tobacco use. This study examined exposure to The Real Cost campaign, including ad and slogan recall, and associations with attitudes and risk perceptions among U.S. adolescents. We analyzed data from a nationally representative sample of adolescents aged 13 to 17 years (n = 1125) surveyed by phone from October 2014 to June 2015. We assessed aided recall of and attitudes toward four campaign ads and the one slogan. Logistic regression models assessed whether aided recall of The Real Cost ads or slogan was associated with perceived likelihood of serious health consequences of cigarette smoking. Most (88%) adolescents reported seeing or hearing at least one of four ads for The Real Cost, and 54% recalled The Real Cost slogan. The majority of adolescents reported more negative attitudes toward tobacco products after seeing or hearing the ads. Recall of any The Real Cost ad was significantly associated with greater perceptions of serious health consequences of cigarette smoking (Adjusted Odd Ratios (AOR) = 5.58, 95% Confidence Interval (CI) = 1.20–25.90). The FDA’s The Real Cost campaign has achieved very high reach and is associated with more negative attitudes toward tobacco products and greater risk perceptions of cigarette smoking among U.S. adolescents. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Environmental Determinants of Bronchial Asthma among Saudi School Children in Southwestern Saudi Arabia
Int. J. Environ. Res. Public Health 2017, 14(1), 22; doi:10.3390/ijerph14010022
Received: 11 November 2016 / Revised: 21 December 2016 / Accepted: 23 December 2016 / Published: 28 December 2016
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Abstract
The aim here was to study the possible environmental and dietary determinants of asthma among school-aged children in Southwestern Saudi Arabia. In a cross-sectional study on a representative sample in Najran in Southwestern Saudi Arabia using an Arabic version of the modified ISAAC
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The aim here was to study the possible environmental and dietary determinants of asthma among school-aged children in Southwestern Saudi Arabia. In a cross-sectional study on a representative sample in Najran in Southwestern Saudi Arabia using an Arabic version of the modified ISAAC Phase III, parent-administered questionnaire data were collected. Skin prick tests (SPTs) were performed. The study included 1700 school children, out of them 468 (27.5%) were diagnosed with, cases of bronchial asthma and 20.8% (353) reported a 12-month nocturnal cough (as a proxy of severe asthma). In multivariable analysis, the study identified the following risk factors for having asthma or severe asthma: having dogs in the house, being male, being exposed to dense truck traffic on the street, using wood as a cooking fuel, conducting vigorous exercise, consuming eggs, consuming vegetables, having an allergic sensitization to dog hair, and being exposed to Cladosporium, pigweed, and Bermuda grass. On the other hand, the following food stuffs were found to be protective: seafood, fruit, and dairy products. Comprehensive school educational programs for both children and their parents should be adopted to prevent the use of wood in cooking and heating, to ensure that house pets are properly cared for, and to encourage proper dietary habits. Physicians should be informed of the patterns of allergens in order to improve asthma diagnosis and management. Full article
(This article belongs to the Section Environment Health)
Open AccessArticle Maternal Exposure to Pyrethroid Insecticides during Pregnancy and Infant Development at 18 Months of Age
Int. J. Environ. Res. Public Health 2017, 14(1), 52; doi:10.3390/ijerph14010052
Received: 22 November 2016 / Revised: 4 January 2017 / Accepted: 5 January 2017 / Published: 8 January 2017
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Abstract
The possible association between maternal exposure to pyrethroid insecticides (PYRs) during pregnancy and infant development was explored. Levels of exposure to PYRs was assessed by metabolite (3-phenoybenzoic acid, 3-PBA) concentration in maternal spot urine sampled in the first trimester of index pregnancy, and
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The possible association between maternal exposure to pyrethroid insecticides (PYRs) during pregnancy and infant development was explored. Levels of exposure to PYRs was assessed by metabolite (3-phenoybenzoic acid, 3-PBA) concentration in maternal spot urine sampled in the first trimester of index pregnancy, and infant development was assessed at 18 months of age using the Kinder Infants Development Scale (KIDS), which is based on a questionnaire to the caretaker. The relationship between KIDS score and maternal urinary 3-PBA levels was examined by a stepwise multiple regression analysis using biological attributes of the mother and infant, breast feeding, and nursing environment as covariates. The analysis extracted 3-PBA and the nursing environment as significant to explain the KIDS score at 18 months of age with positive partial regression coefficients. Inclusion of fish consumption frequency of the mother during pregnancy as an independent variable resulted in the selection of fish consumption as significant, while the two variables were marginally insignificant but still with a positive coefficient with the KIDS score. The result suggested a positive effect of maternal PYR exposure on infant development, the reason for which is not clear, but an unknown confounding factor is suspected. Full article
(This article belongs to the Special Issue Ecological and Human-Health Effects of Pesticides in the Environment)
Open AccessArticle Indoor Temperatures in Patient Waiting Rooms in Eight Rural Primary Health Care Centers in Northern South Africa and the Related Potential Risks to Human Health and Wellbeing
Int. J. Environ. Res. Public Health 2017, 14(1), 43; doi:10.3390/ijerph14010043
Received: 20 October 2016 / Revised: 19 December 2016 / Accepted: 27 December 2016 / Published: 6 January 2017
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Abstract
Increased temperatures affect human health and vulnerable groups including infants, children, the elderly and people with pre-existing diseases. In the southern African region climate models predict increases in ambient temperature twice that of the global average temperature increase. Poor ventilation and lack of
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Increased temperatures affect human health and vulnerable groups including infants, children, the elderly and people with pre-existing diseases. In the southern African region climate models predict increases in ambient temperature twice that of the global average temperature increase. Poor ventilation and lack of air conditioning in primary health care clinics, where duration of waiting time may be as long as several hours, pose a possible threat to patients seeking primary health care. Drawing on information measured by temperature loggers installed in eight clinics in Giyani, Limpopo Province of South Africa, we were able to determine indoor temperatures of waiting rooms in eight rural primary health care facilities. Mean monthly temperature measurements inside the clinics were warmer during the summer months of December, January and February, and cooler during the autumn months of March, April and May. The highest mean monthly temperature of 31.4 ± 2.7 °C was recorded in one clinic during February 2016. Maximum daily indoor clinic temperatures exceeded 38 °C in some clinics. Indoor temperatures were compared to ambient (outdoor) temperatures and the mean difference between the two showed clinic waiting room temperatures were higher by 2–4 °C on average. Apparent temperature (AT) incorporating relative humidity readings made in the clinics showed ‘realfeel’ temperatures were >4 °C higher than measured indoor temperature, suggesting a feeling of ‘stuffiness’ and discomfort may have been experienced in the waiting room areas. During typical clinic operational hours of 8h00 to 16h00, mean ATs fell into temperature ranges associated with heat–health impact warning categories of ‘caution’ and ‘extreme caution’. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Changing Diet Quality in China during 2004–2011
Int. J. Environ. Res. Public Health 2017, 14(1), 13; doi:10.3390/ijerph14010013
Received: 18 September 2016 / Revised: 2 December 2016 / Accepted: 20 December 2016 / Published: 24 December 2016
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Abstract
Currently, under- and over-nutrition problems co-exist in China. However, systematic studies on the diet quality of Chinese residents have been scant. This study described the trend in diet quality of Chinese residents over a recent eight-year period and investigated the relevant influential factors.
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Currently, under- and over-nutrition problems co-exist in China. However, systematic studies on the diet quality of Chinese residents have been scant. This study described the trend in diet quality of Chinese residents over a recent eight-year period and investigated the relevant influential factors. The data of Chinese adults aged 20–59 years was extracted from 2004, 2006, 2009, and 2011 China Health and Nutrition Survey. The China diet quality index (DQI) was employed to assess the diet quality of Chinese adults. The dietary consumption data of each individual was collected using a 24-h dietary recall and weighed food records implemented for three consecutive days. A mixed ordinary least squares regression model was applied to analyze the factors influencing the DQI scores of Chinese residents. Results showed that the diet quality of Chinese residents increased from 2004 to 2006, followed by a decrease in 2009 and 2011. The income, urbanicity index, and southern dummy were positively associated with DQI scores, whereas the size of household and labor intensity were negative predictors of DQI scores. The DQI scores also varied over BMI values. With an increase of the average income level in the future, the diet quality of Chinese residents is estimated to further improve. Moreover, urbanization could also contribute to reaching a more balanced diet. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Association of School Environment and After-School Physical Activity with Health-Related Physical Fitness among Junior High School Students in Taiwan
Int. J. Environ. Res. Public Health 2017, 14(1), 83; doi:10.3390/ijerph14010083
Received: 11 August 2016 / Revised: 10 January 2017 / Accepted: 11 January 2017 / Published: 15 January 2017
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Abstract
The relationship between students’ school environment and exercise habits is complex, and is affected by numerous factors. However, the few studies that have been conducted on this relationship have reported inconsistent results, especially regarding Taiwanese students. We conducted this cross-sectional study to investigate
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The relationship between students’ school environment and exercise habits is complex, and is affected by numerous factors. However, the few studies that have been conducted on this relationship have reported inconsistent results, especially regarding Taiwanese students. We conducted this cross-sectional study to investigate the association of school environment and after-school physical activity with health-related physical fitness in Taiwanese adolescents. Data were drawn from a national survey conducted by the Ministry of Education in Taiwan in 2008 of health-related physical fitness measurements among junior high school students (649,442 total) in grades seven to nine.School environment (level of urbanization, school size, presence of sports field or gymnasium) and after-school physical activity were assessed for their association with adolescents’ physical fitness measurements (body mass index (BMI), bent-leg sit-ups, 800-/1600-m run, sit-and-reach, standing long jump). Urban boys and girls perform significantly better in muscle strength and endurance, cardiorespiratory endurance, flexibility, and explosive power; girls from rural areas exhibited significantly worse scores in body composition. Boys from large-size schools performed the worst in cardiorespiratory endurance, flexibility, and explosive power; whereas girls from large-size schools performed the worst in muscle strength, muscle endurance, and explosive power, but had the best score for body composition. However, the differences in body composition of boys from large-, medium-, and small- size schools did not reach a statistically significant level. Adolescents of both genders in schools with a sports field or gymnasium exhibited significantly better in muscle strength and endurance, cardiorespiratory endurance, and explosive power. Boys in schools with a sports field or gymnasium had significantly better body composition; girls in schools with sports field or gymnasium differed significantly in flexibility. Adolescents of both genders who participated in physical activity after school had significantly better body composition, cardiorespiratory endurance, and flexibility. Boys who participated in physical activity after school significantly differed in explosive power, whereas girls who participated in physical activity after school exhibited significantly better flexibility. Thus, the current study demonstrated that some factors, including urbanization (school location in rural or urban areas), school size, school facility provision (school with or without sports fields or gymnasiums), and after-school physical activity participation are more important than others in shaping adolescents’ physical fitness in Taiwan; meanwhile, these association patterns differed by gender. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Epidemiologic Features of Enterovirus 71-Associated Hand-Foot-and-Mouth Disease from 2009 to 2013 in Zhejiang, China
Int. J. Environ. Res. Public Health 2017, 14(1), 33; doi:10.3390/ijerph14010033
Received: 10 November 2016 / Revised: 20 December 2016 / Accepted: 25 December 2016 / Published: 30 December 2016
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Abstract
Enterovirus 71 (EV71) usually causes hand-foot-and-mouth disease (HFMD) with severe clinical symptoms and even deaths in China. There is no efficient antiviral drug to protect against severe EV71-associated HFMD, making the development of EV71 vaccines therefore a priority. However, the potential target subject
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Enterovirus 71 (EV71) usually causes hand-foot-and-mouth disease (HFMD) with severe clinical symptoms and even deaths in China. There is no efficient antiviral drug to protect against severe EV71-associated HFMD, making the development of EV71 vaccines therefore a priority. However, the potential target subject population(s) to be immunized with EV71 vaccine are not well understood. In this study, we characterized the epidemiology regarding EV71-associated HFMD on the basis of provincial-level surveillance. We extracted data on EV71-associated HFMD from the National Notifiable Disease Reporting System in Zhejiang Province, China between 1 January 2009 and 31 December 2013 (n = 7650). The higher incidence rate of EV71 cases occurred in those children aged 12–23 months, with boys being predominant. Interestingly, different peaks activities of EV71 infection was observed in different calendar year, with one peak in 2009 and 2013 and two peaks in 2010–2012. However, EV71 infection seemed to predominately occur in warm season and a distinguished cyclic peak that seemed to be of about 12 months. Children aged 12–23 months are thus identified as an important target population for public health intervention, for example, it is recommended that these key subjects immunized with EV71 vaccine. In addition, an enhanced surveillance system for EV71-associated with HFMD needs to focus on generic and phylogenetic analysis. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Impact of Dental Fluorosis, Socioeconomic Status and Self-Perception in Adolescents Exposed to a High Level of Fluoride in Water
Int. J. Environ. Res. Public Health 2017, 14(1), 73; doi:10.3390/ijerph14010073
Received: 20 September 2016 / Revised: 16 December 2016 / Accepted: 19 December 2016 / Published: 12 January 2017
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Abstract
Objective: To identify adolescents’ self-perception of dental fluorosis from two areas with different socioeconomic levels. Methods: A cross-sectional, descriptive study was conducted with 15-year-old youths by applying a questionnaire designed and validated to assess self-perceptions of dental fluorosis in two areas
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Objective: To identify adolescents’ self-perception of dental fluorosis from two areas with different socioeconomic levels. Methods: A cross-sectional, descriptive study was conducted with 15-year-old youths by applying a questionnaire designed and validated to assess self-perceptions of dental fluorosis in two areas with different socioeconomic statuses (SESs). Fluorosis was clinically evaluated by applying the Thylstrup and Fejerkov (TF) index on the upper front teeth. Results: A total of 308 adolescents were included in the study. The medium-SES population, which was exposed to 2.5 ppm of fluoride in water, and the low-SES population, which was exposed to 5.1 ppm, presented the following levels of dental fluorosis: TF 2–3 (50%), TF 4–5 (45.6%) and TF 6–7 (4.4%) for medium SES and TF 2–3 (12.3%), TF 4–5 (67.1%) and TF 67 (20.6%) for low SES. A significant association was found between self-perception and dental fluorosis in those with medium and low SESs (p < 0.05). The multiple regression model found differences between TF levels and self-perception, with a 6–7 TF level for concerns about color (OR = 1.6), smile (OR = 1.2) and appearance (OR = 3.36). Conclusions: Self-perceptions of dental fluorosis affect adolescents such that adolescents with a medium SES have more negative perceptions than those with a low SES. Such perceptions increase as the TF index increases. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Developmental Neurotoxicity of Methamidophos in the Embryo-Larval Stages of Zebrafish
Int. J. Environ. Res. Public Health 2017, 14(1), 23; doi:10.3390/ijerph14010023
Received: 8 November 2016 / Revised: 20 December 2016 / Accepted: 26 December 2016 / Published: 28 December 2016
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Abstract
Methamidophos is a representative organophosphate insecticide. The knowledge of its developmental neurotoxicity is limited, especially for zebrafish in the early stages of their life. Four hour post-fertilization (hpf) zebrafish embryos were exposed to several environmentally relevant concentrations of methamidophos (0, 25, and 500
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Methamidophos is a representative organophosphate insecticide. The knowledge of its developmental neurotoxicity is limited, especially for zebrafish in the early stages of their life. Four hour post-fertilization (hpf) zebrafish embryos were exposed to several environmentally relevant concentrations of methamidophos (0, 25, and 500 μg/L) for up to 72 hpf. Locomotor behavior was then studied in the zebrafish larvae at this timepoint. Acridine orange (AO) staining was carried out in the zebrafish larvae, and the mRNA levels of genes associated with neural development (mbp and syn2a) were analyzed by reverse transcription-polymerase chain reaction (RT-PCR). The number of escape responders for mechanical stimulation was significantly decreased in exposed groups. AO staining showed noticeable signs of apoptosis mainly in the brain. In addition, the mRNA levels of mbp and syn2a were both significantly down-regulated in exposed groups. Our study provides the first evidence that methamidophos exposure can cause developmental neurotoxicity in the early stages of zebrafish life, which may be caused by the effect of methamidophos on neurodevelopmental genes and the activation of cell apoptosis in the brain. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Meta-Prediction of the Effect of Methylenetetrahydrofolate Reductase Polymorphisms and Air Pollution on Alzheimer’s Disease Risk
Int. J. Environ. Res. Public Health 2017, 14(1), 63; doi:10.3390/ijerph14010063
Received: 15 November 2016 / Revised: 28 December 2016 / Accepted: 5 January 2017 / Published: 11 January 2017
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Abstract
Background: Alzheimer’s disease (AD) is a significant public health issue. AD has been linked with methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, but the findings have been inconsistent. The purpose of this meta-predictive analysis is to examine the associations between MTHFR polymorphisms
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Background: Alzheimer’s disease (AD) is a significant public health issue. AD has been linked with methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, but the findings have been inconsistent. The purpose of this meta-predictive analysis is to examine the associations between MTHFR polymorphisms and epigenetic factors, including air pollution, with AD risk using big data analytics approaches. Methods and Results: Forty-three studies (44 groups) were identified by searching various databases. MTHFR C677T TT and CT genotypes had significant associations with AD risk in all racial populations (RR = 1.13, p = 0.0047; and RR = 1.12, p < 0.0001 respectively). Meta-predictive analysis showed significant increases of percentages of MTHFR C677T polymorphism with increased air pollution levels in both AD case group and control group (p = 0.0021–0.0457); with higher percentages of TT and CT genotypes in the AD case group than that in the control group with increased air pollution levels. Conclusions: The impact of MTHFR C677T polymorphism on susceptibility to AD was modified by level of air pollution. Future studies are needed to further examine the effects of gene-environment interactions including air pollution on AD risk for world populations. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Transparency of Mandatory Information Disclosure and Concerns of Health Services Providers and Consumers
Int. J. Environ. Res. Public Health 2017, 14(1), 53; doi:10.3390/ijerph14010053
Received: 3 July 2016 / Revised: 23 December 2016 / Accepted: 3 January 2017 / Published: 9 January 2017
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Abstract
Background: This study analyzed differences between transparency of information disclosure and related demands from the health service consumer’s perspective. It also compared how health service providers and consumers are associated by different levels of mandatory information disclosure. Methods: We obtained our research data
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Background: This study analyzed differences between transparency of information disclosure and related demands from the health service consumer’s perspective. It also compared how health service providers and consumers are associated by different levels of mandatory information disclosure. Methods: We obtained our research data using a questionnaire survey (health services providers, n = 201; health service consumers, n = 384). Results: Health service consumers do not have major concerns regarding mandatory information disclosure. However, they are concerned about complaint channels and settlement results, results of patient satisfaction surveys, and disclosure of hospital financial statements (p < 0.001). We identified significant differences in health service providers’ and consumers’ awareness regarding the transparency of information disclosure (p < 0.001). Conclusions: It may not be possible for outsiders to properly interpret the information provided by hospitals. Thus, when a hospital discloses information, it is necessary for the government to consider the information’s applicability. Toward improving medical expertise and information asymmetry, the government has to reduce the burden among health service consumers in dealing with this information, and it has to use the information effectively. Full article
(This article belongs to the Special Issue Health Informatics and Public Health)
Open AccessArticle The Basic Act for Suicide Prevention: Effects on Longitudinal Trend in Deliberate Self-Harm with Reference to National Suicide Data for 1996–2014
Int. J. Environ. Res. Public Health 2017, 14(1), 104; doi:10.3390/ijerph14010104
Received: 11 August 2016 / Revised: 27 December 2016 / Accepted: 17 January 2017 / Published: 21 January 2017
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Abstract
A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals
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A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals close to patients. The national suicide rate has decreased gradually since 2008; however, national information regarding the number of patients who had engaged in deliberate self-harm was absent. Therefore, the present study examined the longitudinal trend in hospital admissions due to deliberate self-harm in Japan. Data from the National Patient Survey between 1996 and 2014—a nationally representative cross-sectional survey of inpatient care every 3 years—were used. Data for 13,014 patients were included in the estimation of the number of hospital admissions due to deliberate self-harm. The results show that the estimated number of admissions due to deliberate self-harm increased from 2078 in September 1996 to 3189 in September 2008, when the national number of suicide cases peaked, and decreased to 1783 in 2014. Approximately half of the patients were admitted to hospital because of self-harm via means other than drug poisoning, which had a high mortality rate (5.6%). The proportion of patients receiving public assistance was higher in those who had engaged in deliberate self-harm (8.5%) relative to that observed in the general population. Overall, the trend in deliberate self-harm was synchronous with the number of suicide cases over time. As economic poverty has been associated with suicidal ideation and behavior and some recipients of public assistance tend to abuse psychotropic medication, the public assistance program should provide mental health support for recipients of social benefit schemes. Full article
(This article belongs to the Special Issue From Understanding Suicide Risk to Preventing Suicide)
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Open AccessArticle Assessment of a Culturally-Tailored Sexual Health Education Program for African American Youth
Int. J. Environ. Res. Public Health 2017, 14(1), 14; doi:10.3390/ijerph14010014
Received: 30 September 2016 / Revised: 16 December 2016 / Accepted: 19 December 2016 / Published: 24 December 2016
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Abstract
African American youth are affected disproportionately by sexually transmitted infections (STIs), human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), and teenage pregnancy when compared to other racial groups. This paper evaluates the effectiveness of the To Help Young People Establish (2 HYPE) Abstinence
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African American youth are affected disproportionately by sexually transmitted infections (STIs), human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), and teenage pregnancy when compared to other racial groups. This paper evaluates the effectiveness of the To Help Young People Establish (2 HYPE) Abstinence Club, a behavioral intervention designed to promote delayed sexual activity among African American youth ages 12–18 in Atlanta, Georgia. The intervention included 20 h of curriculum and creative arts instruction. Pre- and post-intervention survey data collected from 2008–2010 were analyzed to determine the effectiveness of the intervention. Intervention (n = 651) and comparison (n = 112) groups were compared through analysis of variance and multivariate logistic regression models. There was a statistically significant increase in intervention youth who were thinking about being abstinent (p = 0.0005). Those who had not been engaged in sexual activity were two times more likely to plan abstinence compared to participants that had been previously sexually active previously (odds ratio 2.41; 95% confidence interval 1.62, 3.60). Significant results hold implications for subsequent community-based participatory research and practice that broadens the understanding of the relevance of marriage, as just one among other life success milestones that may hold more importance to African American youth in positioning the value of delayed and responsible sexual activity towards effective STIs, HIV/AIDS, and teen pregnancy risk reduction interventions. Full article
(This article belongs to the Special Issue Cultural Determinants of HIV, Substance Abuse and Addiction)
Open AccessArticle Gold Mining in Ecuador: A Cross-Sectional Assessment of Mercury in Urine and Medical Symptoms in Miners from Portovelo/Zaruma
Int. J. Environ. Res. Public Health 2017, 14(1), 34; doi:10.3390/ijerph14010034
Received: 30 October 2016 / Revised: 13 December 2016 / Accepted: 21 December 2016 / Published: 30 December 2016
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Abstract
Mercury is a toxic metal and is used in small scale gold mining. In Portovelo, Ecuador, mercury has been an environmental and health problem for decades. The target of this study was to assess the mercury concentration in the urine of miners from
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Mercury is a toxic metal and is used in small scale gold mining. In Portovelo, Ecuador, mercury has been an environmental and health problem for decades. The target of this study was to assess the mercury concentration in the urine of miners from Portovelo/Zaruma to establish a prevalence of high values. Eight hundred and sixty-five (865) urine samples were collected and analysed for their mercury content, using cold vapor atom absorption spectroscopy. The prevalence of high mercury values (>25 μg/L) was estimated. Forty-four (44) miners with mercury levels >15 μg/L filled in a questionnaire for characteristics and possible confounders, and were examined for intoxication symptoms to establish the ten points medical score sum. The median urine value was 1.8 μg/L; 78.3% of miners were below 7 μg/L and were not at risk of an intoxication, whereas 5.9% of miners exceeded the limit of 25 μg/L and were probable to experience intoxication symptoms. The medical score sum had a range of 2 to 8 points with a median of 6. The low prevalence of high mercury concentrations shows that the politics and techniques to eliminate the use of mercury are being successfully implemented. Further studies are needed to identify factors enabling this process. Full article
(This article belongs to the Special Issue Mercury and Health: Current Perspectives and Future Directions)
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Open AccessArticle Effects of Long-Term In Vivo Exposure to Di-2-Ethylhexylphthalate on Thyroid Hormones and the TSH/TSHR Signaling Pathways in Wistar Rats
Int. J. Environ. Res. Public Health 2017, 14(1), 44; doi:10.3390/ijerph14010044
Received: 18 October 2016 / Revised: 27 December 2016 / Accepted: 28 December 2016 / Published: 4 January 2017
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Abstract
Di-(2-ethylhexyl)phthalate (DEHP) was a widely used chemical with human toxicity. Recent in vivo and in vitro studies suggested that DEHP-exposure may be associated with altered serum thyroid hormones (THs) levels, but the underlying molecular mechanisms were largely unknown. To explore the possible molecular
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Di-(2-ethylhexyl)phthalate (DEHP) was a widely used chemical with human toxicity. Recent in vivo and in vitro studies suggested that DEHP-exposure may be associated with altered serum thyroid hormones (THs) levels, but the underlying molecular mechanisms were largely unknown. To explore the possible molecular mechanisms, 128 Wistar rats were dosed with DEHP by gavage at 0, 150, 300, and 600 mg/kg/day for 3 months (M) and 6 M, respectively. After exposure, expression of genes and proteins in the thyroid, pituitary, and hypothalamus tissues of rats were analyzed by Q-PCR and western blot, while the sera and urine samples were assayed by radioimmunoassay and ELISA. Results showed that serum THs levels were suppressed by DEHP on the whole. DEHP treatment influenced the levels of rats’ thyrotropin releasing hormone receptor (TRHr), Deiodinases 1 (D1), thyroid stimulating hormone beta (TSHβ), sodium iodide symporter (NIS), thyroid stimulating hormone receptor (TSHr), thyroperoxidase (TPO), thyroid transcription factor 1 (TTF-1), and thyroglobulin (TG) mRNA/protein expression in the hypothalamus-pituitary-thyroid (HPT) axis and decreased urine iodine. Taken together, observed findings indicate that DEHP could reduce thyroid hormones via disturbing the HPT axis, and the activated TSH/TSHR pathway is required to regulate thyroid function via altering TRHr, TSHβ, NIS, TSHr, TPO, TTF-1 and TG mRNA/protein expression of the HPT axis. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Lipoprotein Lipase (LPL) Polymorphism and the Risk of Coronary Artery Disease: A Meta-Analysis
Int. J. Environ. Res. Public Health 2017, 14(1), 84; doi:10.3390/ijerph14010084
Received: 19 November 2016 / Revised: 30 December 2016 / Accepted: 3 January 2017 / Published: 16 January 2017
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Abstract
Background: In recent years, the lipoprotein lipase (LPL) polymorphism has been extensively investigated as a potential risk factor for coronary artery disease (CAD). However, the results of these studies have been inconsistent. Therefore, we performed this meta-analysis to explore the association between LPL
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Background: In recent years, the lipoprotein lipase (LPL) polymorphism has been extensively investigated as a potential risk factor for coronary artery disease (CAD). However, the results of these studies have been inconsistent. Therefore, we performed this meta-analysis to explore the association between LPL polymorphism and CAD risk. Methods: The literature was searched from electronic databases such as Embase, China Biological Medicine Database, PubMed, Knowledge Infrastructure, and China National Web of Science by the key words “coronary artery disease”, “lipoprotein lipase” and “polymorphism”. All of the studies included in this manuscript met the inclusion and exclusion criteria. An odds ratio (OR) analysis using a 95% confidence interval (CI) was employed to assess the association of the LPL polymorphism with CAD susceptibility. Results: We performed a meta-analysis of 14 case-control studies including HindIII, Ser447X and PvuII polymorphism. A statistically significant increase in the risk of CAD was associated with LPL HindIII polymorphism. This included HindIII H+H+ genotype (OR = 1.28, 95% CI = 1.09–1.49, p = 0.002, I2 = 43%) and H+ allele genotype (OR = 1.27, 95% CI = 1.03–1.58, p = 0.03, I2 = 67%). Ser447X XX genotype (OR = 2.37, 95% CI = 1.33–4.24, p = 0.004, I2 = 53%) was also associated with CAD risk. However, PvuII polymorphism was found to have no significant association with CAD risk. Conclusions: LPL HindIII polymorphism was significantly associated with the risk of CAD. For Ser447X polymorphism, it was found that only XX genotype was significantly associated with CAD risk. Furthermore, PvuII polymorphism had no significant association with CAD risk. It was considered that LPL HindIII polymorphism might serve as a potential biomarker for CAD risk. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Connecting the Dots: Linking Environmental Justice Indicators to Daily Dose Model Estimates
Int. J. Environ. Res. Public Health 2017, 14(1), 24; doi:10.3390/ijerph14010024
Received: 30 September 2016 / Revised: 21 December 2016 / Accepted: 21 December 2016 / Published: 28 December 2016
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Abstract
Many different quantitative techniques have been developed to either assess Environmental Justice (EJ) issues or estimate exposure and dose for risk assessment. However, very few approaches have been applied to link EJ factors to exposure dose estimate and identify potential impacts of EJ
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Many different quantitative techniques have been developed to either assess Environmental Justice (EJ) issues or estimate exposure and dose for risk assessment. However, very few approaches have been applied to link EJ factors to exposure dose estimate and identify potential impacts of EJ factors on dose-related variables. The purpose of this study is to identify quantitative approaches that incorporate conventional risk assessment (RA) dose modeling and cumulative risk assessment (CRA) considerations of disproportionate environmental exposure. We apply the Average Daily Dose (ADD) model, which has been commonly used in RA, to better understand impacts of EJ indicators upon exposure dose estimates and dose-related variables, termed the Environmental-Justice-Average-Daily-Dose (EJ-ADD) approach. On the U.S. nationwide census tract-level, we defined and quantified two EJ indicators (poverty and race/ethnicity) using an EJ scoring method to examine their relation to census tract-level multi-chemical exposure dose estimates. Pollutant doses for each tract were calculated using the ADD model, and EJ scores were assigned to each tract based on poverty- or race-related population percentages. Single- and multiple-chemical ADD values were matched to the tract-level EJ scores to analyze disproportionate dose relationships and contributing EJ factors. We found that when both EJ indicators were examined simultaneously, ADD for all pollutants generally increased with larger EJ scores. To demonstrate the utility of using EJ-ADD on the local scale, we approximated ADD levels of lead via soil/dust ingestion for simulated communities with different EJ-related scenarios. The local-level simulation indicates a substantial difference in exposure-dose levels between wealthy and EJ communities. The application of the EJ-ADD approach can link EJ factors to exposure dose estimate and identify potential EJ impacts on dose-related variables. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Socio-Environmental and Hematological Profile of Landfill Residents (São Jorge Landfill–Sao Paulo, Brazil)
Int. J. Environ. Res. Public Health 2017, 14(1), 64; doi:10.3390/ijerph14010064
Received: 27 September 2016 / Revised: 29 December 2016 / Accepted: 31 December 2016 / Published: 11 January 2017
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Abstract
We are experiencing an unprecedented urbanization process that, alongside physical, social and economic developments, has been having a significant impact on a population’s health. Due to the increase in pollution, violence and poverty, our modern cities no longer ensure a good quality of
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We are experiencing an unprecedented urbanization process that, alongside physical, social and economic developments, has been having a significant impact on a population’s health. Due to the increase in pollution, violence and poverty, our modern cities no longer ensure a good quality of life so they become unhealthy environments. This study aims to assess the effect of social, environmental and economic factors on the hematologic profile of residents of Santo André’s landfill. In particular, we will assess the effect of social, economic, and environmental factors on current and potential disease markers obtained from hematological tests. The research method is the observational type, from a retrospective cohort, and by convenience sampling in Santo André in the Greater ABC (municipalities of Santo André, São Bernardo do Campo and São Caetano do Sul, southeast part of the Greater São Paulo Metropolitan Area, Brazil). The study determined a socio-environmental profile and the hematologic diseases screening related to a close location to the landfill. The disease manifests itself within a broad spectrum of symptoms that causes changes in blood count parameters. The objective of this work is to show that there is an association between social, environmental and economic factors and a variety of serious disease outcomes that may be detected from blood screening. A causal study of the effect of living near the landfill on these disease outcomes would be a very expensive and time-consuming study. This work we believe is sufficient for public health officials to consider policy and attempt remediation of the effects of living near a landfill. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Maternal and Child Health of Internally Displaced Persons in Ukraine: A Qualitative Study
Int. J. Environ. Res. Public Health 2017, 14(1), 54; doi:10.3390/ijerph14010054
Received: 14 November 2016 / Revised: 30 December 2016 / Accepted: 3 January 2017 / Published: 9 January 2017
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Abstract
Due to the conflict that started in spring 2014 in Eastern Ukraine, a total of 1.75 million internally displaced persons (IDPs) fled the area and have been registered in government-controlled areas of the country. This paper explores perceived health, barriers to access to
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Due to the conflict that started in spring 2014 in Eastern Ukraine, a total of 1.75 million internally displaced persons (IDPs) fled the area and have been registered in government-controlled areas of the country. This paper explores perceived health, barriers to access to healthcare, caring practices, food security, and overall financial situation of mothers and young children displaced by the conflict in Ukraine. This is a qualitative study, which collected data through semi-structured in-depth interviews with nine IDP mothers via Skype and Viber with a convenience sample of participants selected through snowball technique. Contrary to the expectations, the perceived physical health of mothers and their children was found not to be affected by conflict and displacement, while psychological distress was often reported. A weak healthcare system, Ukraine’s proneness to informal payments, and heavy bureaucracy to register as an IDP were reported in our study. A precarious social safety net to IDP mothers in Ukraine, poor dietary diversity, and a generalized rupture of vaccine stocks, with halted or delayed vaccinations in children were identified. Increasing social allowances and their timely delivery to IDP mothers might be the most efficient policy measure to improve health and nutrition security. Reestablishment and sustainability of vaccine stocks in Ukraine is urgent to avoid the risks of a public health crisis. Offering psychological support for IDP mothers is recommended. Full article
(This article belongs to the Special Issue Refugee Health)
Open AccessArticle Phytoplankton Diversity Effects on Community Biomass and Stability along Nutrient Gradients in a Eutrophic Lake
Int. J. Environ. Res. Public Health 2017, 14(1), 95; doi:10.3390/ijerph14010095
Received: 5 October 2016 / Revised: 25 December 2016 / Accepted: 28 December 2016 / Published: 20 January 2017
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Abstract
The relationship between biodiversity and ecosystem functioning is a central issue in ecology, but how this relationship is affected by nutrient stress is still unknown. In this study, we analyzed the phytoplankton diversity effects on community biomass and stability along nutrient gradients in
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The relationship between biodiversity and ecosystem functioning is a central issue in ecology, but how this relationship is affected by nutrient stress is still unknown. In this study, we analyzed the phytoplankton diversity effects on community biomass and stability along nutrient gradients in an artificial eutrophic lake. Four nutrient gradients, varying from slightly eutrophic to highly eutrophic states, were designed by adjusting the amount of polluted water that flowed into the lake. Mean phytoplankton biomass, species richness, and Shannon diversity index all showed significant differences among the four nutrient gradients. Phytoplankton community biomass was correlated with diversity (both species richness and Shannon diversity index), varying from positive to negative along the nutrient gradients. The influence of phytoplankton species richness on resource use efficiency (RUE) also changed from positive to negative along the nutrient gradients. However, the influence of phytoplankton Shannon diversity on RUE was not significant. Both phytoplankton species richness and Shannon diversity had a negative influence on community turnover (measured as community dissimilarity), i.e., a positive diversity–stability relationship. Furthermore, phytoplankton spatial stability decreased along the nutrient gradients in the lake. With increasing nutrient concentrations, the variability (standard deviation) of phytoplankton community biomass increased more rapidly than the average total biomass. Results in this study will be helpful in understanding the phytoplankton diversity effects on ecosystem functioning and how these effects are influenced by nutrient conditions in aquatic ecosystems. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Distribution Characteristics and Risk Assessment of Polycyclic Aromatic Hydrocarbons in the Momoge Wetland, China
Int. J. Environ. Res. Public Health 2017, 14(1), 85; doi:10.3390/ijerph14010085
Received: 17 November 2016 / Revised: 10 January 2017 / Accepted: 12 January 2017 / Published: 18 January 2017
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Abstract
The Momoge Nature Reserve is the research object of this study. Through field sampling, laboratory experiments and analysis, the contents, distribution characteristics, source identification, pollution levels and risk levels of polycyclic aromatic hydrocarbons (PAHs) in wetland soils were studied. The results show that
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The Momoge Nature Reserve is the research object of this study. Through field sampling, laboratory experiments and analysis, the contents, distribution characteristics, source identification, pollution levels and risk levels of polycyclic aromatic hydrocarbons (PAHs) in wetland soils were studied. The results show that the sum content of 16 types of PAHs (Σ16 PAH) in the wetland soil was within the range (0.029–0.4152) mg/kg. PAHs in wetland soil are primarily 2–3-rings PAHs. PAHs in the Momoge wetland soil have multiple sources: petroleum, combustion of petroleum and coal, and others, of which petroleum and the sum of combustion of petroleum and coal account for 38.0% and 59.3%, respectively. Research, using the standard index and pollution range methods, shows that the content of the PAH labelled Nap, found in the Momoge wetland soil, is excessive; some sampling sites exhibit a low level of pollution. The result of a biotoxicity assessment shows that there are two sampling sites that occasionally present an ecological toxicity hazard. The result of the organic carbon normalization process shows that an ecological risk exists only at sampling site No. 10. Full article
(This article belongs to the Special Issue Environmental Pollution and Human Health Risk)
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Open AccessArticle Active Use of Parks in Flanders (Belgium): An Exploratory Observational Study
Int. J. Environ. Res. Public Health 2017, 14(1), 35; doi:10.3390/ijerph14010035
Received: 25 October 2016 / Revised: 19 December 2016 / Accepted: 26 December 2016 / Published: 30 December 2016
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Abstract
Parks have the potential to increase physical activity at the community level by providing opportunities to be active. In order to inform interventions to promote physical activity in parks, insight is needed concerning park user characteristics, the activity level of park users, the
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Parks have the potential to increase physical activity at the community level by providing opportunities to be active. In order to inform interventions to promote physical activity in parks, insight is needed concerning park user characteristics, the activity level of park users, the types of activities performed and associations between park areas and temporal variables with observed physical activity levels. Park user characteristics (sex, age, ethnicity and activity level) were recorded within pre-defined park areas in two parks in Ghent (Belgium) using the System for Observing Play and Recreation in Communities (SOPARC). Most park users were male, adult, and engaged in vigorous-intensity physical activity (48%). Most popular activities were biking (38%), sitting (23%) and walking (15%); accordingly, trails were used most and had the highest levels of physical activity compared to other park areas. Parks were used least frequently in the morning, during the weekend and by seniors. Therefore, active park use during morning periods, on weekend days and by seniors should be promoted and urban planners should consider that different park areas can possibly elicit varying activity levels among park users. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts
Int. J. Environ. Res. Public Health 2017, 14(1), 75; doi:10.3390/ijerph14010075
Received: 6 December 2016 / Revised: 4 January 2017 / Accepted: 10 January 2017 / Published: 12 January 2017
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Abstract
This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts
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This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries. Full article
(This article belongs to the Special Issue Alcohol and Health)
Open AccessArticle Gendered Sources of Distress and Resilience among Afghan Refugees in Northern California: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2017, 14(1), 25; doi:10.3390/ijerph14010025
Received: 25 October 2016 / Revised: 21 December 2016 / Accepted: 23 December 2016 / Published: 28 December 2016
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Abstract
Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in
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Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in knowledge by investigating how gender moderates and mediates the influence of several sources of distress and resilience among 259 Afghan refugees residing in Northern California (USA). Gender moderated the effects of four factors on levels of distress. Intimate and extended family ties have little correlation with men’s distress levels, but are strongly associated with lower distress for women. English ability is positively associated with lower distress for women, but not men. In terms of gender ideology, traditionally oriented women and egalitarian men have lower levels of distress. And experiencing greater dissonant acculturation increases distress for men, but not women. The influence of gender interaction terms is substantial and patterns may reflect difficulty adapting to a different gender order. Future studies of similar populations should investigate gender differences in sources of distress and resilience, and efforts to assist new arrivals might inform them of changes in gender roles they may experience, and facilitate opportunities to renegotiate gender roles. Full article
(This article belongs to the Special Issue Refugee Health)
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Open AccessArticle A Survey of Snakebite Knowledge among Field Forces in China
Int. J. Environ. Res. Public Health 2017, 14(1), 15; doi:10.3390/ijerph14010015
Received: 5 September 2016 / Revised: 22 November 2016 / Accepted: 20 December 2016 / Published: 26 December 2016
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Abstract
Background: A snakebite is a neglected extrinsic injury associated with high morbidity and global mortality. Members of Chinese field forces are at high risk of snakebites, and their perception and knowledge of snakebites are unknown. The aim of this study is to assess
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Background: A snakebite is a neglected extrinsic injury associated with high morbidity and global mortality. Members of Chinese field forces are at high risk of snakebites, and their perception and knowledge of snakebites are unknown. The aim of this study is to assess perception and knowledge of snakebites in field forces in southeast China; Methods: A cross-sectional questionnaire-based survey was conducted in July 2016. A total of 216 field force members participated in this study; Results: A total of 10.3% had experienced snakebites and 86.4% rated their demands for knowledge about snakebite as “high”. No significant correlation between the actual and perceived snakebite knowledge status was detected (κ = 0.0237, p = 0.3852). Ineffective and harmful traditional first-aid methods, such as the application of tourniquets, sucking the venom out of the wound, and making local incisions, were used by more than three quarters of the respondents. However, pressure immobilization bandages were applied by only 17.3% of members. The proportion of responses for each question was not significantly different among the respondents when considering separate demographic groups; Conclusions: Snakebite knowledge among Chinese field force members is inadequate and in some cases misleading, when focusing on manifestation, prevention, and first-aid. A pragmatic, intensive educational scheme should be undertaken in at-risk populations. Full article
(This article belongs to the Section Public Health)
Open AccessArticle The Impact of Transformational Leadership on Safety Climate and Individual Safety Behavior on Construction Sites
Int. J. Environ. Res. Public Health 2017, 14(1), 45; doi:10.3390/ijerph14010045
Received: 29 September 2016 / Revised: 12 December 2016 / Accepted: 27 December 2016 / Published: 5 January 2017
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Abstract
Unsafe acts contribute dominantly to construction accidents, and increasing safety behavior is essential to reduce accidents. Previous research conceptualized safety behavior as an interaction between proximal individual differences (safety knowledge and safety motivation) and distal contextual factors (leadership and safety climate). However, relatively
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Unsafe acts contribute dominantly to construction accidents, and increasing safety behavior is essential to reduce accidents. Previous research conceptualized safety behavior as an interaction between proximal individual differences (safety knowledge and safety motivation) and distal contextual factors (leadership and safety climate). However, relatively little empirical research has examined this conceptualization in the construction sector. Given the cultural background of the sample, this study makes a slight modification to the conceptualization and views transformational leadership as an antecedent of safety climate. Accordingly, this study establishes a multiple mediator model showing the mechanisms through which transformational leadership translates into safety behavior. The multiple mediator model is estimated by the structural equation modeling (SEM) technique, using individual questionnaire responses from a random sample of construction personnel based in Hong Kong. As hypothesized, transformational leadership has a significant impact on safety climate which is mediated by safety-specific leader–member exchange (LMX), and safety climate in turn impacts safety behavior through safety knowledge. The results suggest that future safety climate interventions should be more effective if supervisors exhibit transformational leadership, encourage construction personnel to voice safety concerns without fear of retaliation, and repeatedly remind them about safety on the job. Full article
(This article belongs to the Special Issue Effecting a Safe and Healthy Environment in Construction)
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Open AccessArticle Monitoring Lead (Pb) Pollution and Identifying Pb Pollution Sources in Japan Using Stable Pb Isotope Analysis with Kidneys of Wild Rats
Int. J. Environ. Res. Public Health 2017, 14(1), 56; doi:10.3390/ijerph14010056
Received: 23 November 2016 / Revised: 29 December 2016 / Accepted: 6 January 2017 / Published: 10 January 2017
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Abstract
Although Japan has been considered to have little lead (Pb) pollution in modern times, the actual pollution situation is unclear. The present study aims to investigate the extent of Pb pollution and to identify the pollution sources in Japan using stable Pb isotope
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Although Japan has been considered to have little lead (Pb) pollution in modern times, the actual pollution situation is unclear. The present study aims to investigate the extent of Pb pollution and to identify the pollution sources in Japan using stable Pb isotope analysis with kidneys of wild rats. Wild brown (Rattus norvegicus, n = 43) and black (R. rattus, n = 98) rats were trapped from various sites in Japan. Mean Pb concentrations in the kidneys of rats from Okinawa (15.58 mg/kg, dry weight), Aichi (10.83), Niigata (10.62), Fukuoka (8.09), Ibaraki (5.06), Kyoto (4.58), Osaka (4.57), Kanagawa (3.42), and Tokyo (3.40) were above the threshold (2.50) for histological kidney changes. Similarly, compared with the previous report, it was regarded that even structural and functional kidney damage as well as neurotoxicity have spread among rats in Japan. Additionally, the possibility of human exposure to a high level of Pb was assumed. In regard to stable Pb isotope analysis, distinctive values of stable Pb isotope ratios (Pb-IRs) were detected in some kidney samples with Pb levels above 5.0 mg/kg. This result indicated that composite factors are involved in Pb pollution. However, the identification of a concrete pollution source has not been accomplished due to limited differences among previously reported values of Pb isotope composition in circulating Pb products. Namely, the current study established the limit of Pb isotope analysis for source identification. Further detailed research about monitoring Pb pollution in Japan and the demonstration of a novel method to identify Pb sources are needed. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Association between Polymorphism of Exportin-5 and Susceptibility to Lead Poisoning in a Chinese Population
Int. J. Environ. Res. Public Health 2017, 14(1), 36; doi:10.3390/ijerph14010036
Received: 17 October 2016 / Revised: 11 December 2016 / Accepted: 14 December 2016 / Published: 31 December 2016
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Abstract
Lead (Pb) is one of the major contaminants in many industries, and imposes hazardous effects on multiple human organs and systems. Studies have shown that lead is able to induce the alteration of microRNA (miRNA) expression in serum and organs. In
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Lead (Pb) is one of the major contaminants in many industries, and imposes hazardous effects on multiple human organs and systems. Studies have shown that lead is able to induce the alteration of microRNA (miRNA) expression in serum and organs. In this study we investigated whether polymorphisms in miRNA-regulating genes were associated with the risk of lead exposure. We genotyped seven single-nucleotide polymorphisms (SNPs) in 113 lead-sensitive and 113 lead-resistant lead-related Chinese workers by Taqman analysis. The lead-sensitive group showed a significantly higher blood lead level (BLL) than the resistant group based on unconditional logistic regression results. One SNP in XPO5 extron (rs2257082) was significantly associated with lead-poisoning (p = 0.022, odds rate (OR) = 1.63, 95% confidence interval (CI) = 1.07–2.47 in the C allele compared to the T allele). There were no significant associations between the other six SNPs and the blood lead levels. Therefore, polymorphism rs2257082 could be used to distinguish lead-resistant and lead-susceptible populations, and to develop more specific and accurate preventions. Full article
(This article belongs to the Section Environment Health)
Open AccessArticle Do Not “Let Them Eat Cake”: Correlation of Food-Consumption Patterns among Rural Primary School Children from Welfare and Non-Welfare Households
Int. J. Environ. Res. Public Health 2017, 14(1), 26; doi:10.3390/ijerph14010026
Received: 7 December 2016 / Revised: 23 December 2016 / Accepted: 26 December 2016 / Published: 28 December 2016
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Abstract
Physical and financial access impacts food choice and consumption, while educational attainment, employment, income, gender, and socioeconomic status are also influential. Within this context, the aim of the paper is to examine the association between various foods consumed and eating patterns of children
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Physical and financial access impacts food choice and consumption, while educational attainment, employment, income, gender, and socioeconomic status are also influential. Within this context, the aim of the paper is to examine the association between various foods consumed and eating patterns of children between low and higher income households. A paper-based survey was completed by parents/carers of children in 41 primary schools in rural and regional areas of Victoria. Data collected included demographics and the consumption of fruit, vegetable, and other foods including drinks. Ordinal data were analysed using Spearman’s rank-order correlation. The main findings were that children who consumed more fruit and vegetables tended to have a higher intake of healthy drinks (plain milk and water) as well as a lower intake of unhealthy snacks and drinks (sugar sweetened drinks). Those who perceived that fruit and vegetables cost too much reported greater consumption of unhealthy snacks and sugar-sweetened beverages, which was more prominent in low-income households. Changing food consumption behaviours requires a complex systems-based approach that addresses more than just individual issues variables. A participatory approach that works with local communities and seeks to build an understanding of unique challenges within sub-groups has potential for embedding long-lasting and meaningful change in eating behaviours. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Toward a Socio-Territorial Approach to Health: Health Equity in West Africa
Int. J. Environ. Res. Public Health 2017, 14(1), 106; doi:10.3390/ijerph14010106
Received: 31 October 2016 / Revised: 5 January 2017 / Accepted: 18 January 2017 / Published: 22 January 2017
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Abstract
This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies
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This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies of territorial control. We examine the potential influence of socio-territorial processes on vulnerability to disease, access to medical care, healthscapes, and illness experiences. Our research was conducted in Senegal and relied on a mixed methods design. We identified four neighbourhoods that represent the socio-spatial heterogeneity of the city of Saint-Louis and utilized the following methods: geographic and anthropological field research, household surveys, health knowledge and behaviour surveys, clinical exams, and illness interviews. Our results highlight the socio-territorial processes at work in each neighbourhood, clinical findings on three health measures (overweight, high blood pressure, and hyperglycaemia) and health experiences of individuals with hypertension or type II diabetes. We found significant differences in the prevalence of the three health measures in the study sites, while experiences managing hypertension and diabetes were similar. We conclude that a socio-territorial approach offers insight into the complex constellation of forces that produce health disparities in urban settings. Full article
(This article belongs to the Special Issue Urban Place and Health Equity)
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Open AccessFeature PaperArticle Changes in Depressive Symptoms among Older Adults with Multiple Chronic Conditions: Role of Positive and Negative Social Support
Int. J. Environ. Res. Public Health 2017, 14(1), 16; doi:10.3390/ijerph14010016
Received: 19 September 2016 / Revised: 16 December 2016 / Accepted: 19 December 2016 / Published: 26 December 2016
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Abstract
Depression severely affects older adults in the United States. As part of the social environment, significant social support was suggested to ameliorate depression among older adults. We investigate how varying forms of social support moderate depressive symptomatology among older adults with multiple chronic
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Depression severely affects older adults in the United States. As part of the social environment, significant social support was suggested to ameliorate depression among older adults. We investigate how varying forms of social support moderate depressive symptomatology among older adults with multiple chronic conditions (MCC). Data were analyzed using a sample of 11,400 adults, aged 65 years or older, from the 2006–2012 Health and Retirement Study. The current study investigated the moderating effects of positive or negative social support from spouse, children, other family, and friends on the association between MCC and depression. A linear mixed model with repeated measures was used to estimate the effect of MCC on depression and its interactions with positive and negative social support in explaining depression among older adults. Varying forms of social support played different moderating roles in depressive symptomatology among older adults with MCC. Positive spousal support significantly weakened the deleterious effect of MCC on depression. Conversely, all negative social support from spouse, children, other family, and friends significantly strengthened the deleterious effect of MCC on depression. Minimizing negative social support and maximizing positive spousal support can reduce depression caused by MCC and lead to successful aging among older adults. Full article
(This article belongs to the Special Issue Aging and Health Promotion)
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Open AccessArticle A Mental Health Survey of Different Ethnic and Occupational Groups in Xinjiang, China
Int. J. Environ. Res. Public Health 2017, 14(1), 46; doi:10.3390/ijerph14010046
Received: 2 September 2016 / Revised: 20 December 2016 / Accepted: 29 December 2016 / Published: 5 January 2017
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Abstract
Poor mental health has become a serious social and public health-care burden. This cross-sectional study used multistage stratified cluster random sampling to gather mental health information from 11,891 adults (18–60 years) employed in various occupations categorized according to the Chinese Standard Occupational Classification.
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Poor mental health has become a serious social and public health-care burden. This cross-sectional study used multistage stratified cluster random sampling to gather mental health information from 11,891 adults (18–60 years) employed in various occupations categorized according to the Chinese Standard Occupational Classification. Mental health was measured by the General Health Questionnaire, and participants exceeding the cut-off score were defined as having poor mental health. The overall prevalence of poor mental health was 23.8%. The prevalence of poor mental health was significantly higher in the Han ethnic group than Kazak ethnic group and in health-care workers, teachers, and civil servants compared to manual workers. Females (odds ratios (OR) = 1.139, 95% confidence intervals (CI): 1.012–3.198) and knowledge workers (1.697, 1.097–2.962) were risk factors for poor mental health, while Kazak ethnicity (0.465, 0.466–0.937), other minority status (non-Han) (0.806, 0.205–0.987), and working ≥15 years in the same occupation (0.832, 0.532–0.932) were protective (p < 0.05). We concluded that the general level of mental health in Xinjiang, China, is higher in the Kazak ethnic group than the Han ethnic group. The prevalence of poor mental health is higher among knowledge workers than in manual workers due to high incidences of poor mental health in civil servants, health-care workers, and teachers. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Self-Reported Snoring Is Associated with Dyslipidemia, High Total Cholesterol, and High Low-Density Lipoprotein Cholesterol in Obesity: A Cross-Sectional Study from a Rural Area of China
Int. J. Environ. Res. Public Health 2017, 14(1), 86; doi:10.3390/ijerph14010086
Received: 18 November 2016 / Revised: 11 January 2017 / Accepted: 12 January 2017 / Published: 17 January 2017
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Abstract
Studies to explore the relationship between self-reported snoring and dyslipidemia, especially high total cholesterol (TC) and high low-density lipoprotein cholesterol (LDL-C), in the general population are still lacking. Our study was designed to examine whether self-reported snoring is significantly associated with dyslipidemia and
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Studies to explore the relationship between self-reported snoring and dyslipidemia, especially high total cholesterol (TC) and high low-density lipoprotein cholesterol (LDL-C), in the general population are still lacking. Our study was designed to examine whether self-reported snoring is significantly associated with dyslipidemia and ascertain the effects of different snoring intensities on dyslipidemia. There were 10,139 participants in our study. After adjustment for all confounding factors, self-reported snoring (OR = 1.207; p = 0.003), moderate (OR = 1.229; p = 0.015), strong (OR = 1.222; p = 0.033), and very strong (OR = 1.467; p = 0.012) snoring intensity, but not low (OR = 1.110; p = 0.224) snoring intensity, were significantly associated with dyslipidemia among adults with BMI (body mass index) ≥ 25 kg/m2. In addition, self-reported snoring was significantly associated with high TC (OR = 1.167; p = 0.048) and high LDL-C (OR = 1.228; p = 0.044), rather than low HDL-C (OR = 1.171; p = 0.057) and high triglyceride (TG) (OR = 1.110; p = 0.141). In conclusion, adults with BMI ≥ 25 kg/m2 and who experience snoring, especially moderate, strong, and very strong intensity levels of snoring, should be on the alert regarding the possibility of dyslipidemia, especially high LDL-C and high TC. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey
Int. J. Environ. Res. Public Health 2017, 14(1), 96; doi:10.3390/ijerph14010096
Received: 20 November 2016 / Revised: 15 January 2017 / Accepted: 16 January 2017 / Published: 19 January 2017
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Abstract
This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors
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This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern China, completed the questionnaire. Of the respondents, 83.3% reported exposure to workplace violence, and 68.9% reported non-physical violence. Gender, education, shift work, anxiety level, and occupation were significantly correlated with physical violence (p < 0.05 for all correlations). Additionally, age, professional title, and occupation were correlated with non-physical violence, which critically affected doctors. Thus, gender, age, profession, anxiety, and shift work were predictive of workplace violence toward healthcare workers. Doctors appeared to experience non-physical workplace violence with particularly higher frequency when compared to nurses and other workers in hospitals. For healthcare workers, interventions aimed at WPV reduction should be enacted according to the types of violence, profession, and other factors underlying the various types of WPV in hospitals. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Neighborhood Design, Physical Activity, and Wellbeing: Applying the Walkability Model
Int. J. Environ. Res. Public Health 2017, 14(1), 76; doi:10.3390/ijerph14010076
Received: 24 August 2016 / Revised: 13 December 2016 / Accepted: 20 December 2016 / Published: 13 January 2017
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Abstract
Neighborhood design affects lifestyle physical activity, and ultimately human wellbeing. There are, however, a limited number of studies that examine neighborhood design types. In this research, we examine four types of neighborhood designs: traditional development, suburban development, enclosed community, and cluster housing development,
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Neighborhood design affects lifestyle physical activity, and ultimately human wellbeing. There are, however, a limited number of studies that examine neighborhood design types. In this research, we examine four types of neighborhood designs: traditional development, suburban development, enclosed community, and cluster housing development, and assess their level of walkability and their effects on physical activity and wellbeing. We examine significant associations through a questionnaire (n = 486) distributed in Tucson, Arizona using the Walkability Model. Among the tested neighborhood design types, traditional development showed significant associations and the highest value for walkability, as well as for each of the two types of walking (recreation and transportation) representing physical activity. Suburban development showed significant associations and the highest mean values for mental health and wellbeing. Cluster housing showed significant associations and the highest mean value for social interactions with neighbors and for perceived safety from crime. Enclosed community did not obtain the highest means for any wellbeing benefit. The Walkability Model proved useful in identifying the walkability categories associated with physical activity and perceived crime. For example, the experience category was strongly and inversely associated with perceived crime. This study provides empirical evidence of the importance of including vegetation, particularly trees, throughout neighborhoods in order to increase physical activity and wellbeing. Likewise, the results suggest that regular maintenance is an important strategy to improve mental health and overall wellbeing in cities. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Incidence and Simple Prediction Model of Hyperuricemia for Urban Han Chinese Adults: A Prospective Cohort Study
Int. J. Environ. Res. Public Health 2017, 14(1), 67; doi:10.3390/ijerph14010067
Received: 13 November 2016 / Revised: 15 December 2016 / Accepted: 6 January 2017 / Published: 11 January 2017
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Abstract
Background: Hyperuricemia (HUA) contributes to gout and many other diseases. Many hyperuricemia-related risk factors have been discovered, which provided the possibility for building the hyperuricemia prediction model. In this study we aimed to explore the incidence of hyperuricemia and develop hyperuricemia prediction models
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Background: Hyperuricemia (HUA) contributes to gout and many other diseases. Many hyperuricemia-related risk factors have been discovered, which provided the possibility for building the hyperuricemia prediction model. In this study we aimed to explore the incidence of hyperuricemia and develop hyperuricemia prediction models based on the routine biomarkers for both males and females in urban Han Chinese adults. Methods: A cohort of 58,542 members of the urban population (34,980 males and 23,562 females) aged 20–80 years old, free of hyperuricemia at baseline examination, was followed up for a median 2.5 years. The Cox proportional hazards regression model was used to develop gender-specific prediction models. Harrell’s C-statistics was used to evaluate the discrimination ability of the models, and the 10-fold cross-validation was used to validate the models. Results: In 7139 subjects (5585 males and 1554 females), hyperuricemia occurred during a median of 2.5 years of follow-up, leading to a total incidence density of 49.63/1000 person years (64.62/1000 person years for males and 27.12/1000 person years for females). The predictors of hyperuricemia were age, body mass index (BMI) systolic blood pressure, serum uric acid for males, and BMI, systolic blood pressure, serum uric acid, triglycerides for females. The models’ C statistics were 0.783 (95% confidence interval (CI), 0.779–0.786) for males and 0.784 (95% CI, 0.778–0.789) for females. After 10-fold cross-validation, the C statistics were still steady, with 0.782 for males and 0.783 for females. Conclusions: In this study, gender-specific prediction models for hyperuricemia for urban Han Chinese adults were developed and performed well. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Disability Weights for Chronic Mercury Intoxication Resulting from Gold Mining Activities: Results from an Online Pairwise Comparisons Survey
Int. J. Environ. Res. Public Health 2017, 14(1), 57; doi:10.3390/ijerph14010057
Received: 31 October 2016 / Revised: 15 December 2016 / Accepted: 3 January 2017 / Published: 10 January 2017
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Abstract
In artisanal small-scale gold mining, mercury is used for gold-extraction, putting miners and nearby residents at risk of chronic metallic mercury vapor intoxication (CMMVI). Burden of disease (BoD) analyses allow the estimation of the public health relevance of CMMVI, but until now there
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In artisanal small-scale gold mining, mercury is used for gold-extraction, putting miners and nearby residents at risk of chronic metallic mercury vapor intoxication (CMMVI). Burden of disease (BoD) analyses allow the estimation of the public health relevance of CMMVI, but until now there have been no specific CMMVI disability weights (DWs). The objective is to derive DWs for moderate and severe CMMVI. Disease-specific and generic health state descriptions of 18 diseases were used in a pairwise comparison survey. Mercury and BoD experts were invited to participate in an online survey. Data were analyzed using probit regression. Local regression was used to make the DWs comparable to the Global Burden of Disease (GBD) study. Alternative survey (visual analogue scale) and data analyses approaches (linear interpolation) were evaluated in scenario analyses. A total of 105 participants completed the questionnaire. DWs for moderate and severe CMMVI were 0.368 (0.261–0.484) and 0.588 (0.193–0.907), respectively. Scenario analyses resulted in higher mean values. The results are limited by the sample size, group of interviewees, questionnaire extent, and lack of generally accepted health state descriptions. DWs were derived to improve the data basis of mercury-related BoD estimates, providing useful information for policy-making. Integration of the results into the GBD DWs enhances comparability. Full article
(This article belongs to the Special Issue Mercury and Health: Current Perspectives and Future Directions)
Open AccessArticle Essential Oil of Japanese Cedar (Cryptomeria japonica) Wood Increases Salivary Dehydroepiandrosterone Sulfate Levels after Monotonous Work
Int. J. Environ. Res. Public Health 2017, 14(1), 97; doi:10.3390/ijerph14010097
Received: 4 November 2016 / Revised: 10 January 2017 / Accepted: 16 January 2017 / Published: 21 January 2017
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Abstract
Employee problems arising from mental illnesses have steadily increased and become a serious social problem in recent years. Wood is a widely available plant material, and knowledge of the psychophysiological effects of inhalation of woody volatile compounds has grown considerably. In this study,
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Employee problems arising from mental illnesses have steadily increased and become a serious social problem in recent years. Wood is a widely available plant material, and knowledge of the psychophysiological effects of inhalation of woody volatile compounds has grown considerably. In this study, we established an experimental method to evaluate the effects of Japanese cedar wood essential oil on subjects performing monotonous work. Two experiment conditions, one with and another without diffusion of the essential oil were prepared. Salivary stress markers were determined during and after a calculation task followed by distribution of questionnaires to achieve subjective odor assessment. We found that inhalation of air containing the volatile compounds of Japanese cedar wood essential oil increased the secretion of dehydroepiandrosterone sulfate (DHEA-s). Slight differences in the subjective assessment of the odor of the experiment rooms were observed. The results of the present study indicate that the volatile compounds of Japanese cedar wood essential oil affect the endocrine regulatory mechanism to facilitate stress responses. Thus, we suggest that this essential oil can improve employees’ mental health. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Impact of Air Pollutants on Outpatient Visits for Acute Respiratory Outcomes
Int. J. Environ. Res. Public Health 2017, 14(1), 47; doi:10.3390/ijerph14010047
Received: 16 October 2016 / Revised: 24 December 2016 / Accepted: 3 January 2017 / Published: 5 January 2017
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Abstract
The air pollution in China is a severe problem. The aim of our study was to investigate the impact of air pollutants on acute respiratory outcomes in outpatients. Outpatient data from 2 December 2013 to 1 December 2014 were collected, as well as
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The air pollution in China is a severe problem. The aim of our study was to investigate the impact of air pollutants on acute respiratory outcomes in outpatients. Outpatient data from 2 December 2013 to 1 December 2014 were collected, as well as air pollutant data including ozone (O3), nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), and particulate matter (PM2.5 and PM10). We screened six categories of acute respiratory outcomes and analyzed their associations with different air pollutant exposures, including upper respiratory tract infection (URTI), acute bronchitis (AB), community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), acute exacerbation of asthma (AE-asthma), and acute exacerbation of bronchiectasis (AEBX). A case-crossover design with a bidirectional control sampling approach was used for statistical analysis. A total of 57,144 patients were enrolled for analysis. PM2.5, PM10, NO2, SO2, and CO exposures were positively associated with outpatient visits for URTI, AB, CAP, and AEBX. PM10, SO2, and CO exposures were positively associated with outpatient visits for AECOPD. Exposure to O3 was positively associated with outpatient visits for AE-asthma, but negatively associated with outpatient visits for URTI, CAP, and AEBX. In conclusion, air pollutants had acute effects on outpatient visits for acute respiratory outcomes, with specific outcomes associated with specific pollutants. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Investigation of Indoor Air Quality in Houses of Macedonia
Int. J. Environ. Res. Public Health 2017, 14(1), 37; doi:10.3390/ijerph14010037
Received: 27 September 2016 / Accepted: 19 December 2016 / Published: 1 January 2017
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Abstract
People who live in buildings are exposed to harmful effects of indoor air pollution for many years. Therefore, our research is aimed to investigate the indoor air quality in family houses. The measurements of indoor air temperature, relative humidity, total volatile organic compounds
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People who live in buildings are exposed to harmful effects of indoor air pollution for many years. Therefore, our research is aimed to investigate the indoor air quality in family houses. The measurements of indoor air temperature, relative humidity, total volatile organic compounds (TVOC), particulate matters (PM) and sound pressure level were carried out in 25 houses in several cities of the Republic of Macedonia. Mean values of indoor air temperature and relative humidity ranged from 18.9 °C to 25.6 °C and from 34.1% to 68.0%, respectively. With regard to TVOC, it can be stated that excessive occurrence was recorded. Mean values ranged from 50 μg/m3 to 2610 μg/m3. Recommended value (200 μg/m3) for human exposure to TVOC was exceeded in 32% of houses. Mean concentrations of PM2.5 (particular matter with diameter less than 2.5 μm) and PM10 (diameter less than 10 μm) are determined to be from 16.80 μg/m3 to 30.70 μg/m3 and from 38.30 μg/m3 to 74.60 μg/m3 individually. Mean values of sound pressure level ranged from 29.8 dB(A) to 50.6 dB(A). Dependence between characteristics of buildings (Year of construction, Year of renovation, Smoke and Heating system) and data from measurements (Temperature, Relative humidity, TVOC, PM2.5 and PM10) were analyzed using R software. Van der Waerden test shows dependence of Smoke on TVOC and PM2.5. Permutational multivariate analysis of variance shows the effect of interaction of Renovation and Smoke. Full article
(This article belongs to the Special Issue Indoor Air Quality and Health 2016)
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Open AccessArticle Maternal Exposure to Domestic Hair Cosmetics and Occupational Endocrine Disruptors Is Associated with a Higher Risk of Hypospadias in the Offspring
Int. J. Environ. Res. Public Health 2017, 14(1), 27; doi:10.3390/ijerph14010027
Received: 25 August 2016 / Revised: 29 November 2016 / Accepted: 5 December 2016 / Published: 29 December 2016
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Abstract
Pregnant women are exposed to various chemical products at home and at work. Some of these products contain endocrine-disrupting chemicals (EDCs) such as cosmetics, pesticides, industrial chemicals, heavy metals, plastics or medications that could alter sexual differentiation and increase the risk of hypospadias.
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Pregnant women are exposed to various chemical products at home and at work. Some of these products contain endocrine-disrupting chemicals (EDCs) such as cosmetics, pesticides, industrial chemicals, heavy metals, plastics or medications that could alter sexual differentiation and increase the risk of hypospadias. We evaluated maternal occupational and household exposures that could constitute risk factors for hypospadias. From 2011 to 2014, we enrolled 57 full-term newborns with hypospadias and three randomly selected controls per case (162 control newborns), matched for gestational age, from 11 maternity units in Picardy, France. Neonatal and parental data were collected at birth (personal characteristics, maternal lifestyle, and medical history). Maternal occupational exposure was assessed by a job-exposure matrix for EDCs from a job history questionnaire completed by mothers. Odds ratios (OR) and 95% confidence intervals (CI) were calculated with univariate and multivariable logistic regression, and adjusted for relevant covariates. Multivariate analysis showed a strong association between hypospadias and potential maternal occupational exposure to EDCs and maternal household use of hair cosmetics (OR 6.1, 95% CI: 1.1–34.9; OR: 9.6, 95% CI: 1.4–66.1, respectively). Our results suggest that maternal occupational exposure to EDCs is a risk factor for hypospadias and suggests a possible influence of household use of hair cosmetics during early pregnancy on the incidence of hypospadias in the offspring. A larger study with more accurate exposure assessment should evaluate the impact of EDCs in hair cosmetics on the incidence of hypospadias. Full article
Open AccessArticle Acute Anterior Uveitis as a Risk Factor of Ankylosing Spondylitis—A National Population-Based Study
Int. J. Environ. Res. Public Health 2017, 14(1), 107; doi:10.3390/ijerph14010107
Received: 13 November 2016 / Revised: 11 January 2017 / Accepted: 19 January 2017 / Published: 23 January 2017
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Abstract
Introduction: In clinical settings, acute anterior uveitis (AAU) could be the first presentation of ankylosing spondylitis (AS). Based on this hypothesis, we investigate whether AAU is a risk factor in developing AS later by using National Health Insurance Research Database (NHIRD) in Taiwan.
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Introduction: In clinical settings, acute anterior uveitis (AAU) could be the first presentation of ankylosing spondylitis (AS). Based on this hypothesis, we investigate whether AAU is a risk factor in developing AS later by using National Health Insurance Research Database (NHIRD) in Taiwan. Materials and Methods: This cohort comparison study used longitudinal Taiwanese NHIRD to probe the relative risk odds of AAU for AS development, and consisted of all patients diagnosed with AAU (n = 5621) (ICD-9-CM codes 364.00). The relative risks of AS between AAU patients and controls were compared by estimating the crude hazard ratio with logistic regression. Kaplan–Meier analysis was used to calculate the cumulative incidence rates of developing AS, and a log-rank test was used to analyze the differences between the survival curves. Separate Cox proportional hazard regressions were performed to compute the AS-free rate after adjusting for possible confounding factors such as age and sex. Results: The crude hazard ratio was 2.667 for the AAU group, and the adjusted hazard ratio was 2.705 for the AAU group. The observation time of the AS-free group was shorter for AAU patients compared with the control group (1507 versus 1578 days). Moreover, in the AAU patients, the younger age onset of AAU (less than 30 years old here) would lead to an earlier diagnosis of AS later with a median of 1445.5 (742–2241) versus 1544 (819–2289) days of survival for the group of age onset of AAU greater than 30 years old. The difference is statistically significant (p < 0.05). Conclusions: AAU was a risk factor for AS. To identify AAU as an extra-articular manifestation is crucial for early diagnosis and treatment of AS and containing functional loss accordingly. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Pathological Impairment, Cell Cycle Arrest and Apoptosis of Thymus and Bursa of Fabricius Induced by Aflatoxin-Contaminated Corn in Broilers
Int. J. Environ. Res. Public Health 2017, 14(1), 77; doi:10.3390/ijerph14010077
Received: 22 November 2016 / Revised: 30 December 2016 / Accepted: 10 January 2017 / Published: 13 January 2017
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Abstract
This study aimed to evaluate the comparative effects of aflatoxin-contaminated corn on the thymus and bursa of Fabricius (BF) in chickens by detecting histopathological lesions, cell cycle phase distribution and apoptosis. A total of 900 COBB500 male broilers were randomly allocated into five
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This study aimed to evaluate the comparative effects of aflatoxin-contaminated corn on the thymus and bursa of Fabricius (BF) in chickens by detecting histopathological lesions, cell cycle phase distribution and apoptosis. A total of 900 COBB500 male broilers were randomly allocated into five groups. The experiment lasted for six weeks and the five dietary treatments consisted of uncontaminated corn (control), 25% contaminated corn, 50% contaminated corn, 75% contaminated corn and 100% contaminated corn groups. The gross changes showed the decreased size of the thymus and BF, as well as the pale color of the BF in the broilers after aflatoxin contaminated diet exposure. There were more nuclear debris in the thymus and BF of birds in the 50%, 75%, and 100% contaminated corn groups, but the pathological impairments of the BF were more obvious than those of the thymus, which showed as more obvious lymphocyte depletion and the proliferation of reticulocytes and fibroblasts. At 21 days of age, the percentage of thymocytes and BF cells in the G2M phase was increased in a dose-dependent manner in the four AFB-contaminated corn groups. However, at 42 days of age, dietary AFB1 induced cell cycle perturbation at the G0G1 phase in thymocytes, but at the G2M phase in BF cells. The increased percentage of apoptotic cells in the thymus and BF were similarly observed in the AFB groups. According to these results, the severity of histopathological lesions may be correlated with the different sensitivity of the two central immune organs when exposed to AFB; different arrested cell cycle phases suggest that different mechanisms may be involved in the lesions of the thymus and BF, which need to be further researched. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Bisphenol A and Ovarian Reserve among Infertile Women with Polycystic Ovarian Syndrome
Int. J. Environ. Res. Public Health 2017, 14(1), 18; doi:10.3390/ijerph14010018
Received: 24 November 2016 / Revised: 20 December 2016 / Accepted: 22 December 2016 / Published: 27 December 2016
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Abstract
To better understand possible effects of bisphenol A (BPA) exposure on ovarian reserve in women with polycystic ovary syndrome (PCOS), we measured creatinine adjusted urinary BPA (BPA_Cre) concentrations and used regression models to evaluate the association between urinary BPA level and antral follicle
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To better understand possible effects of bisphenol A (BPA) exposure on ovarian reserve in women with polycystic ovary syndrome (PCOS), we measured creatinine adjusted urinary BPA (BPA_Cre) concentrations and used regression models to evaluate the association between urinary BPA level and antral follicle count (AFC), antimullerian hormone (AMH), day-3 follicle stimulating hormone levels (FSH) and inhibin B (INHB) in 268 infertile women diagnosed with PCOS. BPA was detected in all women with a median concentration of 2.35 ng/mL (the 25th and 75th percentiles of 1.47 ng/mL and 3.95 ng/mL). A unit increase in BPA_Cre was associated with a significant decrease of 0.34 in AFC (β = −0.34, 95% CI = −0.60, −0.08; p = 0.01). Likewise, BPA was negatively associated with AMH and day-3 FSH levels, but neither of them reached statistical significance. No association was observed between BPA and INHB. Our results suggest that in women with PCOS, BPA may affect ovarian follicles and, therefore, reduce ovarian reserve. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Knowledge and Attitudes towards Handling Eggs in the Home: An Unexplored Food Safety Issue?
Int. J. Environ. Res. Public Health 2017, 14(1), 48; doi:10.3390/ijerph14010048
Received: 7 November 2016 / Revised: 3 January 2017 / Accepted: 4 January 2017 / Published: 6 January 2017
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Abstract
Foodborne illness is a global public health issue, with food handling in the home identified as an underestimated source. In Australia, there has been a significant increase in the incidence of salmonellosis with the majority of outbreaks linked to eggs. This study investigated
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Foodborne illness is a global public health issue, with food handling in the home identified as an underestimated source. In Australia, there has been a significant increase in the incidence of salmonellosis with the majority of outbreaks linked to eggs. This study investigated Australian eggs consumer attitudes, behaviours and risk perceptions associated with the handling of raw eggs in the home. It was identified that 67% of participants chose free range eggs, 11% kept poultry, 7% did not have any preference, 7% cage eggs, 4% barn eggs, 2% organic eggs and 1% pasteurized eggs. The majority of participants (91%) reported they stored eggs in the fridge. It was identified that there is an underestimation of “risky behaviour” associated with the consumption of raw eggs in the home, as 84% of participants indicated that they did not consume raw eggs, but subsequently 86% indicated that they had eaten mixture/batter containing raw eggs. Participants’ responses relating to food safety were also examined in relation to their profession and gender. Safer food handling practices were identified by Environmental Health Officers (EHO) and Food handlers compared to all other professions (p < 0.05). However, the gender of participants did not significantly affect (p > 0.05) their responses. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Support Vector Machine Classification of Drunk Driving Behaviour
Int. J. Environ. Res. Public Health 2017, 14(1), 108; doi:10.3390/ijerph14010108
Received: 10 November 2016 / Revised: 11 January 2017 / Accepted: 13 January 2017 / Published: 23 January 2017
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Abstract
Alcohol is the root cause of numerous traffic accidents due to its pharmacological action on the human central nervous system. This study conducted a detection process to distinguish drunk driving from normal driving under simulated driving conditions. The classification was performed by a
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Alcohol is the root cause of numerous traffic accidents due to its pharmacological action on the human central nervous system. This study conducted a detection process to distinguish drunk driving from normal driving under simulated driving conditions. The classification was performed by a support vector machine (SVM) classifier trained to distinguish between these two classes by integrating both driving performance and physiological measurements. In addition, principal component analysis was conducted to rank the weights of the features. The standard deviation of R–R intervals (SDNN), the root mean square value of the difference of the adjacent R–R interval series (RMSSD), low frequency (LF), high frequency (HF), the ratio of the low and high frequencies (LF/HF), and average blink duration were the highest weighted features in the study. The results show that SVM classification can successfully distinguish drunk driving from normal driving with an accuracy of 70%. The driving performance data and the physiological measurements reported by this paper combined with air-alcohol concentration could be integrated using the support vector regression classification method to establish a better early warning model, thereby improving vehicle safety. Full article
(This article belongs to the Special Issue Alcohol and Health)
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Open AccessArticle Determinants of Quality of Life in High-Dose Benzodiazepine Misusers
Int. J. Environ. Res. Public Health 2017, 14(1), 38; doi:10.3390/ijerph14010038
Received: 9 October 2016 / Revised: 20 December 2016 / Accepted: 29 December 2016 / Published: 4 January 2017
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Abstract
Benzodiazepines (BZDs) are among the most widely prescribed drugs in developed countries, but they have a high potential for tolerance, dependence and misuse. High-dose BZD misuse represents an emerging addiction phenomenon, but data on quality of life (QoL) in high-dose BZD misusers are
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Benzodiazepines (BZDs) are among the most widely prescribed drugs in developed countries, but they have a high potential for tolerance, dependence and misuse. High-dose BZD misuse represents an emerging addiction phenomenon, but data on quality of life (QoL) in high-dose BZD misusers are scant. This study aimed to explore QoL in high-dose BZD misuse. We recruited 267 high-dose BZD misusers, compared the QoL scores in those who took BZD only to poly-drug misusers, and explored the role of demographic and clinical covariates through multivariable analysis. Our data confirmed worse QoL in high-dose BZD misusers and showed that (a) QoL scores were not negatively influenced by the misuse of alcohol or other drugs, or by coexisting psychiatric disorders; (b) demographic variables turned out to be the most significant predictors of QoL scores; (c) BZD intake significantly and negatively influenced QoL. Physical and psychological dimensions of QoL are significantly lower in high-dose BZD misusers with no significant effect of comorbidities. Our data suggest that the main reason for poor QoL in these patients is high-dose BZD intake per se. QoL should be considered among outcome measures in these patients. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle The Association between Warning Label Requirements and Cigarette Smoking Prevalence by Education-Findings from the Global Adult Tobacco Survey (GATS)
Int. J. Environ. Res. Public Health 2017, 14(1), 98; doi:10.3390/ijerph14010098
Received: 31 October 2016 / Revised: 16 January 2017 / Accepted: 18 January 2017 / Published: 21 January 2017
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Abstract
Introduction: The Guidelines for the implementation of Article 11 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) require that cigarette health warning labels should include pictures and take up 50% or more of the principal display area. This study
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Introduction: The Guidelines for the implementation of Article 11 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) require that cigarette health warning labels should include pictures and take up 50% or more of the principal display area. This study examined how the association between large pictorial warnings, those covering ≥50% of the front and back of the package, and the prevalence of cigarette smoking varies by educational attainment. Methods: We pooled individual-level tobacco use data from the Global Adult Tobacco Survey (GATS) in 18 countries between 2008 and 2013 and linked them with warning label requirements during the same period from the MPOWER database and reports regarding warnings. The respondents’ self-reported exposure to warnings was examined according to education. Logistic regressions were further employed to analyze education-specific associations between large pictorial warnings and smoking prevalence, and whether such association differed by education was examined using an interaction test. Results: At the time of the survey, eight out of 18 countries had imposed graphic warning labels that covered ≥50% of the package. These warnings were associated with a 10.0% (OR = 0.89; 95% CI: 0.81, 0.97; p ≤ 0.01) lower cigarette smoking prevalence among adults with less than a secondary education or no formal education, but not among respondents with at least a secondary education. Less educated respondents were also less likely to be exposed to warnings in all 18 countries. The association between strong warnings and lower smoking prevalence among less educated respondents could be greater if their exposure to warnings increases. Conclusions: Prominent pictorial warning labels can potentially reduce health disparities resulting from smoking across different education levels. Full article
(This article belongs to the Special Issue Tobacco Control and Priority Groups)
Open AccessArticle Prevalence and Social Risk Factors for Hearing Impairment in Chinese Children—A National Survey
Int. J. Environ. Res. Public Health 2017, 14(1), 88; doi:10.3390/ijerph14010088
Received: 5 December 2016 / Revised: 11 January 2017 / Accepted: 12 January 2017 / Published: 18 January 2017
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Abstract
Hearing impairment may affect children’s communication skills, social development, and educational achievement. Little is known about the prevalence of hearing impairment among Chinese children. Data were taken from the 2006 second China National Survey on Disability (CNSD). Hearing impairment was defined as moderate
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Hearing impairment may affect children’s communication skills, social development, and educational achievement. Little is known about the prevalence of hearing impairment among Chinese children. Data were taken from the 2006 second China National Survey on Disability (CNSD). Hearing impairment was defined as moderate (41–60 dB HL), severe (61–80 dB HL), profound (81–90 dB HL), or complete (>91 dB HL). Logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI). A weighted number of 567,915 hearing impairment children were identified, yielding a prevalence of 17.49 per 10,000 people (95% CI: 16.90–18.08), with prevention or treatment options possible for 64.6% of hearing impairment children. The main causes of hearing impairment were hereditary, tympanitis, and drug intoxication. Illiteracy in one or both parents (mother: OR = 1.388, 95% CI: 1.125–1.714, p < 0.0001; father: OR = 1.537, 95% CI: 1.152–2.049, p < 0.0001 relative to no school or primary school), annual family income lower than national average (OR = 1.323, 95% CI: 1.044–1.675, p = 0.0203, relative to higher than national average), household size larger than three people (OR = 1.432, 95% CI: 1.164–1.762, p = 0.0007, relative to smaller than three people) and single-mother family (OR = 2.056, 95% CI: 1.390–3.042, p = 0.0176, relative to intact family) were the independence risk factors for hearing impairment among Chinese children. Lower annual family income, male children, larger household size, single-mother family, and lower levels of maternal and paternal education were independent risk factors for hearing impairment for Chinese children. Further studies on hearing impairment prevention and the relationship between parental social factors and the risk of hearing impairment are needed. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Brief Counseling on Secondhand Smoke Exposure in Pregnant Women in Argentina and Uruguay
Int. J. Environ. Res. Public Health 2017, 14(1), 28; doi:10.3390/ijerph14010028
Received: 4 October 2016 / Revised: 7 December 2016 / Accepted: 21 December 2016 / Published: 29 December 2016
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Abstract
Argentina and Uruguay have a high prevalence of smoking during pregnancy, as well as of secondhand smoke (SHS) exposure. In this secondary analysis of a trial to implement brief smoking cessation counseling during antenatal care in Argentina and Uruguay, we aim to evaluate
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Argentina and Uruguay have a high prevalence of smoking during pregnancy, as well as of secondhand smoke (SHS) exposure. In this secondary analysis of a trial to implement brief smoking cessation counseling during antenatal care in Argentina and Uruguay, we aim to evaluate the effects of the intervention on the rates of self-reported SHS exposure at home and at work, and on attitudes recalled by non-smoker women enrolled in the intervention group compared with the control group. We randomly assigned (1:1) 20 antenatal care clusters in Argentina and Uruguay to receive a multifaceted intervention to implement brief smoking cessation counseling, which also included questions and counseling regarding SHS exposure, or to receive the standard of care. There was not a statistically significant difference between groups of the intervention’s effect (reduction of exposure to SHS) on any of the three exposure outcome measures (exposure at home, work or other indoor areas) or on the attitudes of women regarding exposure (avoiding breathing SHS and having rooms where smoking is forbidden). This analysis shows that we should not expect reductions in SHS exposure with this modest intervention alone. To achieve such reductions, strategies engaging partners and other household members may be more effective. Full article
(This article belongs to the Special Issue Tobacco Control and Priority Groups)
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Open AccessArticle Critical Windows of Prenatal Exposure to Cadmium and Size at Birth
Int. J. Environ. Res. Public Health 2017, 14(1), 58; doi:10.3390/ijerph14010058
Received: 30 October 2016 / Revised: 9 December 2016 / Accepted: 14 December 2016 / Published: 9 January 2017
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Abstract
Prenatal cadmium (Cd) exposure has been associated with adverse birth outcomes, but the findings of previous studies are inconsistent. We measured Cd concentrations in urine samples at or near 13, 24, and 35 gestational weeks from 282 women in Wuhan, China. We used
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Prenatal cadmium (Cd) exposure has been associated with adverse birth outcomes, but the findings of previous studies are inconsistent. We measured Cd concentrations in urine samples at or near 13, 24, and 35 gestational weeks from 282 women in Wuhan, China. We used generalized estimating equation models to assess the associations between maternal creatinine adjusted urinary Cd concentrations at each trimester and birth size. A significant inverse association was observed between higher maternal Cd levels measured during the 1st trimester and birth size in girls. For each log unit increase in Cd (µg/g creatinine) levels from the 1st trimester, there was a decrease in birth weight by 116.99 g (95% confidence interval (CI): −208.87, −25.11 g). The Cd levels from the 1st and 2nd trimesters were also borderline significantly associated with ponderal index in girls. Joint estimation of trimester-specific effects suggested that associations with Cd levels for ponderal index (pint = 0.02) were significantly different across trimesters, and differences for effects across trimesters for birth weight were marginally significant (pint = 0.08) in girls. No significant associations were observed between Cd levels from any trimester and birth size in boys. Maternal Cd exposure during earlier periods of pregnancy may have a larger impact on delayed fetal growth. Full article
(This article belongs to the Special Issue Heavy Metals: Environmental and Human Health)
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Open AccessArticle Evaluation of Potential Average Daily Doses (ADDs) of PM2.5 for Homemakers Conducting Pan-Frying Inside Ordinary Homes under Four Ventilation Conditions
Int. J. Environ. Res. Public Health 2017, 14(1), 78; doi:10.3390/ijerph14010078
Received: 19 September 2016 / Revised: 21 December 2016 / Accepted: 6 January 2017 / Published: 13 January 2017
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Abstract
Several studies reported that commercial barbecue restaurants likely contribute to the indoor emission of particulate matters with a diameter of 2.5 micrometers or less (PM2.5) while pan-frying meat. However, there is inadequate knowledge of exposure level to indoor PM2.5 in
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Several studies reported that commercial barbecue restaurants likely contribute to the indoor emission of particulate matters with a diameter of 2.5 micrometers or less (PM2.5) while pan-frying meat. However, there is inadequate knowledge of exposure level to indoor PM2.5 in homes and the contribution of a typical indoor pan-frying event. We measured the indoor PM2.5 concentration and, using Monte-Carlo simulation, estimated potential average daily dose (ADD) of PM2.5 for homemakers pan-frying a piece of pork inside ordinary homes. Convenience-based sampling at 13 homes was conducted over four consecutive days in June 2013 (n = 52). Although we pan-fried 100 g pork for only 9 min, the median (interquartile range, IQR) value was 4.5 (2.2–5.6) mg/m3 for no ventilation and 0.5 (0.1–1.3) mg/m3 with an active stove hood ventilation system over a 2 h sampling interval. The probabilities that the ADDs from inhalation of indoor PM2.5 would be higher than the ADD from inhalation of PM2.5 on an outdoor roadside (4.6 μg/kg·day) were 99.44%, 97.51%, 93.64%, and 67.23%, depending on the ventilation conditions: (1) no window open; (2) one window open in the kitchen; (3) two windows open, one each in the kitchen and living room; and (4) operating a forced-air stove hood, respectively. Full article
(This article belongs to the Section Public Health)
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Open AccessArticle Occurrence of Emerging Micropollutants in Water Systems in Gauteng, Mpumalanga, and North West Provinces, South Africa
Int. J. Environ. Res. Public Health 2017, 14(1), 79; doi:10.3390/ijerph14010079
Received: 18 November 2016 / Revised: 28 December 2016 / Accepted: 10 January 2017 / Published: 13 January 2017
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Abstract
The ubiquitous occurrence of emerging micropollutants (EMPs) in water is an issue of growing environmental-health concern worldwide. However, there remains a paucity of data regarding their levels and occurrence in water. This study determined the occurrence of EMPs namely: carbamazepine (CBZ), galaxolide (HHCB),
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The ubiquitous occurrence of emerging micropollutants (EMPs) in water is an issue of growing environmental-health concern worldwide. However, there remains a paucity of data regarding their levels and occurrence in water. This study determined the occurrence of EMPs namely: carbamazepine (CBZ), galaxolide (HHCB), caffeine (CAF), tonalide (AHTN), 4-nonylphenol (NP), and bisphenol A (BPA) in water from Gauteng, Mpumalanga, and North West provinces, South Africa using comprehensive two-dimensional gas chromatography coupled to high resolution time-of-flight mass spectrometry (GCxGC-HRTOFMS). Kruskal-Wallis test and ANOVA were performed to determine temporal variations in occurrence of the EMPs. Principal component analysis (PCA) and Surfer Golden Graphics software for surface mapping were used to determine spatial variations in levels and occurrence of the EMPs. The mean levels ranged from 11.22 ± 18.8 ng/L for CAF to 158.49 ± 662 ng/L for HHCB. There was no evidence of statistically significant temporal variations in occurrence of EMPs in water. Nevertheless, their levels and occurrence vary spatially and are a function of two principal components (PCs, PC1 and PC2) which controlled 89.99% of the variance. BPA was the most widely distributed EMP, which was present in 62% of the water samples. The detected EMPs pose ecotoxicological risks in water samples, especially those from Mpumalanga province. Full article
(This article belongs to the Special Issue Organic Micro-Pollutants and Human Exposure)
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Open AccessArticle Efficiency of Emission Control Measures on Particulate Matter-Related Health Impacts and Economic Cost during the 2014 Asia-Pacific Economic Cooperation Meeting in Beijing
Int. J. Environ. Res. Public Health 2017, 14(1), 19; doi:10.3390/ijerph14010019
Received: 10 October 2016 / Revised: 20 December 2016 / Accepted: 21 December 2016 / Published: 28 December 2016
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Abstract
Background: The Asia-Pacific Economic Cooperation (APEC) meeting was held from 5 November to 11 November 2014 in Beijing, and comprehensive emission control measures were implemented. The efficiency of these measures on particulate matter-related health impacts and economic cost need to be evaluated.
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Background: The Asia-Pacific Economic Cooperation (APEC) meeting was held from 5 November to 11 November 2014 in Beijing, and comprehensive emission control measures were implemented. The efficiency of these measures on particulate matter-related health impacts and economic cost need to be evaluated. Methods: The influences of emission control measures during APEC on particulate matter were evaluated, and health economic effects were assessed. Results: Average concentrations of PM2.5 and PM10 during APEC were reduced by 57.0%, and 50.6% respectively, compared with pre-APEC period. However, the concentrations of particulate matter rebounded after APEC. Compared with the pre-APEC and post-APEC periods, the estimated number of deaths caused by non-accidental, cardiovascular and respiratory diseases that could be attributed to PM2.5 and PM10 during the APEC were the lowest. The economic cost associated with mortality caused by PM2.5 and PM10 during the APEC were reduced by (61.3% and 66.6%) and (50.3% and 60.8%) respectively, compared with pre-APEC and post-APEC. Conclusions: The emission control measures were effective in improving short term air quality and reducing health risks and medical expenses during 2014 APEC, but more efforts is needed for long term and continuous air quality improvement and health protection. Full article
(This article belongs to the Section Health Economics)
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Open AccessArticle Estimating the Cost and Payment for Sanitation in the Informal Settlements of Kisumu, Kenya: A Cross Sectional Study
Int. J. Environ. Res. Public Health 2017, 14(1), 49; doi:10.3390/ijerph14010049
Received: 22 November 2016 / Revised: 25 December 2016 / Accepted: 30 December 2016 / Published: 6 January 2017
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Abstract
Lack of sanitation facilities is a common occurrence in informal settlements that are common in most developing countries. One challenge with sanitation provision in these settlements is the cost and financing of sanitation. This study aimed at estimating the cost of sanitation, and
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Lack of sanitation facilities is a common occurrence in informal settlements that are common in most developing countries. One challenge with sanitation provision in these settlements is the cost and financing of sanitation. This study aimed at estimating the cost of sanitation, and investigating the social and economic dynamics within Kisumu’s informal settlements that hinder provision and uptake of sanitation facilities. Primary data was collected from residents of the settlements, and using logistic and hedonic regression analysis, we identify characteristics of residents with sanitation facilities, and estimate the cost of sanitation as revealed in rental prices. Our study finds that sanitation constitutes approximately 54% of the rent paid in the settlements; and dynamics such as landlords and tenants preferences, and sharing of sanitation facilities influence provision and payment for sanitation. This study contributes to general development by estimating the cost of sanitation, and further identifies barriers and opportunities for improvement including the interplay between landlords and tenants. Provision of sanitation in informal settlements is intertwined in social and economic dynamics, and development approaches should target both landlords and tenants, while also engaging various stakeholders to work together to identify affordable and appropriate sanitation technologies. Full article
(This article belongs to the Section Health Economics)
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Open AccessArticle Antioxidant Pre-Treatment Reduces the Toxic Effects of Oxalate on Renal Epithelial Cells in a Cell Culture Model of Urolithiasis
Int. J. Environ. Res. Public Health 2017, 14(1), 109; doi:10.3390/ijerph14010109
Received: 23 November 2016 / Revised: 10 January 2017 / Accepted: 17 January 2017 / Published: 23 January 2017
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Abstract
Urolithiasis is characterized by the formation and retention of solid crystals within the urinary tract. Kidney stones are mostly composed of calcium oxalate, which predominantly generates free radicals that are toxic to renal tubular cells. The aim of the study is to explore
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Urolithiasis is characterized by the formation and retention of solid crystals within the urinary tract. Kidney stones are mostly composed of calcium oxalate, which predominantly generates free radicals that are toxic to renal tubular cells. The aim of the study is to explore possible effects of antioxidant pre-treatment on inhibition of oxidative stress. Three cell lines were used as in vitro model of urolithiasis: MDCK I, MDCK II and LLC-PK1. Oxidative stress was induced by exposure of cells to sodium oxalate in concentration of 8 mM. In order to prevent oxidative stress, cells were pre-treated with three different concentrations of l-arginine and vitamin E. Oxidative stress was evaluated by determining the expression of superoxide dismutase (SOD), osteopontin (OPN), and by the concentration of glutathione (GSH). In all three cell lines, pre-treatment of antioxidants increased cell survival. Positive correlation of SOD and OPN expression as well as GSH concentration was observed in all groups of cells. Our results indicate that an antioxidant pre-treatment with l-arginine and vitamin E is able to hamper oxalate-induced oxidative stress in kidney epithelial cells and as such could play a role in prevention of urolithiasis. Full article
(This article belongs to the Section Environment Health)
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Open AccessArticle Water Quality, Sanitation, and Hygiene Conditions in Schools and Households in Dolakha and Ramechhap Districts, Nepal: Results from A Cross-Sectional Survey
Int. J. Environ. Res. Public Health 2017, 14(1), 89; doi:10.3390/ijerph14010089
Received: 18 November 2016 / Revised: 3 January 2017 / Accepted: 9 January 2017 / Published: 18 January 2017
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Abstract
This study assessed drinking water quality, sanitation, and hygiene (WASH) conditions among 708 schoolchildren and 562 households in Dolakha and Ramechhap districts of Nepal. Cross-sectional surveys were carried out in March and June 2015. A Delagua water quality testing kit was employed on
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This study assessed drinking water quality, sanitation, and hygiene (WASH) conditions among 708 schoolchildren and 562 households in Dolakha and Ramechhap districts of Nepal. Cross-sectional surveys were carried out in March and June 2015. A Delagua water quality testing kit was employed on 634 water samples obtained from 16 purposively selected schools, 40 community water sources, and 562 households to examine water quality. A flame atomic absorption spectrophotometer was used to test lead and arsenic content of the same samples. Additionally, a questionnaire survey was conducted to obtain WASH predictors. A total of 75% of school drinking water source samples and 76.9% point-of-use samples (water bottles) at schools, 39.5% water source samples in the community, and 27.4% point-of-use samples at household levels were contaminated with thermo-tolerant coliforms. The values of water samples for pH (6.8–7.6), free and total residual chlorine (0.1–0.5 mg/L), mean lead concentration (0.01 mg/L), and mean arsenic concentration (0.05 mg/L) were within national drinking water quality standards. The presence of domestic animals roaming inside schoolchildren’s homes was significantly associated with drinking water contamination (adjusted odds ratio: 1.64; 95% confidence interval: 1.08–2.50; p = 0.02). Our findings call for an improvement of WASH conditions at the unit of school, households, and communities. Full article
(This article belongs to the Special Issue Environmental Pollution and Human Health Risk)
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Open AccessArticle Knowledge and Attitudes of Dentists with Respect to the Risks of Blood-Borne Pathogens—A Cross-Sectional Study in Poland
Int. J. Environ. Res. Public Health 2017, 14(1), 69; doi:10.3390/ijerph14010069
Received: 3 December 2016 / Revised: 3 January 2017 / Accepted: 6 January 2017 / Published: 12 January 2017
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Abstract
Background: To analyze dentists’ knowledge of blood-borne infections, their attitudes towards infected patients, and to determine the frequency of the contact with infectious material; Methods: We surveyed 192 dentists using an anonymous questionnaire. Results: Only a quarter of dentists responded
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Background: To analyze dentists’ knowledge of blood-borne infections, their attitudes towards infected patients, and to determine the frequency of the contact with infectious material; Methods: We surveyed 192 dentists using an anonymous questionnaire. Results: Only a quarter of dentists responded correctly to all questions. 96% of the examined dentists confirmed that they were more cautious during treatment of patients with HBV, HCV and HIV. 25% of all respondents refuse to help infected patients due to concerns about their own health. The dentists occasionally removed protective clothing to make it “easier” to perform specific procedures. The dentists experienced contact with infectious material most frequently by splashes onto the conjunctiva or as a result of superficial injuries. The risk of injury by a medical tool increased with the years of employment. Re-capping needles was associated with an increased risk of injury; Conclusions: Despite the widespread tolerance of people infected with blood-borne viruses and the well-proven low infection risk to medical personnel, dentists continue to be prejudiced and concerned about their own health and may refuse to treat infected patients. It may be assumed that the proportion of refusing treatment is even greater. This attitude should imply the implementation of training in the field of pathogen transmission and the real risk of infection. Full article
(This article belongs to the Section Public Health)
Open AccessArticle Microbiological Contamination at Workplaces in a Combined Heat and Power (CHP) Station Processing Plant Biomass
Int. J. Environ. Res. Public Health 2017, 14(1), 99; doi:10.3390/ijerph14010099
Received: 9 November 2016 / Revised: 6 January 2017 / Accepted: 17 January 2017 / Published: 21 January 2017
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Abstract
The aim of the study was to evaluate the microbial contamination at a plant biomass processing thermal power station (CHP). We found 2.42 × 103 CFU/m3 of bacteria and 1.37 × 104 CFU/m3 of fungi in the air; 2.30
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The aim of the study was to evaluate the microbial contamination at a plant biomass processing thermal power station (CHP). We found 2.42 × 103 CFU/m3 of bacteria and 1.37 × 104 CFU/m3 of fungi in the air; 2.30 × 107 CFU/g of bacteria and 4.46 × 105 CFU/g of fungi in the biomass; and 1.61 × 102 CFU/cm2 bacteria and 2.39 × 101 CFU/cm2 fungi in filtering facepiece respirators (FFRs). Using culture methods, we found 8 genera of mesophilic bacteria and 7 of fungi in the air; 10 genera each of bacteria and fungi in the biomass; and 2 and 5, respectively, on the FFRs. Metagenomic analysis (Illumina MiSeq) revealed the presence of 46 bacterial and 5 fungal genera on the FFRs, including potential pathogens Candida tropicalis, Escherichia coli, Prevotella sp., Aspergillus sp., Penicillium sp.). The ability of microorganisms to create a biofilm on the FFRs was confirmed using scanning electron microscopy (SEM). We also identified secondary metabolites in the biomass and FFRs, including fumigaclavines, quinocitrinines, sterigmatocistin, and 3-nitropropionic acid, which may be toxic to humans. Due to the presence of potential pathogens and mycotoxins, the level of microbiological contamination at workplaces in CHPs should be monitored. Full article
(This article belongs to the Special Issue Indoor Air Quality and Health 2016)
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Open AccessArticle Serum Polychlorinated Biphenyls Increase and Oxidative Stress Decreases with a Protein-Pacing Caloric Restriction Diet in Obese Men and Women
Int. J. Environ. Res. Public Health 2017, 14(1), 59; doi:10.3390/ijerph14010059
Received: 5 October 2016 / Revised: 28 December 2016 / Accepted: 4 January 2017 / Published: 10 January 2017
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Abstract
The purposes were to compare the effects of a: (1) 12-week P-CR weight loss (WL) diet (Phase 1) between obese men and women and; (2) 52-week modified P-CR (mP-CR) vs. heart healthy (HH) weight maintenance (WM) diet (Phase 2) on serum PCBs and
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The purposes were to compare the effects of a: (1) 12-week P-CR weight loss (WL) diet (Phase 1) between obese men and women and; (2) 52-week modified P-CR (mP-CR) vs. heart healthy (HH) weight maintenance (WM) diet (Phase 2) on serum PCBs and oxidative stress biomarkers (thiobarbituric acid reactive substances, TBARS; total antioxidant capacity, TAC) in 40 obese participants (men, n = 21; women, n = 19). Participants received dietary counseling and monitoring of compliance. PCBs, TBARS, and TAC were assessed at weeks −1 (CON), 12 (WL), and 64 (WM). Following WL (Week 12), concomitant with reductions in TBARS (0.24 ± 0.15 vs. 0.18 ± 0.11 µM; p < 0.01), PCB serum concentrations (86.7 ± 45.6 vs. 115.6 ± 65.9 ng/g lipid; p < 0.01) and TAC (18.9 ± 2.6 vs. 19.9 ± 2.3 nmol/mL; p < 0.02) were increased similarly in men and women. At the end of WM (Week 64), a significant effect of time × group interaction was observed for % change in PCB 170 and 187; whereby mP-CR values were higher compared to HH (PCB170: 19.31% ± 26.48% vs. −6.61% ± 28.88%, p = 0.02; PCB187: −3.04% ± 17.78% vs. −21.4% ± 27.31%, p = 0.04). PCB changes were positively correlated with TBARS levels (r > 0.42, p < 0.05) and negatively correlated with body weight, fat mass, and abdominal fat (r < −0.46, p < 0.02). Our results support mobilization of stored PCBs as well as enhanced redox status following a 12-week P-CR WL diet. Additionally, a 52-week mP-CR WM diet demonstrated an advantage in preventing weight gain relapse accompanied by an increase in circulating PCBs compared to a traditional HH diet. Full article
(This article belongs to the Special Issue Organic Micro-Pollutants and Human Exposure)
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Open AccessArticle Pesticide Use and Risk Perceptions among Small-Scale Farmers in Anqiu County, China
Int. J. Environ. Res. Public Health 2017, 14(1), 29; doi:10.3390/ijerph14010029
Received: 6 November 2016 / Revised: 22 December 2016 / Accepted: 23 December 2016 / Published: 30 December 2016
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Abstract
The unsafe use and misuse of pesticides in China are major threats to farmers’ health and the environment. The purpose of this study is to evaluate small-scale farmers’ practices with regard to pesticide use and identify the determinants of their behavior in Anqiu
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The unsafe use and misuse of pesticides in China are major threats to farmers’ health and the environment. The purpose of this study is to evaluate small-scale farmers’ practices with regard to pesticide use and identify the determinants of their behavior in Anqiu County, China. The results show that the frequency of pesticide application by local farmers is high and that the improper disposal of pesticides after use is common in the study area. Although most farmers felt that they were at some degree of risk when using pesticides, farmers were found to overuse pesticides in the study area. The probability of pesticide overuse significantly decreased with farmers’ risk perceptions, willingness to reduce pesticide use, better social relationships, and strict government monitoring. The perception of risk can thus be an important element in education and communication efforts. Full article
(This article belongs to the Special Issue Ecological and Human-Health Effects of Pesticides in the Environment)
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Review

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Open AccessReview Implications of Changing Temperatures on the Growth, Fecundity and Survival of Intermediate Host Snails of Schistosomiasis: A Systematic Review
Int. J. Environ. Res. Public Health 2017, 14(1), 80; doi:10.3390/ijerph14010080
Received: 7 November 2016 / Revised: 4 January 2017 / Accepted: 9 January 2017 / Published: 13 January 2017
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Abstract
Climate change has been predicted to increase the global mean temperature and to alter the ecological interactions among organisms. These changes may play critical roles in influencing the life history traits of the intermediate hosts (IHs). This review focused on studies and disease
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Climate change has been predicted to increase the global mean temperature and to alter the ecological interactions among organisms. These changes may play critical roles in influencing the life history traits of the intermediate hosts (IHs). This review focused on studies and disease models that evaluate the potential effect of temperature rise on the ecology of IH snails and the development of parasites within them. The main focus was on IH snails of schistosome parasites that cause schistosomiasis in humans. A literature search was conducted on Google Scholar, EBSCOhost and PubMed databases using predefined medical subject heading terms, Boolean operators and truncation symbols in combinations with direct key words. The final synthesis included nineteen published articles. The studies reviewed indicated that temperature rise may alter the distribution, optimal conditions for breeding, growth and survival of IH snails which may eventually increase the spread and/or transmission of schistosomiasis. The literature also confirmed that the life history traits of IH snails and their interaction with the schistosome parasites are affected by temperature and hence a change in climate may have profound outcomes on the population size of snails, parasite density and disease epidemiology. We concluded that understanding the impact of temperature on the growth, fecundity and survival of IH snails may broaden the knowledge on the possible effects of climate change and hence inform schistosomiasis control programmes. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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Open AccessReview Genetic Aspects of Susceptibility to Mercury Toxicity: An Overview
Int. J. Environ. Res. Public Health 2017, 14(1), 93; doi:10.3390/ijerph14010093
Received: 3 November 2016 / Revised: 16 December 2016 / Accepted: 12 January 2017 / Published: 18 January 2017
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Abstract
Human exposure to mercury is still a major public health concern. In this context, children have a higher susceptibility to adverse neurological mercury effects, compared to adults with similar exposures. Moreover, there exists a marked variability of personal response to detrimental mercury action,
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Human exposure to mercury is still a major public health concern. In this context, children have a higher susceptibility to adverse neurological mercury effects, compared to adults with similar exposures. Moreover, there exists a marked variability of personal response to detrimental mercury action, in particular among population groups with significant mercury exposure. New scientific evidence on genetic backgrounds has raised the issue of whether candidate susceptibility genes can make certain individuals more or less vulnerable to mercury toxicity. In this review, the aim is to evaluate a new genetic dimension and its involvement in mercury risk assessment, focusing on the important role played by relevant polymorphisms, located in attractive gene targets for mercury toxicity. Existing original articles on epidemiologic research which report a direct link between the genetic basis of personal vulnerability and different mercury repercussions on human health will be reviewed. Based on this evidence, a careful evaluation of the significant markers of susceptibility will be suggested, in order to obtain a powerful positive “feedback” to improve the quality of life. Large consortia of studies with clear phenotypic assessments will help clarify the “window of susceptibility” in the human health risks due to mercury exposure. Full article
(This article belongs to the Special Issue Mercury and Health: Current Perspectives and Future Directions)
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Open AccessReview Mercury Exposure and Heart Diseases
Int. J. Environ. Res. Public Health 2017, 14(1), 74; doi:10.3390/ijerph14010074
Received: 9 October 2016 / Revised: 13 December 2016 / Accepted: 30 December 2016 / Published: 12 January 2017
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Abstract
Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways.
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Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease, and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence has shown that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system. Full article
(This article belongs to the Special Issue Mercury and Health: Current Perspectives and Future Directions)
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Open AccessReview A New Strategy for Heavy Metal Polluted Environments: A Review of Microbial Biosorbents
Int. J. Environ. Res. Public Health 2017, 14(1), 94; doi:10.3390/ijerph14010094
Received: 20 October 2016 / Revised: 26 December 2016 / Accepted: 13 January 2017 / Published: 19 January 2017
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Abstract
Persistent heavy metal pollution poses a major threat to all life forms in the environment due to its toxic effects. These metals are very reactive at low concentrations and can accumulate in the food web, causing severe public health concerns. Remediation using conventional
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Persistent heavy metal pollution poses a major threat to all life forms in the environment due to its toxic effects. These metals are very reactive at low concentrations and can accumulate in the food web, causing severe public health concerns. Remediation using conventional physical and chemical methods is uneconomical and generates large volumes of chemical waste. Bioremediation of hazardous metals has received considerable and growing interest over the years. The use of microbial biosorbents is eco-friendly and cost effective; hence, it is an efficient alternative for the remediation of heavy metal contaminated environments. Microbes have various mechanisms of metal sequestration that hold greater metal biosorption capacities. The goal of microbial biosorption is to remove and/or recover metals and metalloids from solutions, using living or dead biomass and their components. This review discusses the sources of toxic heavy metals and describes the groups of microorganisms with biosorbent potential for heavy metal removal. Full article
(This article belongs to the Special Issue Heavy Metals: Environmental and Human Health)
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Open AccessReview Global Sources and Pathways of Mercury in the Context of Human Health
Int. J. Environ. Res. Public Health 2017, 14(1), 105; doi:10.3390/ijerph14010105
Received: 12 December 2016 / Revised: 6 January 2017 / Accepted: 19 January 2017 / Published: 22 January 2017
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Abstract
This paper reviews information from the existing literature and the EU GMOS (Global Mercury Observation System) project to assess the current scientific knowledge on global mercury releases into the atmosphere, on global atmospheric transport and deposition, and on the linkage between environmental contamination
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This paper reviews information from the existing literature and the EU GMOS (Global Mercury Observation System) project to assess the current scientific knowledge on global mercury releases into the atmosphere, on global atmospheric transport and deposition, and on the linkage between environmental contamination and potential impacts on human health. The review concludes that assessment of global sources and pathways of mercury in the context of human health is important for being able to monitor the effects from implementation of the Minamata Convention targets, although new research is needed on the improvement of emission inventory data, the chemical and physical behaviour of mercury in the atmosphere, the improvement of monitoring network data, predictions of future emissions and speciation, and on the subsequent effects on the environment, human health, as well as the economic costs and benefits of reducing these aspects. Full article
(This article belongs to the Special Issue Mercury and Health: Current Perspectives and Future Directions)
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Open AccessReview Bioactive Nanocomposites for Tissue Repair and Regeneration: A Review
Int. J. Environ. Res. Public Health 2017, 14(1), 66; doi:10.3390/ijerph14010066
Received: 2 October 2016 / Revised: 9 December 2016 / Accepted: 24 December 2016 / Published: 11 January 2017
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Abstract
This review presents scientific findings concerning the use of bioactive nanocomposites in the field of tissue repair and regeneration. Bioactivity is the ability of a material to incite a specific biological reaction, usually at the boundary of the material. Nanocomposites have been shown
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This review presents scientific findings concerning the use of bioactive nanocomposites in the field of tissue repair and regeneration. Bioactivity is the ability of a material to incite a specific biological reaction, usually at the boundary of the material. Nanocomposites have been shown to be ideal bioactive materials due the many biological interfaces and structures operating at the nanoscale. This has resulted in many researchers investigating nanocomposites for use in bioapplications. Nanocomposites encompass a number of different structures, incorporating organic-inorganic, inorganic-inorganic and bioinorganic nanomaterials and based upon ceramic, metallic or polymeric materials. This enables a wide range of properties to be incorporated into nanocomposite materials, such as magnetic properties, MR imaging contrast or drug delivery, and even a combination of these properties. Much of the classical research was focused on bone regeneration, however, recent advances have enabled further use in soft tissue body sites too. Despite recent technological advances, more research is needed to further understand the long-term biocompatibility impact of the use of nanoparticles within the human body. Full article
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Open AccessReview Food and Nutrition Insecurity in Selected Rural Communities of KwaZulu-Natal, South Africa—Linking Human Nutrition and Agriculture
Int. J. Environ. Res. Public Health 2017, 14(1), 17; doi:10.3390/ijerph14010017
Received: 17 November 2016 / Revised: 19 December 2016 / Accepted: 22 December 2016 / Published: 27 December 2016
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Abstract
Lack of access to nutritious and balanced diets remains a major impediment to the health and well-being of people living in rural areas. The study utilizes a qualitative systematic approach to conduct an environmental scan and review of scientific literature of studies conducted
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Lack of access to nutritious and balanced diets remains a major impediment to the health and well-being of people living in rural areas. The study utilizes a qualitative systematic approach to conduct an environmental scan and review of scientific literature of studies conducted in South Africa, specifically KwaZulu-Natal (KZN). Availability and access to nutritious, diverse and balanced diets were identified as key constraints for achieving food and nutrition security as well as for human health and well-being. This has led to both under- and over-nutrition, with the former, in particular stunting, affecting children under 5 years. A high incidence of over-nutrition, both overweight and obesity, was observed among black African females. In South Africa, poor people rely mostly on social grants and cannot afford a balanced diet. Under these circumstances, agriculture could be used to increase availability and access to diverse and nutritious foods for the attainment of a balanced diet. The wider use of traditional vegetable crops and pulses could improve availability and access to healthy and locally available alternatives. The promotion of household and community food gardens, and the use of nutrient dense crops with low levels of water use, i.e., high nutritional water productivity, offers prospects for addressing malnutrition in poor rural areas. Full article
(This article belongs to the Section Public Health)
Open AccessReview New Immunotherapy Strategies in Breast Cancer
Int. J. Environ. Res. Public Health 2017, 14(1), 68; doi:10.3390/ijerph14010068
Received: 9 October 2016 / Revised: 5 January 2017 / Accepted: 9 January 2017 / Published: 12 January 2017
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Abstract
Breast cancer is the most commonly diagnosed cancer among women. Therapeutic treatments for breast cancer generally include surgery, chemotherapy, radiotherapy, endocrinotherapy and molecular targeted therapy. With the development of molecular biology, immunology and pharmacogenomics, immunotherapy becomes a promising new field in breast cancer
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Breast cancer is the most commonly diagnosed cancer among women. Therapeutic treatments for breast cancer generally include surgery, chemotherapy, radiotherapy, endocrinotherapy and molecular targeted therapy. With the development of molecular biology, immunology and pharmacogenomics, immunotherapy becomes a promising new field in breast cancer therapies. In this review, we discussed recent progress in breast cancer immunotherapy, including cancer vaccines, bispecific antibodies, and immune checkpoint inhibitors. Several additional immunotherapy modalities in early stages of development are also highlighted. It is believed that these new immunotherapeutic strategies will ultimately change the current status of breast cancer therapies. Full article
(This article belongs to the Section Public Health)
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Other

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Open AccessComment Visualizing the Heterogeneity of Effects in the Analysis of Associations of Multiple Myeloma with Glyphosate Use. Comments on Sorahan, T. Multiple Myeloma and Glyphosate Use: A Re-Analysis of US Agricultural Health Study (AHS) Data. Int. J. Environ. Res. Public Health 2015, 12, 1548–1559
Int. J. Environ. Res. Public Health 2017, 14(1), 5; doi:10.3390/ijerph14010005
Received: 7 December 2016 / Accepted: 14 December 2016 / Published: 22 December 2016
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Abstract
We address a methodological issue of the evaluation of the difference in effects in epidemiological studies that may arise, for example, from stratum-specific analyses or differences in analytical decisions during data analysis. We propose a new simulation-based method to quantify the plausible extent
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We address a methodological issue of the evaluation of the difference in effects in epidemiological studies that may arise, for example, from stratum-specific analyses or differences in analytical decisions during data analysis. We propose a new simulation-based method to quantify the plausible extent of such heterogeneity, rather than testing a hypothesis about its existence. We examine the contribution of the method to the debate surrounding risk of multiple myeloma and glyphosate use and propose that its application contributes to a more balanced weighting of evidence. Full article
(This article belongs to the Section Environment Health)
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Open AccessReply Visualising and Thinking and Interpreting. Response to the Burstyn and De Roos Comments on Sorahan, T. Multiple Myeloma and Glyphosate Use: A Re-Analysis of US Agricultural Health Study (AHS) Data. Int. J. Environ. Res. Public Health 2015, 12, 1548–1559
Int. J. Environ. Res. Public Health 2017, 14(1), 6; doi:10.3390/ijerph14010006
Received: 16 December 2016 / Revised: 16 December 2016 / Accepted: 16 December 2016 / Published: 22 December 2016
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(This article belongs to the Section Environment Health)
Open AccessCommentary Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing
Int. J. Environ. Res. Public Health 2017, 14(1), 12; doi:10.3390/ijerph14010012
Received: 5 December 2016 / Revised: 20 December 2016 / Accepted: 22 December 2016 / Published: 24 December 2016
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Abstract
Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of
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Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of the guidelines is required. Worldwide, Legionella has been detected from many potable water sources, suggesting it is ubiquitous in this environment. Previous studies have identified the limitations of the current standard method for Legionella detection and the high possibility of it returning both false negative and false positive results. There is also huge variability in Legionella test results for the same water sample when conducted at different laboratories. However, many guidelines still recommend the testing of water systems. This commentary argues for the removal of routine Legionella monitoring from all water distribution guidelines. This procedure is financially consuming and false negatives may result in managers being over-confident with a system or a control mechanism. Instead, the presence of the pathogen should be assumed and focus spent on managing appropriate control measures and protecting high-risk population groups. Full article
(This article belongs to the Section Environment Health)
Open AccessShort Note An Electrostatic-Barrier-Forming Window that Captures Airborne Pollen Grains to Prevent Pollinosis
Int. J. Environ. Res. Public Health 2017, 14(1), 82; doi:10.3390/ijerph14010082
Received: 7 December 2016 / Revised: 11 January 2017 / Accepted: 12 January 2017 / Published: 15 January 2017
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Abstract
An electrostatic-barrier-forming window (EBW) was devised to capture airborne pollen, which can cause allergic pollinosis. The EBW consisted of three layers of insulated conductor wires (ICWs) and two voltage generators that supplied negative charges to the two outer ICW layers and a positive
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An electrostatic-barrier-forming window (EBW) was devised to capture airborne pollen, which can cause allergic pollinosis. The EBW consisted of three layers of insulated conductor wires (ICWs) and two voltage generators that supplied negative charges to the two outer ICW layers and a positive charge to the middle ICW layer. The ICWs generated an attractive force that captured pollen of the Japanese cedar, Cryptomeria japonica, from air blown through the EBW. The attractive force was directly proportional to the applied voltage. At ≥3.5 kV, the EBW exerted sufficient force to capture all pollen carried at an air flow of 3 m/s, and pollen-free air passed through the EBW. The findings demonstrated that the electrostatic barrier that formed inside the EBW was very effective at capturing airborne pollen; thus, it could allow a home to remain pollen-free and healthy despite continuous pollen exposure. Full article
(This article belongs to the Section Public Health)
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Open AccessComment Comments on Whiley Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing. Int. J. Environ. Res. Public Health 2017, 14, 12
Int. J. Environ. Res. Public Health 2017, 14(1), 102; doi:10.3390/ijerph14010102
Received: 4 January 2017 / Revised: 8 January 2017 / Accepted: 11 January 2017 / Published: 21 January 2017
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Abstract
In their recent article, Whiley makes an interesting case for the abolishment of routine testing in Legionella risk management and control plans. Here, we present our views regarding this suggestion, drawing upon our own experiences in the UK. We urge caution against the
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In their recent article, Whiley makes an interesting case for the abolishment of routine testing in Legionella risk management and control plans. Here, we present our views regarding this suggestion, drawing upon our own experiences in the UK. We urge caution against the removal of routine monitoring from guidelines due to the impending public health risks that would result. Full article
(This article belongs to the Section Public Health)
Open AccessReply Response to Comments on Whiley Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing. Int. J. Environ. Res. Public Health 2017, 14, 12
Int. J. Environ. Res. Public Health 2017, 14(1), 103; doi:10.3390/ijerph14010103
Received: 10 January 2017 / Revised: 11 January 2017 / Accepted: 11 January 2017 / Published: 21 January 2017
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(This article belongs to the Section Environment Health)
Open AccessShort Communication Assessment of Food Safety Knowledge, Attitude, Self-Reported Practices, and Microbiological Hand Hygiene of Food Handlers
Int. J. Environ. Res. Public Health 2017, 14(1), 55; doi:10.3390/ijerph14010055
Received: 3 September 2016 / Revised: 21 December 2016 / Accepted: 26 December 2016 / Published: 10 January 2017
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Abstract
Institutional foodborne illness outbreaks continue to hit the headlines in the country, indicating the failure of food handlers to adhere to safe practices during food preparation. Thus, this study aimed to compare the knowledge, attitude, and self-reported practices (KAP) of food safety assessment
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Institutional foodborne illness outbreaks continue to hit the headlines in the country, indicating the failure of food handlers to adhere to safe practices during food preparation. Thus, this study aimed to compare the knowledge, attitude, and self-reported practices (KAP) of food safety assessment and microbiological assessment of food handlers’ hands as an indicator of hygiene practices in food premises. This study involved 85 food handlers working in a university located in Kuala Lumpur, Malaysia. The food safety KAP among food handlers (n = 67) was assessed using a questionnaire; while the hand swabs (n = 85) were tested for the total aerobic count, coliforms, and Escherichia coli, Staphylococcus aureus, Salmonella, Vibrio cholerae and Vibrio parahaemolyticus. The food handlers had moderate levels of food safety knowledge (61.7%) with good attitude (51.9/60) and self-reported practices (53.2/60). It is noteworthy that the good self-reported practices were not reflected in the microbiological assessment of food handlers’ hands, in which 65% of the food handlers examined had a total aerobic count ≥20 CFU/cm2 and Salmonella was detected on 48% of the food handlers’ hands. In conclusion, the suggestion of this study was that the food handlers had adequate food safety knowledge, but perceived knowledge failed to be translated into practices at work. Full article
(This article belongs to the Section Public Health)
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Open AccessBrief Report Is a Perceived Activity-Friendly Environment Associated with More Physical Activity and Fewer Screen-Based Activities in Adolescents?
Int. J. Environ. Res. Public Health 2017, 14(1), 39; doi:10.3390/ijerph14010039
Received: 7 November 2016 / Revised: 16 December 2016 / Accepted: 21 December 2016 / Published: 3 January 2017
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Abstract
Background: The aim of this study is to explore if perception of an activity-friendly environment is associated with more physical activity and fewer screen-based activities among adolescents. Methods: We collected self-reported data in 2014 via the Health Behavior in School-aged Children cross-sectional study
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Background: The aim of this study is to explore if perception of an activity-friendly environment is associated with more physical activity and fewer screen-based activities among adolescents. Methods: We collected self-reported data in 2014 via the Health Behavior in School-aged Children cross-sectional study from four European countries (n = 13,800, mean age = 14.4, 49.4% boys). We explored the association of perceived environment (e.g., “There are other children nearby home to go out and play with”) with physical activity and screen-based activities using a binary logistic regression model adjusted for age, gender, family affluence and country. Results: An environment perceived as activity-friendly was associated with higher odds that adolescents meet recommendations for physical activity (odds ratio (OR) for one standard deviation (SD) change = 1.11, 95% confidence interval (CI) 1.05–1.18) and lower odds for excessive screen-based activities (OR for 1 SD better = 0.93, 95% CI 0.88–0.98). Conclusions: Investment into an activity-friendly environment may support the promotion of active life styles in adolescence. Full article
(This article belongs to the Section Public Health)

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