International Journal of Environmental Research and Public Health

503 KiB

Open AccessArticle

Artificial Intelligence in Public Health Prevention of Legionelosis in Drinking Water Systems

by Peter Sinčak, Jaroslav Ondo, Daniela Kaposztasova, Maria Virčikova, Zuzana Vranayova and Jakub Sabol

Int. J. Environ. Res. Public Health 2014, 11(8), 8597-8611; https://doi.org/10.3390/ijerph110808597 - 21 Aug 2014

Cited by 11 | Viewed by 8403

Abstract

Good quality water supplies and safe sanitation in urban areas are a big challenge for governments throughout the world. Providing adequate water quality is a basic requirement for our lives. The colony forming units of the bacterium Legionella pneumophila in potable water represent [...] Read more.

Good quality water supplies and safe sanitation in urban areas are a big challenge for governments throughout the world. Providing adequate water quality is a basic requirement for our lives. The colony forming units of the bacterium Legionella pneumophila in potable water represent a big problem which cannot be overlooked for health protection reasons. We analysed several methods to program a virtual hot water tank with AI (artificial intelligence) tools including neuro-fuzzy systems as a precaution against legionelosis. The main goal of this paper is to present research which simulates the temperature profile in the water tank. This research presents a tool for a water management system to simulate conditions which are able to prevent legionelosis outbreaks in a water system. The challenge is to create a virtual water tank simulator including the water environment which can simulate a situation which is common in building water distribution systems. The key feature of the presented system is its adaptation to any hot water tank. While respecting the basic parameters of hot water, a water supplier and building maintainer are required to ensure the predefined quality and water temperature at each sampling site and avoid the growth of Legionella. The presented system is one small contribution how to overcome a situation when legionelosis could find good conditions to spread and jeopardize human lives. Full article

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Open AccessArticle

Influence of Surfactant and Lipid Type on the Physicochemical Properties and Biocompatibility of Solid Lipid Nanoparticles

by Carine Dal Pizzol, Fabíola Branco Filippin-Monteiro, Jelver Alexander Sierra Restrepo, Frederico Pittella, Adny Henrique Silva, Paula Alves de Souza, Angela Machado de Campos and Tânia Beatriz Creczynski-Pasa

Int. J. Environ. Res. Public Health 2014, 11(8), 8581-8596; https://doi.org/10.3390/ijerph110808581 - 20 Aug 2014

Cited by 61 | Viewed by 8438

Abstract

Nine types of solid lipid nanoparticle (SLN) formulations were produced using tripalmitin (TPM), glyceryl monostearate (GM) or stearic acid (SA), stabilized with lecithin S75 and polysorbate 80. Formulations were prepared presenting PI values within 0.25 to 0.30, and the physicochemical properties, stability upon [...] Read more.

Nine types of solid lipid nanoparticle (SLN) formulations were produced using tripalmitin (TPM), glyceryl monostearate (GM) or stearic acid (SA), stabilized with lecithin S75 and polysorbate 80. Formulations were prepared presenting PI values within 0.25 to 0.30, and the physicochemical properties, stability upon storage and biocompatibility were evaluated. The average particle size ranged from 116 to 306 nm, with a negative surface charge around −11 mV. SLN presented good stability up to 60 days. The SLN manufactured using SA could not be measured by DLS due to the reflective feature of this formulation. However, TEM images revealed that SA nanoparticles presented square/rod shapes with an approximate size of 100 nm. Regarding biocompatibility aspects, SA nanoparticles showed toxicity in fibroblasts, causing cell death, and produced high hemolytic rates, indicating toxicity to red blood cells. This finding might be related to lipid type, as well as, the shape of the nanoparticles. No morphological alterations and hemolytic effects were observed in cells incubated with SLN containing TPM and GM. The SLN containing TPM and GM showed long-term stability, suggesting good shelf-life. The results indicate high toxicity of SLN prepared with SA, and strongly suggest that the components of the formulation should be analyzed in combination rather than separately to avoid misinterpretation of the results. Full article

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

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Open AccessArticle

Histological Lesions, Cell Cycle Arrest, Apoptosis and T Cell Subsets Changes of Spleen in Chicken Fed Aflatoxin-contaminated Corn

by Xi Peng, Keying Zhang, Shiping Bai, Xuemei Ding, Qiufeng Zeng, Jun Yang, Jing Fang and Kejie Chen

Int. J. Environ. Res. Public Health 2014, 11(8), 8567-8580; https://doi.org/10.3390/ijerph110808567 - 20 Aug 2014

Cited by 36 | Viewed by 10951

Abstract

The purpose of this study was to evaluate the effects of corn naturally contaminated with aflatoxin B1 and aflatoxin B2 on pathological lesions, apoptosis, cell cycle phases and T lymphocyte subsets of spleen, and to provide an experimental basis for understanding the mechanism [...] Read more.

The purpose of this study was to evaluate the effects of corn naturally contaminated with aflatoxin B1 and aflatoxin B2 on pathological lesions, apoptosis, cell cycle phases and T lymphocyte subsets of spleen, and to provide an experimental basis for understanding the mechanism of aflatoxin-induced immunosuppression. A total of 900 COBB500 male broilers were randomly allocated into five groups with six replicates per group and 30 birds per replicate. The experiment lasted for 6 weeks and the five dietary treatments consisted of control, 25% contaminated corn, 50% contaminated corn, 75% contaminated corn and 100% contaminated corn groups. The histopathological spleen lesions from the contaminated corn groups was characterized as congestion of red pulp, increased necrotic cells and vacuoles in the splenic corpuscle and periarterial lymphatic sheath. The contaminated corn intake significantly increased relative weight of spleen, percentages of apoptotic splenocytes, induced cell cycle arrest of splenocytes, increased the percentages of CD3⁺CD8⁺ T cells and decreased the ratios of CD3⁺CD4⁺ to CD3⁺CD8⁺. The results suggest that AFB-induced immunosuppression maybe closely related to the lesions of spleen. Full article

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Open AccessArticle

HIV Risky Sexual Behaviors and HIV Infection Among Immigrants: A Cross-Sectional Study in Lisbon, Portugal

by Sónia Dias, Adilson Marques, Ana Gama and Maria O. Martins

Int. J. Environ. Res. Public Health 2014, 11(8), 8552-8566; https://doi.org/10.3390/ijerph110808552 - 20 Aug 2014

Cited by 18 | Viewed by 6658

Abstract

This study aimed to examine risky sexual behavior, its associated factors and HIV infection among immigrants. A participatory cross-sectional survey was conducted with 1187 immigrants at the National Immigrant Support Centre, in Lisbon (52.2% female; 34.0% Africans, 33.8% Brazilians, 32.2% Eastern Europeans). About [...] Read more.

This study aimed to examine risky sexual behavior, its associated factors and HIV infection among immigrants. A participatory cross-sectional survey was conducted with 1187 immigrants at the National Immigrant Support Centre, in Lisbon (52.2% female; 34.0% Africans, 33.8% Brazilians, 32.2% Eastern Europeans). About 38% of participants reported ≥2 sexual partners in the previous year, 16.2% both regular and occasional sexual partners (last 12 months), 33.1% inconsistent condom use with occasional partners, and 64% no condom use in the last sexual intercourse. Unprotected sex in the last sexual intercourse was more likely among women, Africans, those older, with elementary education, those married and those who didn’t receive free condoms in the previous year. No condom use was less likely among those having only occasional sexual partners and both regular and occasional sexual partners. One third of participants had never been tested for HIV. Those never tested reported more frequently inconsistent condom use than those ever tested. Overall, 2.0% reported being HIV positive (2.5% of men; 4.4% of Africans); 4.3% admitted having a STI in previous year. HIV-positive immigrants reported high-risk sexual behaviors. Tailored interventions to promote awareness of HIV serostatus among immigrants as well as culturally adapted risk reduction strategies should be strengthened. Full article

(This article belongs to the Special Issue Migrant Health)

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Open AccessArticle

Human Leptospirosis Trends: Northeast Thailand, 2001–2012

by Wilawan Thipmontree, Yupin Suputtamongkol, Wiwit Tantibhedhyangkul, Chuanpit Suttinont, Ekkarat Wongswat and Saowaluk Silpasakorn

Int. J. Environ. Res. Public Health 2014, 11(8), 8542-8551; https://doi.org/10.3390/ijerph110808542 - 20 Aug 2014

Cited by 23 | Viewed by 6274

Abstract

The objective of this study was to determine the changing trend of leptospirosis over time in Thailand using two prospective hospital-based studies conducted amongst adult patients with acute undifferentiated fever (AUFI) admitted to Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima Province, Thailand between July [...] Read more.

The objective of this study was to determine the changing trend of leptospirosis over time in Thailand using two prospective hospital-based studies conducted amongst adult patients with acute undifferentiated fever (AUFI) admitted to Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima Province, Thailand between July 2001 to December 2002 and between July 2011 to December 2012. During the first period, leptospirosis (98 patients, 40%) and scrub typhus (59 patients, 24.1%) were the two major causes of AUFI. In the second period, scrub typhus (137 patients, 28.3%) was found to be more common than leptospirosis (61 patients, 12.7%). Amongst patients with leptospirosis, the proportion of male patients and the median age were similar. Leptospira interrogans serogroup Autumnalis was the major infecting serogroup in both study periods. The case fatality rate of leptospirosis was significantly higher in 2011–2012 as compared with the case fatality rate in 2001–2002 (19.7% vs. 6.3%, p < 0.001). In summary, we found that number of leptospirosis cases had decreased over time. This trend is similar to reportable data for leptospirosis complied from passive surveillance by the Ministry of Public Health, Thailand. However, the case fatality rate of severe leptospirosis has increased. Severe lung hemorrhage associated with leptospirosis remained the major cause of death. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Open AccessArticle

An Early Warning System Based on Syndromic Surveillance to Detect Potential Health Emergencies among Migrants: Results of a Two-Year Experience in Italy

by Christian Napoli, Flavia Riccardo, Silvia Declich, Maria Grazia Dente, Maria Grazia Pompa, Caterina Rizzo, Maria Cristina Rota, Antonino Bella and The National Working Group

Int. J. Environ. Res. Public Health 2014, 11(8), 8529-8541; https://doi.org/10.3390/ijerph110808529 - 20 Aug 2014

Cited by 44 | Viewed by 10274

Abstract

Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and [...] Read more.

Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and to migration surges from affected countries to southern Europe, especially to Italy. To respond to the humanitarian emergency triggered by this migration surge, Italy implemented a syndromic surveillance system in order to rapidly detect potential public health emergencies in immigrant reception centres. This system was discontinued after two years. This paper presents the results of this experience detailing its strengths and weaknesses in order to document the applicability and usefulness of syndromic surveillance in this specific context. Full article

(This article belongs to the Special Issue Migrant Health)

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Open AccessArticle

Research on Chinese Life Cycle-Based Wind Power Plant Environmental Influence Prevention Measures

by Hanxi Wang, Jianling Xu, Yuanyuan Liu and Tian Zhang

Int. J. Environ. Res. Public Health 2014, 11(8), 8508-8528; https://doi.org/10.3390/ijerph110808508 - 19 Aug 2014

Cited by 1 | Viewed by 6125

Abstract

The environmental impact of wind power plants over their life cycle is divided into three stages: construction period, operation period and retired period. The impact is mainly reflected in ecological destruction, noise pollution, water pollution and the effect on bird migration. In response [...] Read more.

The environmental impact of wind power plants over their life cycle is divided into three stages: construction period, operation period and retired period. The impact is mainly reflected in ecological destruction, noise pollution, water pollution and the effect on bird migration. In response to these environmental effects, suggesting reasonable locations, reducing plant footprint, optimizing construction programs, shielding noise, preventing pollution of terrestrial ecosystems, implementing combined optical and acoustical early warning signals, making synthesized use of power generation equipment in the post-retired period and using other specific measures, including methods involving governance and protection efforts to reduce environmental pollution, can be performed to achieve sustainable development. Full article

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Open AccessArticle

Effects and Risk Evaluation of Oil Spillage in the Sea Areas of Changxing Island

by Hanxi Wang, Jianling Xu, Wenkui Zhao and Jiquan Zhang

Int. J. Environ. Res. Public Health 2014, 11(8), 8491-8507; https://doi.org/10.3390/ijerph110808491 - 19 Aug 2014

Cited by 17 | Viewed by 6710

Abstract

This paper evaluated the oil spillage risk in the waters near the island of Changxing in Dalian (China) based on the established risk assessment index. Four wind regimes (windless, northerly wind, westerly wind and southerly wind) were selected as weather conditions for the [...] Read more.

This paper evaluated the oil spillage risk in the waters near the island of Changxing in Dalian (China) based on the established risk assessment index. Four wind regimes (windless, northerly wind, westerly wind and southerly wind) were selected as weather conditions for the dynamic prediction of oil drift. If an oil spill occurs near the Koumen (a place near the island of Changxing), the forecast and evaluation are conducted based on a three-dimensional mathematical model of oil spillage, and the results obtained show the scope of the affected area when winds from various directions are applied. The oil spillage would, under various conditions, flow into the northern and western sea area of Changxing Island Bay, namely the Dalian harbor seal National Nature Reserve, and create adverse effects on the marine ecological environment. The rationality of combining the established oil spillage risk comprehensive index system with model prediction is further confirmed. Finally, preventive measures and quick fixes are presented in the case of accidental oil spillages. The most effective method to reduce environment risk is to adopt reasonable preventive measures and quick fixes. Full article

(This article belongs to the Special Issue Preparedness and Emergency Response)

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Open AccessArticle

The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

by David Eisenman, Anita Chandra, Stella Fogleman, Aizita Magana, Astrid Hendricks, Ken Wells, Malcolm Williams, Jennifer Tang and Alonzo Plough

Int. J. Environ. Res. Public Health 2014, 11(8), 8475-8490; https://doi.org/10.3390/ijerph110808475 - 19 Aug 2014

Cited by 41 | Viewed by 19918

Abstract

Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel [...] Read more.

Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports. Full article

(This article belongs to the Special Issue Preparedness and Emergency Response)

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Open AccessArticle

Size Matters — Determinants of Modern, Community-Oriented Mental Health Services

by Taina Ala-Nikkola, Sami Pirkola, Raija Kontio, Grigori Joffe, Maiju Pankakoski, Maili Malin, Minna Sadeniemi, Minna Kaila and Kristian Wahlbeck

Int. J. Environ. Res. Public Health 2014, 11(8), 8456-8474; https://doi.org/10.3390/ijerph110808456 - 19 Aug 2014

Cited by 19 | Viewed by 7132

Abstract

Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., [...] Read more.

Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., personnel resources, of mental health and substance abuse services (MHS) and evaluate correlation between population needs and quality and quantity of MHS. The European Service Mapping Schedule—Revised (ESMS-R) was used to classify mental health and substance abuse services in southern Finland. Municipal-level aggregate data, local data on unemployment rate, length of education, age of retirement, proportion of single households, alcohol sales and a composite mental health index were used as indicators of population mental health needs. Population size correlated strongly with service diversity, explaining 84% of the variance. Personnel resources did not associate with diversity or community orientation. The indicators of mental health services need did not have the expected association with quality and quantity of services. In terms of service organization, the results may support larger population bases, at least 150,000 adult inhabitants, when aiming for higher diversity. Full article

(This article belongs to the Special Issue Mental Health Care)

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Open AccessArticle

The Joint Influence of Gender and Amount of Smoking on Weight Gain One Year after Smoking Cessation

by Isabella Locatelli, Tinh-Hai Collet, Carole Clair, Nicolas Rodondi and Jacques Cornuz

Int. J. Environ. Res. Public Health 2014, 11(8), 8443-8455; https://doi.org/10.3390/ijerph110808443 - 18 Aug 2014

Cited by 16 | Viewed by 5780

Abstract

Weight gain is often associated with smoking cessation and may discourage smokers from quitting. This study estimated the weight gained one year after smoking cessation and examined the risk factors associated with weight gain in order to identify socio-demographic groups at higher risk [...] Read more.

Weight gain is often associated with smoking cessation and may discourage smokers from quitting. This study estimated the weight gained one year after smoking cessation and examined the risk factors associated with weight gain in order to identify socio-demographic groups at higher risk of increased weight after quitting. We analyzed data from 750 adults in two randomized controlled studies that included smokers motivated to quit and found a gradient in weight gain according to the actual duration of abstinence during follow-up. Subjects who were abstinent for at least 40 weeks gained 4.6 kg (SD = 3.8) on average, compared to 1.2 kg (SD = 2.6) for those who were abstinent less than 20 weeks during the 1-year follow-up. Considering the duration of abstinence as an exposure variable, we found an age effect and a significant interaction between sex and the amount of smoking before quitting: younger subjects gained more weight than older subjects; among light smokers, men gained more weight on average than women one year after quitting, while the opposite was observed among heavy smokers. Young women smoking heavily at baseline had the highest risk of weight gain after quitting. Full article

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Open AccessArticle

Maternal Mercury Exposure, Season of Conception and Adverse Birth Outcomes in an Urban Immigrant Community in Brooklyn, New York, U.S.A.

by Cynthia J. Bashore, Laura A. Geer, Xin He, Robin Puett, Patrick J. Parsons, Christopher D. Palmer, Amy J. Steuerwald, Ovadia Abulafia, Mudar Dalloul and Amir Sapkota

Int. J. Environ. Res. Public Health 2014, 11(8), 8414-8442; https://doi.org/10.3390/ijerph110808414 - 18 Aug 2014

Cited by 30 | Viewed by 7839

Abstract

Adverse birth outcomes including preterm birth (PTB: <37 weeks gestation) and low birth weight (LBW: <2500 g) can result in severe infant morbidity and mortality. In the United States, there are racial and ethnic differences in the prevalence of PTB and LBW. We [...] Read more.

Adverse birth outcomes including preterm birth (PTB: <37 weeks gestation) and low birth weight (LBW: <2500 g) can result in severe infant morbidity and mortality. In the United States, there are racial and ethnic differences in the prevalence of PTB and LBW. We investigated the association between PTB and LBW with prenatal mercury (Hg) exposure and season of conception in an urban immigrant community in Brooklyn, New York. We recruited 191 pregnant women aged 18–45 in a Brooklyn Prenatal Clinic and followed them until delivery. Urine specimens were collected from the participants during the 6th to 9th month of pregnancy. Cord blood specimens and neonate anthropometric data were collected at birth. We used multivariate logistic regression models to investigate the odds of LBW or PTB with either maternal urinary mercury or neonate cord blood mercury. We used linear regression models to investigate the association between continuous anthropometric outcomes and maternal urinary mercury or neonate cord blood mercury. We also examined the association between LBW and PTB and the season that pregnancy began. Results showed higher rates of PTB and LBW in this cohort of women compared to other studies. Pregnancies beginning in winter (December, January, February) were at increased odds of LBW births compared with births from pregnancies that began in all other months (OR7.52 [95% CI 1.65, 34.29]). We observed no association between maternal exposure to Hg, and either LBW or PTB. The apparent lack of association is consistent with other studies. Further examination of seasonal association with LBW is warranted. Full article

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Open AccessReview

Impact of Bisphenol A on the Cardiovascular System — Epidemiological and Experimental Evidence and Molecular Mechanisms

by Xiaoqian Gao and Hong-Sheng Wang

Int. J. Environ. Res. Public Health 2014, 11(8), 8399-8413; https://doi.org/10.3390/ijerph110808399 - 15 Aug 2014

Cited by 135 | Viewed by 14374

Abstract

Bisphenol A (BPA) is a ubiquitous plasticizing agent used in the manufacturing of polycarbonate plastics and epoxy resins. There is well-documented and broad human exposure to BPA. The potential risk that BPA poses to the human health has attracted much attention from regulatory [...] Read more.

Bisphenol A (BPA) is a ubiquitous plasticizing agent used in the manufacturing of polycarbonate plastics and epoxy resins. There is well-documented and broad human exposure to BPA. The potential risk that BPA poses to the human health has attracted much attention from regulatory agencies and the general public, and has been extensively studied. An emerging and rapidly growing area in the study of BPA’s toxicity is its impact on the cardiovascular (CV) system. Recent epidemiological studies have shown that higher urinary BPA concentration in humans is associated with various types of CV diseases, including angina, hypertension, heart attack and coronary and peripheral arterial disease. Experimental studies have demonstrated that acute BPA exposure promotes the development of arrhythmias in female rodent hearts. Chronic exposure to BPA has been shown to result in cardiac remodeling, atherosclerosis, and altered blood pressure in rodents. The underlying mechanisms may involve alteration of cardiac Ca²⁺ handling, ion channel inhibition/activation, oxidative stress, and genome/transcriptome modifications. In this review, we discuss these recent findings that point to the potential CV toxicity of BPA, and highlight the knowledge gaps in this growing research area. Full article

(This article belongs to the Special Issue Endocrine Disruptors and Human Health)

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Open AccessArticle

Practical Barriers and Ethical Challenges in Genetic Data Sharing

by Claire L. Simpson, Aaron J. Goldenberg, Rob Culverhouse, Denise Daley, Robert P. Igo, Jr., Gail P. Jarvik, Diptasri M. Mandal, Deborah Mascalzoni, Courtney Gray Montgomery, Brandon L. Pierce, Rosemarie Plaetke, Sanjay Shete, Katrina A. B. Goddard and Catherine M. Stein

Int. J. Environ. Res. Public Health 2014, 11(8), 8383-8398; https://doi.org/10.3390/ijerph110808383 - 15 Aug 2014

Cited by 20 | Viewed by 10628

Abstract

The underlying ethos of dbGaP is that access to these data by secondary data analysts facilitates advancement of science. NIH has required that genome-wide association study data be deposited in the Database of Genotypes and Phenotypes (dbGaP) since 2003. In 2013, a proposed [...] Read more.

The underlying ethos of dbGaP is that access to these data by secondary data analysts facilitates advancement of science. NIH has required that genome-wide association study data be deposited in the Database of Genotypes and Phenotypes (dbGaP) since 2003. In 2013, a proposed updated policy extended this requirement to next-generation sequencing data. However, recent literature and anecdotal reports suggest lingering logistical and ethical concerns about subject identifiability, informed consent, publication embargo enforcement, and difficulty in accessing dbGaP data. We surveyed the International Genetic Epidemiology Society (IGES) membership about their experiences. One hundred and seventy five (175) individuals completed the survey, a response rate of 27%. Of respondents who received data from dbGaP (43%), only 32% perceived the application process as easy but most (75%) received data within five months. Remaining challenges include difficulty in identifying an institutional signing official and an overlong application process. Only 24% of respondents had contributed data to dbGaP. Of these, 31% reported local IRB restrictions on data release; an additional 15% had to reconsent study participants before depositing data. The majority of respondents (56%) disagreed that the publication embargo period was sufficient. In response, we recommend longer embargo periods and use of varied data-sharing models rather than a one-size-fits-all approach. Full article

(This article belongs to the Special Issue Genetic Epidemiology)

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Utility and Cutoff Value of Hair Nicotine as a Biomarker of Long-Term Tobacco Smoke Exposure, Compared to Salivary Cotinine

by Sungroul Kim, Benjamin J. Apelberg, Erika Avila-Tang, Lisa Hepp, Dongmin Yun, Jonathan M. Samet and Patrick N. Breysse

Int. J. Environ. Res. Public Health 2014, 11(8), 8368-8382; https://doi.org/10.3390/ijerph110808368 - 15 Aug 2014

Cited by 28 | Viewed by 6963

Abstract

While hair samples are easier to collect and less expensive to store and transport than biological fluids, and hair nicotine characterizes tobacco exposure over a longer time period than blood or urine cotinine, information on its utility, compared with salivary cotinine, is still [...] Read more.

While hair samples are easier to collect and less expensive to store and transport than biological fluids, and hair nicotine characterizes tobacco exposure over a longer time period than blood or urine cotinine, information on its utility, compared with salivary cotinine, is still limited. We conducted a cross-sectional study with 289 participants (107 active smokers, 105 passive smokers with self-reported secondhand smoke (SHS) exposure, and 77 non-smokers with no SHS exposure) in Baltimore (Maryland, USA). A subset of the study participants (n = 52) were followed longitudinally over a two-month interval. Median baseline hair nicotine concentrations for active, passive and non-smokers were 16.2, 0.36, and 0.23 ng/mg, respectively, while those for salivary cotinine were 181.0, 0.27, and 0.27 ng/mL, respectively. Hair nicotine concentrations for 10% of passive or non-smokers were higher than the 25th percentile value for active smokers while all corresponding salivary cotinine concentrations for them were lower than the value for active smokers. This study showed that hair nicotine concentration values could be used to distinguish active or heavy passive adult smokers from non-SHS exposed non-smokers. Our results indicate that hair nicotine is a useful biomarker for the assessment of long-term exposure to tobacco smoke. Full article

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Open AccessArticle

Dietary Exposure of Nigerians to Mutagens and Estrogen-Like Chemicals

by Iyekhoetin Matthew Omoruyi, Derek Ahamioje and Raimo Pohjanvirta

Int. J. Environ. Res. Public Health 2014, 11(8), 8347-8367; https://doi.org/10.3390/ijerph110808347 - 15 Aug 2014

Cited by 9 | Viewed by 6548

Abstract

Food and drinking water are poorly delineated sources of human exposure to chemical food mutagens and endocrine-disrupting chemicals. In this study, we investigated the presence of mutagens and chemicals exhibiting estrogenic activity in the daily diet of Nigerians, using in vitro assays. Commercially [...] Read more.

Food and drinking water are poorly delineated sources of human exposure to chemical food mutagens and endocrine-disrupting chemicals. In this study, we investigated the presence of mutagens and chemicals exhibiting estrogenic activity in the daily diet of Nigerians, using in vitro assays. Commercially processed foods or snacks and various brands of pure water sachets were extracted by solid-phase extraction and liquid-liquid extraction, respectively. Mutagenicity was determined by the conventional Ames test and two complementary assays on two strains of Salmonella (TA 100 and TA 98), while the estrogenic activity was assessed by a yeast bioluminescent assay, using two recombinant yeast strains (Saccharomyces cerevisiae BMAEREluc/ERα and S. cerevisiae BMA64/luc). A third of the food varieties investigated (chin-chin, hamburger, suya and bean cake) were mutagenic in all three assays, either in the presence or absence of S9 mix. Of the packed water samples, five out of the sixteen investigated (31%), were found to be estrogenic, with estradiol and bisphenol A equivalents ranging from 0.79 to 44.0 ng/L and 124.2 to 1,000.8 ng/L, respectively. Hence, although the current situation in Nigeria does not appear to be substantially worse than, e.g., in Europe, regular monitoring is warranted in the future. Full article

(This article belongs to the Special Issue Endocrine Disruptors and Human Health)

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Open AccessArticle

Measuring the Safety of Excreta Disposal Behavior in India with the New Safe San Index: Reliability, Validity and Utility

by Marion W. Jenkins, Matthew C. Freeman and Parimita Routray

Int. J. Environ. Res. Public Health 2014, 11(8), 8319-8346; https://doi.org/10.3390/ijerph110808319 - 15 Aug 2014

Cited by 42 | Viewed by 8628

Abstract

Methods to assess household excreta disposal practices are critical for informing public health outcomes of efforts to improve sanitation in developing countries. We present a new metric, the Safe San Index (SSI), to quantify the hygienic safety of a household’s defecation and human [...] Read more.

Methods to assess household excreta disposal practices are critical for informing public health outcomes of efforts to improve sanitation in developing countries. We present a new metric, the Safe San Index (SSI), to quantify the hygienic safety of a household’s defecation and human feces disposal practices in India, where behavioral outcomes from on-going public expenditures to construct household sanitation facilities and eliminate open defecation are poorly measured. We define hygienic safety of feces disposal as capture in a hygienic sanitation facility. The SSI consists of 15 self-report items and two sub-scales, Latrine Use Frequency and Seven-Day Open Defecation Rate. Households are scored on a standardized scale from 0 (no defecation safely captured) to 100 (all defecation safely captured). We present results of a pilot study in Odisha, India to apply the Index to assess excreta disposal behaviors among rural households and evaluate the reliability and validity of the Index for estimating the rate of correct and consistent sanitation facility usage of household with an improved latrine. Full article

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Open AccessArticle

Socioeconomic Factors and Vulnerability to Outbreaks of Leptospirosis in Nicaragua

by Jorge Bacallao, Maria Cristina Schneider, Patricia Najera, Sylvain Aldighieri, Aida Soto, Wilmer Marquiño, Carlos Sáenz, Eduardo Jiménez, Gilberto Moreno, Octavio Chávez, Deise I. Galan and Marcos A. Espinal

Int. J. Environ. Res. Public Health 2014, 11(8), 8301-8318; https://doi.org/10.3390/ijerph110808301 - 15 Aug 2014

Cited by 21 | Viewed by 9060

Abstract

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide, with more than 500,000 human cases reported annually. It is influenced by environmental and socioeconomic factors that affect the occurrence of outbreaks and the incidence of the disease. Critical areas and potential drivers for [...] Read more.

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide, with more than 500,000 human cases reported annually. It is influenced by environmental and socioeconomic factors that affect the occurrence of outbreaks and the incidence of the disease. Critical areas and potential drivers for leptospirosis outbreaks have been identified in Nicaragua, where several conditions converge and create an appropriate scenario for the development of leptospirosis. The objectives of this study were to explore possible socioeconomic variables related to leptospirosis critical areas and to construct and validate a vulnerability index based on municipal socioeconomic indicators. Municipalities with lower socioeconomic status (greater unsatisfied basic needs for quality of the household and for sanitary services, and higher extreme poverty and illiteracy rates) were identified with the highest leptospirosis rates. The municipalities with highest local vulnerability index should be the priority for intervention. A distinction between risk given by environmental factors and vulnerability to risk given by socioeconomic conditions was shown as important, which also applies to the “causes of outbreaks” and “causes of cases”. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Open AccessArticle

Exploring Bikeability in a Suburban Metropolitan Area Using the Active Commuting Route Environment Scale (ACRES)

by Lina Wahlgren and Peter Schantz

Int. J. Environ. Res. Public Health 2014, 11(8), 8276-8300; https://doi.org/10.3390/ijerph110808276 - 15 Aug 2014

Cited by 26 | Viewed by 10403

Abstract

Background and Aim: Commuting by bicycle could contribute to public health, and route environments may influence this behaviour. Therefore, the aim of this study is to assess the potential associations between appraisals of the overall route environment as hindering or stimulating for bicycle [...] Read more.

Background and Aim: Commuting by bicycle could contribute to public health, and route environments may influence this behaviour. Therefore, the aim of this study is to assess the potential associations between appraisals of the overall route environment as hindering or stimulating for bicycle commuting, with both perceptions of commuting route environmental factors in a suburban area and background factors. Methods: The Active Commuting Route Environment Scale (ACRES) was used for the assessment of bicycle commuters’ perceptions and appraisals of their route environments in the suburban parts of Greater Stockholm, Sweden. A simultaneous multiple regression analysis was used to assess the relationship between the outcome variable whether the overall route environment hinders or stimulates bicycle commuting and environmental factors (e.g., exhaust fumes, speeds of motor vehicles, greenery), as well as background factors (sex, age, education, income) as predictor variables. Results and Conclusions: The results indicate that in suburban areas, the factors aesthetics, greenery and bicycle paths seem to be, independently of each other, stimulating factors for bicycle commuting. On the other hand, flows of motor vehicles, noise, and low “directness” of the route seem to be hindering factors. A comparison of these results with those obtained from an inner urban area points to the importance of studying different types of built-up areas separately. Full article

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Open AccessCommunication

Pediatric Exposure to Drugs of Abuse by Hair Testing: Monitoring 15 Years of Evolution in Spain

by Simona Pichini, Oscar García-Algar, Airam-Tenesor Alvarez, Maria Mercadal, Claudia Mortali, Massimo Gottardi, Fiorenza Svaizer and Roberta Pacifici

Int. J. Environ. Res. Public Health 2014, 11(8), 8267-8275; https://doi.org/10.3390/ijerph110808267 - 14 Aug 2014

Cited by 13 | Viewed by 5572

Abstract

Hair testing is a useful tool to investigate the prevalence of unsuspected chronic exposure to drugs of abuse in pediatric populations and it has been applied to three different cohorts of children from Barcelona, Spain along fifteen years to evaluate eventual changes in [...] Read more.

Hair testing is a useful tool to investigate the prevalence of unsuspected chronic exposure to drugs of abuse in pediatric populations and it has been applied to three different cohorts of children from Barcelona, Spain along fifteen years to evaluate eventual changes in this exposure. Children were recruited from three independent studies performed at Hospital del Mar (Barcelona, Spain) and approved by the local Ethics Committee. Hair samples were collected from the first 187 children cohort (around 4 years of age) in 1998, from the second 90 children cohort (1.5–5 years of age) in 2008 and from the third 114 children cohort (5–14 years of age) in 2013. Hair samples were analysed for the presence of opiates, cocaine, amphetamines, and cannabis by validated methodologies using gas or liquid chromatography-mass spectrometry. Familiar sociodemographics and eventual consumption of drugs of abuse by parents, and caregivers were recorded. Hair samples from 24.6% children in 1998 were positive for any drug of abuse (23.0% cocaine), 25.5% in 2008 (23.3% cocaine), and 28.1% in 2013 (20.1% cocaine and 11.4% cannabis). In none of the cohorts, parental sociodemographics were associated with children exposure to drugs of abuse. The results of the three study cohorts demonstrated a significant prevalence of unsuspected pediatric exposure to drugs of abuse which mainly involved cocaine maintained along fifteen years in Barcelona, Spain. We recommend to be aware about unsuspected passive exposure to drugs of abuse in general population and to use general or selected hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions. Full article

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

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Open AccessArticle

Cancer Screening among Immigrants Living in Urban and Regional Australia: Results from the 45 and Up Study

by Marianne F. Weber, May Chiew, Eleonora Feletto, Clare Kahn, Freddy Sitas and Lucy Webster

Int. J. Environ. Res. Public Health 2014, 11(8), 8251-8266; https://doi.org/10.3390/ijerph110808251 - 14 Aug 2014

Cited by 22 | Viewed by 8412

Abstract

Over 25% of the Australian population are immigrants, and are less active participants in cancer screening programmes. Most immigrants live in urban areas of Australia, but a significant proportion (~20%), live in regional areas. This study explored differences in cancer screening participation by [...] Read more.

Over 25% of the Australian population are immigrants, and are less active participants in cancer screening programmes. Most immigrants live in urban areas of Australia, but a significant proportion (~20%), live in regional areas. This study explored differences in cancer screening participation by place of birth and residence. Self-reported use of mammogram, faecal occult blood test (FOBT), and/or prostate specific antigen (PSA) tests was obtained from 48,642 immigrants and 141,275 Australian-born participants aged 50 years or older in the 45 and Up Study (New South Wales, Australia 2006–2010). Poisson regression was used to estimate relative risks of test use, adjusting for key socio-demographic characteristics. Overall, immigrants from Asia and Europe were less likely to have had any of the tests in the previous two years than Australian-born participants. Regional Australian-born participants were more likely to have had any of the tests than those living in urban areas. Regional immigrant participants were more likely to have had an FOBT or PSA test than those living in urban areas, but there were no differences in mammograms. This report identifies key immigrant groups in urban and regional areas that policymakers and healthcare providers should target with culturally appropriate information to promote cancer screening. Full article

(This article belongs to the Special Issue Migrant Health)

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Open AccessArticle

Factors Influencing Household Uptake of Improved Solid Fuel Stoves in Low- and Middle-Income Countries: A Qualitative Systematic Review

by Stanistreet Debbi, Puzzolo Elisa, Bruce Nigel, Pope Dan and Rehfuess Eva

Int. J. Environ. Res. Public Health 2014, 11(8), 8228-8250; https://doi.org/10.3390/ijerph110808228 - 13 Aug 2014

Cited by 76 | Viewed by 8197

Abstract

Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS) are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors [...] Read more.

Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS) are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors that influence household uptake of IS in low- and middle-income countries. Extensive searches were carried out and studies were screened and extracted using established systematic review methods. Fourteen qualitative studies from Asia, Africa and Latin-America met the inclusion criteria. Thematic synthesis was used to synthesise data and findings are presented under seven framework domains. Findings relate to user and stakeholder perceptions and highlight the importance of cost, good stove design, fuel and time savings, health benefits, being able to cook traditional dishes and cleanliness in relation to uptake. Creating demand, appropriate approaches to business, and community involvement, are also discussed. Achieving and sustaining uptake is complex and requires consideration of a broad range of factors, which operate at household, community, regional and national levels. Initiatives aimed at IS scale up should include quantitative evaluations of effectiveness, supplemented with qualitative studies to assess factors affecting uptake, with an equity focus. Full article

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Open AccessArticle

Prevalence and Antibiogram Profiling of Escherichia coli Pathotypes Isolated from the Kat River and the Fort Beaufort Abstraction Water

by Nolonwabo Nontongana, Timothy Sibanda, Elvis Ngwenya and Anthony I. Okoh

Int. J. Environ. Res. Public Health 2014, 11(8), 8213-8227; https://doi.org/10.3390/ijerph110808213 - 12 Aug 2014

Cited by 39 | Viewed by 8015

Abstract

Escherichia coli is a widespread bacterium encompassing a variety of strains, ranging from highly pathogenic strains, causing worldwide outbreaks of severe diseases to avirulent, well characterized safe laboratory strains. This study evaluated the prevalence and antibiogram profiles of E. coli pathotypes isolated from [...] Read more.

Escherichia coli is a widespread bacterium encompassing a variety of strains, ranging from highly pathogenic strains, causing worldwide outbreaks of severe diseases to avirulent, well characterized safe laboratory strains. This study evaluated the prevalence and antibiogram profiles of E. coli pathotypes isolated from the Kat River and Fort Beaufort abstraction water. A total of 171 out of 278 confirmed E. coli isolates were positive for at least one pathogenic determinant and these included enteropathogenic E. coli (6%), enterotoxigenic E. coli (47%), uropathogenic E. coli (2%), neonatal meningitis E. coli (5%), diffusely adherent E. coli (1%) and enterohaemorrhagic E. coli (1%). Interestingly, enteroinvasive and enteroaggregative E. coli were not detected. The phenotypic antibiogram profiles of the isolates revealed that all were resistant to penicillin G, while 98% and 38% of the pathotypes were resistant to ampicillin and trimethoprim-sulphamethoxazole, respectively. About 8% of the isolates were resistant to streptomycin. More than half of the isolates exhibited multiple antibiotic resistance with 44% being resistant to three antibiotics and 8% resistant to four antibiotics. We conclude that the Kat River is a reservoir of potentially virulent antibiotic resistant E. coli strains that can cause serious health risks to humans who drink raw water from this river, or in the case that consumption of treated drinking water coincides with failed drinking water processes. Full article

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Open AccessReview

E-Health Interventions for Suicide Prevention

by Helen Christensen, Philip J. Batterham and Bridianne O'Dea

Int. J. Environ. Res. Public Health 2014, 11(8), 8193-8212; https://doi.org/10.3390/ijerph110808193 - 12 Aug 2014

Cited by 104 | Viewed by 19079

Abstract

Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or [...] Read more.

Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals’ posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain. Full article

(This article belongs to the Special Issue Mental Health Care)

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Open AccessArticle

Toxicological Effects of Nickel Chloride on IgA⁺ B Cells and sIgA, IgA, IgG, IgM in the Intestinal Mucosal Immunity in Broilers

by Bangyuan Wu, Hengmin Cui, Xi Peng, Jing Fang, Zhicai Zuo, Junliang Deng and Jianying Huang

Int. J. Environ. Res. Public Health 2014, 11(8), 8175-8192; https://doi.org/10.3390/ijerph110808175 - 11 Aug 2014

Cited by 17 | Viewed by 7256

Abstract

The objective of this study was to investigate the toxicological effects of dietary NiCl₂ on IgA⁺ B cells and the immunoglobulins including sIgA, IgA, IgG and IgM in the small intestine and cecal tonsil of broilers by the methods of immunohistochemistry [...] Read more.

The objective of this study was to investigate the toxicological effects of dietary NiCl₂ on IgA⁺ B cells and the immunoglobulins including sIgA, IgA, IgG and IgM in the small intestine and cecal tonsil of broilers by the methods of immunohistochemistry and enzyme-linked immunosorbent assay (ELISA). Two hundred and forty one-day-old avian broilers were randomly divided into four groups and fed on a control diet and three experimental diets supplemented with 300, 600, and 900 mg/kg NiCl₂ for 42 days. Compared with the control group, the IgA⁺ B cell number and the sIgA, IgA, IgG, and IgM contents in the NiCl₂-treated groups were significantly decreased (p < 0.05 or p < 0.01). It was concluded that dietary NiCl₂ in the excess of 300 mg/kg had negative effects on the IgA⁺Bcell number and the abovementioned immunoglobulin contents in the small intestine and the cecal tonsil. NiCl₂-reduced sIgA, IgA, IgG and IgM contents is due to decrease in the population and/or the activation of B cell. The results suggest that NiCl₂at high levels has intestinal mucosal humoral immunotoxicity in animals. Full article

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Open AccessArticle

The Association between Season of Pregnancy and Birth-Sex among Chinese

by Tan Xu, Dongdong Lin, Hui Liang, Mei Chen, Weijun Tong, Yongping Mu, Cindy Xin Feng, Yongqing Gao, Yumei Zheng and Wenjie Sun

Int. J. Environ. Res. Public Health 2014, 11(8), 8166-8174; https://doi.org/10.3390/ijerph110808166 - 11 Aug 2014

Cited by 4 | Viewed by 6819

Abstract

Objective: although numerous studies have reported the association between birth season and sex ratio, few studies have been conducted in subtropical regions in a non-Western setting. The present study assessed the effects of pregnancy season on birth sex ratio in China. Methods [...] Read more.

Objective: although numerous studies have reported the association between birth season and sex ratio, few studies have been conducted in subtropical regions in a non-Western setting. The present study assessed the effects of pregnancy season on birth sex ratio in China. Methods: We conducted a national population-based retrospective study from 2006–2008 with 3175 children-parents pairs enrolled in the Northeast regions of China. Demographics and data relating to pregnancy and birth were collected and analyzed. A multiple logistical regression model was fitted to estimate the regression coefficient and 95% confidence interval (CI) of refractive error for mother pregnancy season, adjusting for potential confounders. Results: After adjusting for parental age (cut-off point was 30 years), region, nationality, mother education level, and mother miscarriage history, there is a significant statistical different mother pregnancy season on birth-sex. Compared with mothers who were pregnant in spring, those pregnant in summer or winter had a high probability of delivering girls (p < 0.05). The birth-sex ratio varied with months. Conclusions: Our results suggested that mothers pregnant in summer and winter were more likely to deliver girls, compared with those pregnant in spring. Pregnancy season may play an important role in the birth-sex. Full article

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Open AccessReview

Global Monitoring of Water Supply and Sanitation: History, Methods and Future Challenges

by Jamie Bartram, Clarissa Brocklehurst, Michael B. Fisher, Rolf Luyendijk, Rifat Hossain, Tessa Wardlaw and Bruce Gordon

Int. J. Environ. Res. Public Health 2014, 11(8), 8137-8165; https://doi.org/10.3390/ijerph110808137 - 11 Aug 2014

Cited by 191 | Viewed by 24548

Abstract

International monitoring of drinking water and sanitation shapes awareness of countries’ needs and informs policy, implementation and research efforts to extend and improve services. The Millennium Development Goals established global targets for drinking water and sanitation access; progress towards these targets, facilitated by [...] Read more.

International monitoring of drinking water and sanitation shapes awareness of countries’ needs and informs policy, implementation and research efforts to extend and improve services. The Millennium Development Goals established global targets for drinking water and sanitation access; progress towards these targets, facilitated by international monitoring, has contributed to reducing the global disease burden and increasing quality of life. The experiences of the MDG period generated important lessons about the strengths and limitations of current approaches to defining and monitoring access to drinking water and sanitation. The methods by which the Joint Monitoring Programme (JMP) of WHO and UNICEF tracks access and progress are based on analysis of data from household surveys and linear regression modelling of these results over time. These methods provide nationally representative and internationally comparable insights into the drinking water and sanitation facilities used by populations worldwide, but also have substantial limitations: current methods do not address water quality, equity of access, or extra-household services. Improved statistical methods are needed to better model temporal trends. This article describes and critically reviews JMP methods in detail for the first time. It also explores the impact of, and future directions for, international monitoring of drinking water and sanitation. Full article

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Open AccessReview

Toward an Effective Long-Term Strategy for Preventing Motor Vehicle Crashes and Injuries

by Anthony R. Mawson and E. Kenneth Walley

Int. J. Environ. Res. Public Health 2014, 11(8), 8123-8136; https://doi.org/10.3390/ijerph110808123 - 11 Aug 2014

Cited by 16 | Viewed by 7807

Abstract

Casualties due to motor vehicle crashes (MVCs) include some 40,000 deaths each year in the United States and one million deaths worldwide. One strategy that has been recommended for improving automobile safety is to lower speed limits and enforce them with speed cameras. [...] Read more.

Casualties due to motor vehicle crashes (MVCs) include some 40,000 deaths each year in the United States and one million deaths worldwide. One strategy that has been recommended for improving automobile safety is to lower speed limits and enforce them with speed cameras. However, motor vehicles can be hazardous even at low speeds whereas properly protected human beings can survive high-speed crashes without injury. Emphasis on changing driver behavior as the focus for road safety improvements has been largely unsuccessful; moreover, drivers today are increasingly distracted by secondary tasks such as cell phone use and texting. Indeed, the true limiting factor in vehicular safety is the capacity of human beings to sense and process information and to make rapid decisions. Given that dramatic reductions in injuries and deaths from MVCs have occurred over the past century due to improvements in safety technology, despite increases in the number of vehicles on the road and miles driven per vehicle, we propose that an effective long-term strategy for reducing MVC-related injury would be continued technological innovation in vehicle design, aimed at progressively removing the driver from routine operational decision-making. Once this is achieved, high rates of speed could be achieved on open highways, with minimal risk of crashes and injury to occupants and pedestrians. Full article

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Open AccessArticle

Atopic Diseases and Systemic Lupus Erythematosus: An Epidemiological Study of the Risks and Correlations

by Yu-Ping Hsiao, Jeng-Dau Tsai, Chih-Hsin Muo, Chung-Hung Tsai, Fung-Chang Sung, Ya-Tang Liao, Yen-Jung Chang and Jen-Hung Yang

Int. J. Environ. Res. Public Health 2014, 11(8), 8112-8122; https://doi.org/10.3390/ijerph110808112 - 8 Aug 2014

Cited by 47 | Viewed by 8556

Abstract

Both atopic diseases and systemic lupus erythematosus (SLE) are immune disorders that may lead to physical complications or multi-system comorbidities. This population-based case-control study was designed to evaluate the risk of SLE associated with atopic diseases. Using a national insurance claims dataset in [...] Read more.

Both atopic diseases and systemic lupus erythematosus (SLE) are immune disorders that may lead to physical complications or multi-system comorbidities. This population-based case-control study was designed to evaluate the risk of SLE associated with atopic diseases. Using a national insurance claims dataset in Taiwan, we identified 1673 patients newly diagnosed with SLE and 6692 randomly selected controls frequency matched for gender, age and index date. The odds ratios (OR) for SLE were calculated for associations with allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. The SLE patients were predominantly female (82.5%) with a mean age of 40.1 (SD = 18.2). The patients with SLE had a higher rate of atopic dermatitis (6.81% vs. 3.06%), and asthma (10.6% vs. 7.64%) was approximately 2 times more common in the patients with lupus than in those without. The patients with atopic disease (atopic dermatitis, allergic rhinitis, allergic conjunctivitis and asthma) were at a significant risk for SLE. The overall risk for SLE increased as the number of atopic diseases increased from 1.46 to 2.29, compared with—individuals without the diseases (p < 0.0001). In conclusion, this population-based case-control study demonstrates a significant relationship between atopic diseases and the risk of SLE, especially for females. Atopic dermatitis plays a stronger role than other types of atopic disease in association with SLE. Full article

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Open AccessArticle

Physical Activity and the Perceived Neighbourhood Environment — Looking at the Association the Other Way Around

by Birgit Wallmann-Sperlich, Ingo Froboese and Peter Schantz

Int. J. Environ. Res. Public Health 2014, 11(8), 8093-8111; https://doi.org/10.3390/ijerph110808093 - 8 Aug 2014

Cited by 10 | Viewed by 8942

Abstract

The association between physical activity (PA) and variables of the perceived environment mainly originate from cross-sectional studies that introduced the idea that the environment influences the PA level of residents. However, the direction of cause and effect has not been solved with finality. [...] Read more.

The association between physical activity (PA) and variables of the perceived environment mainly originate from cross-sectional studies that introduced the idea that the environment influences the PA level of residents. However, the direction of cause and effect has not been solved with finality. The aim of this study was to investigate whether residents’ perception of their proximate environment differs depending on their level of PA in transport and recreation. We conducted a cross-sectional survey with residents of six different parts of the city of Cologne, Germany. The sample of 470 adults (52.8% females; mean age = 35.5 ± 13.8 years) filled in the Global Physical Activity Questionnaire (GPAQ), as well as the European Environmental Questionnaire ALPHA. To distinguish between residents with “low” and “high” PA, we split the samples into two on the basis of the specific median in transport- and recreation-related PA. In the “high” vs. “low” PA group of the overall sample, we noted 4%–16% more “PA favourable” environmental perceptions in seven of the 15 environmental variables. Multiple linear regression analyses were performed to investigate associations of socio-demographic correlates and transport- and recreation-related PA on the dependent variables of the environmental perception. In this case, levels of PA were significant predictors for eight of the 15 items concerning environmental perceptions. Thus, the present study introduces the idea that residents with higher levels of transport and recreational PA may perceive their environment in a more “PA-favourable” way than residents with lower levels. Full article

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Int. J. Environ. Res. Public Health, Volume 11, Issue 8 (August 2014) – 63 articles , Pages 7562-8611

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