1
|
Moeini B, Barati M, Khazaei M, Tapak L, Hashemian M. In-depth analysis to develop a social marketing model to promote women's participation in waste segregation behaviour: A qualitative study. Heliyon 2024; 10:e28690. [PMID: 38571602 PMCID: PMC10988043 DOI: 10.1016/j.heliyon.2024.e28690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/06/2024] [Accepted: 03/22/2024] [Indexed: 04/05/2024] Open
Abstract
Waste separation is one of the key factors in managing solid waste and creating a healthy environment. Waste separation at source has always been associated with challenges. Therefore, this study was conducted to determine the perceptions of housewives and related parties regarding the factors that influence waste separation behaviour and to identify approaches to improve behaviour based on the social marketing framework. This study was conducted as a qualitative content analysis in Amol City in 2022. The data was collected through semi-structured individual interviews. A total of 25 housewives were selected as main participants and 5 stakeholders through purposive selection. The results of the study included lack of awareness of recyclable materials (product), personal, family and environmental barriers (price), lack of doorstep collection of dry waste (place), and lack of use of appropriate technology (promotion). The lack of financial resources, inappropriate political measures and the coronavirus pandemic were also the causes of this challenge. Most participants cited environmental and educational deficits as the main reason for not separating waste. It is possible to improve waste sorting behaviour at source through appropriate behavioural interventions at the individual, social and environmental levels. Researchers can use the results of this study to design, implement and evaluate waste segregation intervention programmes for housewives.
Collapse
Affiliation(s)
- Babak Moeini
- Social Determinants of Health Research Center, Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Department of Public Health, School of Public Health, Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Khazaei
- Department of Environmental Health, School of Public Health, Research Center for Health Sciences, Health Sciences & Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leili Tapak
- Department of Biostatistics, School of Public Health, Modelling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Hashemian
- Health Education and Health Promotion, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
2
|
Zhang Y, Gao Y, Liu QS, Zhou Q, Jiang G. Chemical contaminants in blood and their implications in chronic diseases. JOURNAL OF HAZARDOUS MATERIALS 2024; 466:133511. [PMID: 38262316 DOI: 10.1016/j.jhazmat.2024.133511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/27/2023] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
Artificial chemical products are widely used and ubiquitous worldwide and pose a threat to the environment and human health. Accumulating epidemiological and toxicological evidence has elucidated the contributions of environmental chemical contaminants to the incidence and development of chronic diseases that have a negative impact on quality of life or may be life-threatening. However, the pathways of exposure to these chemicals and their involvements in chronic diseases remain unclear. We comprehensively reviewed the research progress on the exposure risks of humans to environmental contaminants, their body burden as indicated by blood monitoring, and the correlation of blood chemical contaminants with chronic diseases. After entering the human body through various routes of exposure, environmental contaminants are transported to target organs through blood circulation. The application of the modern analytical techniques based on human plasma or serum specimens is promising for determining the body burden of environmental contaminants, including legacy persistent organic pollutants, emerging pollutants, and inorganic elements. Furthermore, their body burden, as indicated by blood monitoring correlates with the incidence and development of metabolic syndromes, cancers, chronic nervous system diseases, cardiovascular diseases, and reproductive disorders. On this basis, we highlight the urgent need for further research on environmental pollution causing health problems in humans.
Collapse
Affiliation(s)
- Yuzhu Zhang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Yurou Gao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Qian S Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China.
| | - Qunfang Zhou
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, PR China; School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310000, PR China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, PR China; School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310000, PR China
| |
Collapse
|
3
|
Lee J, Oh S, Byon JY, Lee W, Weon B, Ko A, Jin W, Kim DK, Kim S, Oh YK, Kim YS, Lim CS, Lee JP. Long-term exposure to high perceived temperature and risk of mortality among patients with chronic kidney disease. Heliyon 2024; 10:e25222. [PMID: 38322898 PMCID: PMC10844275 DOI: 10.1016/j.heliyon.2024.e25222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Health risks due to climate change are emerging, particularly from high-temperature exposure. The perceived temperature is an equivalent temperature based on the complete heat budget model of the human body. Therefore, we aimed to analyze the effect of perceived temperature on overall mortality among patients with chronic kidney disease. In total, 32,870 patients with chronic kidney disease in Seoul participated in this retrospective study (2001-2018) at three medical centers. The perceived temperature during the summer season was calculated using meteorological factors, including the air temperature near the automated weather station, dew point temperature, wind velocity, and total cloud amount. We assessed the association between perceived temperature using Kriging spatial interpolation and mortality in patients with CKD in the time-varying Cox proportional hazards model that was adjusted for sex, age, body mass index, hypertension, diabetes mellitus, estimated glomerular filtration rate, smoking, alcohol consumption, and educational level. During the 6.14 ± 3.96 years of follow-up, 3863 deaths were recorded. In multivariable analysis, the average level of perceived temperature and maximum level of perceived temperature demonstrated an increased risk of overall mortality among patients with chronic kidney disease. The concordance index for mortality of perceived temperature was higher than temperature, discomfort index, and heat index. When stratified by age, diabetes mellitus, and estimated glomerular filtration rate, patients with chronic kidney disease with young age (age <65 years) showed higher hazard ratio for mortality (interaction P = 0.049). Moreover, the risk of death in the winter and spring seasons was more significant compared to that of the summer and autumn seasons. Therefore, long-term exposure to high perceived temperature during summer increases the risk of mortality among patients with chronic kidney disease.
Collapse
Affiliation(s)
- Jeonghwan Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sohee Oh
- Medical Research Collaborating Center, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jae-Young Byon
- National Meteorological Satellite Center, Korea Meteorological Administration, Jincheon, Chungcheongbuk-do, Republic of Korea
| | - Whanhee Lee
- Data Science, School of Biomedical Convergence Engineering, Pusan National University, Pusan, Republic of Korea
| | - Boram Weon
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ara Ko
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Wencheng Jin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sejoong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chun Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| |
Collapse
|
4
|
Liu M, Patel VR, Salas RN, Rice MB, Kazi DS, Zheng Z, Wadhera RK. Neighborhood Environmental Burden and Cardiovascular Health in the US. JAMA Cardiol 2024; 9:153-163. [PMID: 37955891 PMCID: PMC10644252 DOI: 10.1001/jamacardio.2023.4680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
Importance Cardiovascular disease is the leading cause of death in the US. However, little is known about the association between cumulative environmental burden and cardiovascular health across US neighborhoods. Objective To evaluate the association of neighborhood-level environmental burden with prevalence of cardiovascular risk factors and diseases, overall and by levels of social vulnerability. Design, Settings, and Participants This was a national cross-sectional study of 71 659 US Census tracts. Environmental burden (EBI) and social vulnerability indices from the US Centers for Disease Control and Prevention (CDC) and Agency for Toxic Substances and Disease Registry were linked to the 2020 CDC PLACES data set. Data were analyzed from March to October 2023. Exposures The EBI, a measure of cumulative environmental burden encompassing 5 domains (air pollution, hazardous or toxic sites, built environment, transportation infrastructure, and water pollution). Main Outcomes and Measures Neighborhood-level prevalence of cardiovascular risk factors (hypertension, diabetes, and obesity) and cardiovascular diseases (coronary heart disease and stroke). Results Across the US, neighborhoods with the highest environmental burden (top EBI quartile) were more likely than those with the lowest environmental burden (bottom EBI quartile) to be urban (16 626 [92.7%] vs 13 414 [75.4%]), in the Midwest (5191 [28.9%] vs 2782 [15.6%]), have greater median (IQR) social vulnerability scores (0.64 [0.36-0.85] vs 0.42 [0.20-0.65]), and have higher proportions of adults in racial or ethnic minority groups (median [IQR], 34% [12-73] vs 12% [5-30]). After adjustment, neighborhoods with the highest environmental burden had significantly higher rates of cardiovascular risk factors than those with the lowest burden, including hypertension (mean [SD], 32.83% [7.99] vs 32.14% [6.99]; adjusted difference, 0.84%; 95% CI, 0.71-0.98), diabetes (mean [SD], 12.19% [4.33] vs 10.68% [3.27]; adjusted difference, 0.62%; 95% CI, 0.53-0.70), and obesity (mean [SD], 33.57% [7.62] vs 30.86% [6.15]; adjusted difference, 0.77%; 95% CI, 0.60-0.94). Similarly, neighborhoods with the highest environmental burden had significantly higher rates of coronary heart disease (mean [SD], 6.66% [2.15] vs 6.82% [2.41]; adjusted difference, 0.28%; 95% CI, 0.22-0.33) and stroke (mean [SD], 3.65% [1.47] vs 3.31% [1.12]; adjusted difference, 0.19%; 95% CI, 0.15-0.22). Results were consistent after matching highest and lowest environmentally burdened neighborhoods geospatially and based on other covariates. The associations between environmental burden quartiles and cardiovascular risk factors and diseases were most pronounced among socially vulnerable neighborhoods. Conclusions and Relevance In this cross-sectional study of US neighborhoods, cumulative environmental burden was associated with higher rates of cardiovascular risk factors and diseases, although absolute differences were small. The strongest associations were observed in socially vulnerable neighborhoods. Whether initiatives that address poor environmental conditions will improve cardiovascular health requires additional prospective investigations.
Collapse
Affiliation(s)
- Michael Liu
- Section of Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | | | - Renee N. Salas
- Harvard Medical School, Boston, Massachusetts
- Center for Social Justice and Health Equity, Department of Emergency Medicine, Massachusetts General Hospital, Boston
- C-CHANGE, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Harvard Global Health Institute, Boston, Massachusetts
| | - Mary B. Rice
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Dhruv S. Kazi
- Section of Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - ZhaoNian Zheng
- Section of Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Rishi K. Wadhera
- Section of Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
5
|
Ozkan S, Tari Selcuk K, Kan ZE. Is green behaviors of health professionals related to green practices in the workplace? Multicenter study in Turkey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:898-910. [PMID: 36854645 DOI: 10.1080/09603123.2023.2185209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
In this study, it is aimed to examine the relationship between green behaviors of health professionals and green practices in the workplace. The study sample consisted of 174 health professionals from 34 Family Healthcare Centers (FHCs) in Turkey. Number, percent, mean, standard deviation, student's test, Mann - Whitney U test, One Way Anova test, Kruskal-Wallis H test, linear regression analysis were used for statistical analysis. Energy-saving (β: 0.197; 95%CI: 0.040;0.266) and waste reduction practices (β: 0.174; 95%CI: 0.019;0.256) in the workplace were positive associated with environmental sensitivity. Waste reduction practices (β: 0.228; 95%CI: 0.093;0.478) in the workplace were positive associated with environmental participation. Recycling bins (β: 0.181; 95%CI :0.084;0.799) and using solar energy (β: 0.198; 95%CI: 0.030; 0.785) in the workplace were positive associated with technological sensitivity. Health professionals who work in workplaces with energy-saving, waste reduction practices, recycling bins and using solar energy more likely to display green behaviors.
Collapse
Affiliation(s)
- Sirin Ozkan
- Department of Medical Services and Techniques, Uludag University, Bursa, Turkey
| | - Kevser Tari Selcuk
- Department of Nutrition and Dietetics, Bandırma Onyedi Eylül University Faculty of Health Science, Bandirma, Turkey
| | - Zeynep Ece Kan
- Department of Healthcare Management, Bandırma Onyedi Eylül University, Bandirma, Turkey
| |
Collapse
|
6
|
Heidari H, Lawrence DA. Climate Stressors and Physiological Dysregulations: Mechanistic Connections to Pathologies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:28. [PMID: 38248493 PMCID: PMC10815632 DOI: 10.3390/ijerph21010028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
This review delves into the complex relationship between environmental factors, their mechanistic cellular and molecular effects, and their significant impact on human health. Climate change is fueled by industrialization and the emission of greenhouse gases and leads to a range of effects, such as the redistribution of disease vectors, higher risks of disease transmission, and shifts in disease patterns. Rising temperatures pose risks to both food supplies and respiratory health. The hypothesis addressed is that environmental stressors including a spectrum of chemical and pathogen exposures as well as physical and psychological influences collectively impact genetics, metabolism, and cellular functions affecting physical and mental health. The objective is to report the mechanistic associations linking environment and health. As environmental stressors intensify, a surge in health conditions, spanning from allergies to neurodegenerative diseases, becomes evident; however, linkage to genetic-altered proteomics is more hidden. Investigations positing that environmental stressors cause mitochondrial dysfunction, metabolic syndrome, and oxidative stress, which affect missense variants and neuro- and immuno-disorders, are reported. These disruptions to homeostasis with dyslipidemia and misfolded and aggregated proteins increase susceptibility to cancers, infections, and autoimmune diseases. Proposed interventions, such as vitamin B supplements and antioxidants, target oxidative stress and may aid mitochondrial respiration and immune balance. The mechanistic interconnections of environmental stressors and disruptions in health need to be unraveled to develop strategies to protect public health.
Collapse
Affiliation(s)
- Hajar Heidari
- Department of Biomedical Sciences, University at Albany School of Public Health, Rensselaer, NY 12144, USA;
| | - David A. Lawrence
- Department of Biomedical Sciences, University at Albany School of Public Health, Rensselaer, NY 12144, USA;
- Department of Environmental Health Sciences, University at Albany School of Public Health, Rensselaer, NY 12144, USA
- Wadsworth Center, New York State Department of Health, Albany, NY 12208, USA
| |
Collapse
|
7
|
Montano L, Giorgini E, Notarstefano V, Notari T, Ricciardi M, Piscopo M, Motta O. Raman Microspectroscopy evidence of microplastics in human semen. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 901:165922. [PMID: 37532047 DOI: 10.1016/j.scitotenv.2023.165922] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/04/2023]
Abstract
The presence of microplastics (MPs) in human fluids and organs is a great concern, since, as highlighted by recent studies on animal models, they could cause alterations of several physiological functions, including reproduction. In this study, semen samples collected from men living in a polluted area of the Campania Region (Southern Italy), were analyzed to assess the presence of MPs. N. 16 pigmented microplastic fragments (ranging from 2 to 6 μm in size) with spheric or irregular shapes were found in six out of ten samples. All the detected MPs were characterized in terms of morphology (size, colour, and shape) and chemical composition by Raman Microspectroscopy. Chemical composition showed the presence of polypropylene (PP), polyethylene (PE), polyethylene terephthalate (PET), polystyrene (PS), polyvinylchloride (PVC), polycarbonate (PC), polyoxymethylene (POM) and acrylic, suggesting ingestion and/or inhalation as a route of exposure to environmental MPs. In this work, we propose for the first time a mechanism by which MPs pass into the semen most likely through the epididymis and seminal vesicles, which are the most susceptible to inflammation.
Collapse
Affiliation(s)
- Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL) Salerno, Coordination Unit of the Network for Environmental and Reproductive Health (Eco-Food Fertility Project), "S. Francesco di Assisi Hospital", 84020 Oliveto Citra, SA, Italy; PhD Program in Evolutionary Biology and Ecology, University of Rome "Tor Vergata", 00133 Rome, Italy.
| | - Elisabetta Giorgini
- Department of Life and Environmental Sciences, DiSVA, Università Politecnica Delle Marche, 60121 Ancona, AN, Italy
| | - Valentina Notarstefano
- Department of Life and Environmental Sciences, DiSVA, Università Politecnica Delle Marche, 60121 Ancona, AN, Italy.
| | - Tiziana Notari
- Check-Up PolyDiagnostics and Research Laboratory, Andrology Unit, Viale Andrea De Luca 5, 84131 Salerno, Italy
| | - Maria Ricciardi
- Department of Chemistry and Biology, University of Salerno, via Giovanni Paolo II, 84084 Fisciano, SA, Italy
| | - Marina Piscopo
- Department of Biology, University of Naples Federico II, 80126 Napoli, Italy
| | - Oriana Motta
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy
| |
Collapse
|
8
|
Puspitasari MD, Rahardja MB, Herartri R, Surbakti IM. Managing Age-Related Disability in Indonesia: An Issue That Extends Beyond the Concept of Active Aging. J Aging Soc Policy 2023; 35:842-858. [PMID: 37337435 DOI: 10.1080/08959420.2023.2226313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 03/22/2023] [Indexed: 06/21/2023]
Abstract
This study evaluates how various village services help older Indonesians perform daily activities and reduce age-related disability. Individual-level data from the 2020 National Socio-Economic Survey (SUSENAS) (N = 121,961 older people) and community-level data from the 2018 Village Potential Data Census Collection (PODES) (N = 83,931 villages in a data aggregation across 514 municipalities) were used in a multilevel binary logistic regression model. The interclass coefficient correlation (ICC) was calculated to determine the variation in characteristics across 514 municipalities to explain the differences in functional status. The ICC was approximately 16.2%, indicating that creating an age-friendly environment would help to delay the onset of disability. Older populations in Indonesia have a high percentage of informal employment, a low educational level, low percentages of affluent households, and few leisure activities. The findings highlight that the development of age-friendly services in the village should consider employment status and leisure activities. Participation in employment is a well-acknowledged concept for promoting active aging in developed nations but is secondary in managing age-related disability in Indonesia. The municipal government must develop an aging-friendly community (AFC) to create a supportive environment to meet the basic health and social needs of older people with age-related disability.
Collapse
Affiliation(s)
- Mardiana Dwi Puspitasari
- Research Center for Population, National Research and Innovation Agency, Republic of Indonesia (BRIN RI), Jakarta, Indonesia
| | - Mugia Bayu Rahardja
- Research Center for Population, National Research and Innovation Agency, Republic of Indonesia (BRIN RI), Jakarta, Indonesia
| | - Rina Herartri
- Research Center for Population, National Research and Innovation Agency, Republic of Indonesia (BRIN RI), Jakarta, Indonesia
| | - Indra Murty Surbakti
- Population Research and Development Center, National Population and Family Planning Board (BKKBN), Jakarta, Indonesia
| |
Collapse
|
9
|
Aminian-Dehkordi J, Rahimi S, Golzar-Ahmadi M, Singh A, Lopez J, Ledesma-Amaro R, Mijakovic I. Synthetic biology tools for environmental protection. Biotechnol Adv 2023; 68:108239. [PMID: 37619824 DOI: 10.1016/j.biotechadv.2023.108239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/17/2023] [Accepted: 08/20/2023] [Indexed: 08/26/2023]
Abstract
Synthetic biology transforms the way we perceive biological systems. Emerging technologies in this field affect many disciplines of science and engineering. Traditionally, synthetic biology approaches were commonly aimed at developing cost-effective microbial cell factories to produce chemicals from renewable sources. Based on this, the immediate beneficial impact of synthetic biology on the environment came from reducing our oil dependency. However, synthetic biology is starting to play a more direct role in environmental protection. Toxic chemicals released by industries and agriculture endanger the environment, disrupting ecosystem balance and biodiversity loss. This review highlights synthetic biology approaches that can help environmental protection by providing remediation systems capable of sensing and responding to specific pollutants. Remediation strategies based on genetically engineered microbes and plants are discussed. Further, an overview of computational approaches that facilitate the design and application of synthetic biology tools in environmental protection is presented.
Collapse
Affiliation(s)
| | - Shadi Rahimi
- Department of Life Sciences, Chalmers University of Technology, Göteborg, Sweden
| | - Mehdi Golzar-Ahmadi
- Norman B. Keevil Institute of Mining Engineering, University of British Columbia, Vancouver, Canada
| | - Amritpal Singh
- Department of Bioengineering, Imperial College London, London, SW72AZ, UK
| | - Javiera Lopez
- Department of Bioengineering, Imperial College London, London, SW72AZ, UK
| | | | - Ivan Mijakovic
- Department of Life Sciences, Chalmers University of Technology, Göteborg, Sweden; Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Lyngby, Denmark.
| |
Collapse
|
10
|
Sarycheva T, Čapková N, Pająk A, Tamošiūnas A, Bobák M, Pikhart H. Can spirometry improve the performance of cardiovascular risk model in high-risk Eastern European countries? Front Cardiovasc Med 2023; 10:1228807. [PMID: 37711557 PMCID: PMC10497938 DOI: 10.3389/fcvm.2023.1228807] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/08/2023] [Indexed: 09/16/2023] Open
Abstract
Aims Impaired lung function has been strongly associated with cardiovascular disease (CVD) events. We aimed to assess the additive prognostic value of spirometry indices to the risk estimation of CVD events in Eastern European populations in this study. Methods We randomly selected 14,061 individuals with a mean age of 59 ± 7.3 years without a previous history of cardiovascular and pulmonary diseases from population registers in the Czechia, Poland, and Lithuania. Predictive values of standardised Z-scores of forced expiratory volume measured in 1 s (FEV1), forced vital capacity (FVC), and FEV1 divided by height cubed (FEV1/ht3) were tested. Cox proportional hazards models were used to estimate hazard ratios (HRs) of CVD events of various spirometry indices over the Framingham Risk Score (FRS) model. The model performance was evaluated using Harrell's C-statistics, likelihood ratio tests, and Bayesian information criterion. Results All spirometry indices had a strong linear relation with the incidence of CVD events (HR ranged from 1.10 to 1.12 between indices). The model stratified by FEV1/ht3 tertiles had a stronger link with CVD events than FEV1 and FVC. The risk of CVD event for the lowest vs. highest FEV1/ht3 tertile among people with low FRS was higher (HR: 2.35; 95% confidence interval: 1.96-2.81) than among those with high FRS. The addition of spirometry indices showed a small but statistically significant improvement of the FRS model. Conclusions The addition of spirometry indices might improve the prediction of incident CVD events particularly in the low-risk group. FEV1/ht3 is a more sensitive predictor compared to other spirometry indices.
Collapse
Affiliation(s)
| | - Naděžda Čapková
- Environmental and Population Health Monitoring Centre, The National Institute of Public Health (NIPH), Prague, Czechia
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Abdonas Tamošiūnas
- Laboratory of Population Research, Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Martin Bobák
- RECETOX, Faculty of Science, Masaryk University, Brno, Czechia
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Hynek Pikhart
- RECETOX, Faculty of Science, Masaryk University, Brno, Czechia
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| |
Collapse
|
11
|
Sentamu DN, Kungu J, Dione M, Thomas LF. Prevention of human exposure to livestock faecal waste in the household: a scoping study of interventions conducted in sub-Saharan Africa. BMC Public Health 2023; 23:1613. [PMID: 37612675 PMCID: PMC10463677 DOI: 10.1186/s12889-023-16567-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/20/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Poorly managed animal faecal waste can result in detrimental environmental and public health implications. Limiting human exposure to animal waste through Animal inclusive Water Sanitation and Hygiene (A-WASH) strategies is imperative to improve public health in livestock keeping households but has received little attention to date. A small number of A-WASH interventions have previously been identified through a systematic review by another research team, and published in 2017. To inform intervention design with the most up-to-date information, a scoping study was conducted to map the existing evidence for A-WASH in sub-Saharan Africa (SSA) emerging since the previous review. METHODS This review followed PRISMA guidelines to identify interventions in SSA published between January 2016 to October 2022. Databases searched included PubMed, PMC Europe, CabDirect and Web of Science. Studies were eligible for inclusion if they were written in English and documented interventions limiting human contact with animal faecal material in the SSA context. Key data extracted included: the intervention itself, its target population, cost, measure of effectiveness, quantification of effect, assessment of success, acceptability and limitations. These data were synthesized into a narrative, structured around the intervention type. FINDINGS Eight eligible articles were identified. Interventions to reduce human exposure to animal faecal matter were conducted in combination with 'standard' human-centric WASH practices. Identified interventions included the management of human-animal co-habitation, educational programs and the creation of child-safe spaces. No novel A-WASH interventions were identified in this review, beyond those identified by the review in 2017. Randomised Controlled Trials (RCTs) were used to evaluate six of the eight identified interventions, but as effect was evaluated through various measures, the ability to formally compare efficacy of interventions is lacking. CONCLUSION This study indicates that the number of A-WASH studies in SSA is increasing and the use of RCTs suggests a strong desire to create high-quality evidence within this field. There is a need for standardisation of effect measures to enable meta-analyses to be conducted to better understand intervention effectiveness. Evaluation of scalability and sustainability of interventions is still lacking in A - WASH research.
Collapse
Affiliation(s)
- Derrick N Sentamu
- Animal and Human Health Program, International Livestock Research Institute, P.O Box 30709, Nairobi, 00100, Kenya
| | - Joseph Kungu
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Michel Dione
- International Livestock Research Institute, c/o AfricaRice, Rue 18 CitéMamelles, BP 24265, Dakar, Senegal
| | - Lian F Thomas
- Animal and Human Health Program, International Livestock Research Institute, P.O Box 30709, Nairobi, 00100, Kenya.
- Institute of Infection, Veterinary & Ecological Sciences, The University of Liverpool, Leahurst Campus, Neston, Liverpool, CH64 7TE, UK.
| |
Collapse
|
12
|
Cohen Y, Valdés-Mas R, Elinav E. The Role of Artificial Intelligence in Deciphering Diet-Disease Relationships: Case Studies. Annu Rev Nutr 2023; 43:225-250. [PMID: 37207358 DOI: 10.1146/annurev-nutr-061121-090535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Modernization of society from a rural, hunter-gatherer setting into an urban and industrial habitat, with the associated dietary changes, has led to an increased prevalence of cardiometabolic and additional noncommunicable diseases, such as cancer, inflammatory bowel disease, and neurodegenerative and autoimmune disorders. However, while dietary sciences have been rapidly evolving to meet these challenges, validation and translation of experimental results into clinical practice remain limited for multiple reasons, including inherent ethnic, gender, and cultural interindividual variability, among other methodological, dietary reporting-related, and analytical issues. Recently, large clinical cohorts with artificial intelligence analytics have introduced new precision and personalized nutrition concepts that enable one to successfully bridge these gaps in a real-life setting. In this review, we highlight selected examples of case studies at the intersection between diet-disease research and artificial intelligence. We discuss their potential and challenges and offer an outlook toward the transformation of dietary sciences into individualized clinical translation.
Collapse
Affiliation(s)
- Yotam Cohen
- Systems Immunology Department, Weizmann Institute of Science, Rehovot, Israel;
| | - Rafael Valdés-Mas
- Systems Immunology Department, Weizmann Institute of Science, Rehovot, Israel;
| | - Eran Elinav
- Systems Immunology Department, Weizmann Institute of Science, Rehovot, Israel;
- Division of Microbiome & Cancer, National German Cancer Research Center (DKFZ), Heidelberg, Germany;
| |
Collapse
|
13
|
Buse CG, Aker A, McLaren L, HubkaRao T, Sweeney E, van der Jagt RHC. Canada needs a funding institute focused on environments, health, and societal well-being research. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:525-529. [PMID: 37410366 PMCID: PMC10351254 DOI: 10.17269/s41997-023-00802-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Affiliation(s)
- Chris G Buse
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
| | - Amira Aker
- Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada
| | - Lindsay McLaren
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Tate HubkaRao
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ellen Sweeney
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | | |
Collapse
|
14
|
Schlünssen V, Mandrioli D, Pega F, Momen NC, Ádám B, Chen W, Cohen RA, Godderis L, Göen T, Hadkhale K, Kunpuek W, Lou J, Mandic-Rajcevic S, Masci F, Nemery B, Popa M, Rajatanavin N, Sgargi D, Siriruttanapruk S, Sun X, Suphanchaimat R, Thammawijaya P, Ujita Y, van der Mierden S, Vangelova K, Ye M, Zungu M, Scheepers PTJ. The prevalences and levels of occupational exposure to dusts and/or fibres (silica, asbestos and coal): A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2023; 178:107980. [PMID: 37487377 DOI: 10.1016/j.envint.2023.107980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 05/03/2023] [Accepted: 05/12/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large number of individual experts. Evidence from human, animal and mechanistic data suggests that occupational exposure to dusts and/or fibres (silica, asbestos and coal dust) causes pneumoconiosis. In this paper, we present a systematic review and meta-analysis of the prevalences and levels of occupational exposure to silica, asbestos and coal dust. These estimates of prevalences and levels will serve as input data for estimating (if feasible) the number of deaths and disability-adjusted life years that are attributable to occupational exposure to silica, asbestos and coal dust, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the prevalences and levels of occupational exposure to silica, asbestos and coal dust among working-age (≥ 15 years) workers. DATA SOURCES We searched electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥ 15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (< 15 years) and unpaid domestic workers. We included all study types with objective dust or fibre measurements, published between 1960 and 2018, that directly or indirectly reported an estimate of the prevalence and/or level of occupational exposure to silica, asbestos and/or coal dust. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, then data were extracted from qualifying studies. We combined prevalence estimates by industrial sector (ISIC-4 2-digit level with additional merging within Mining, Manufacturing and Construction) using random-effects meta-analysis. Two or more review authors assessed the risk of bias and all available authors assessed the quality of evidence, using the ROB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates. RESULTS Eighty-eight studies (82 cross-sectional studies and 6 longitudinal studies) met the inclusion criteria, comprising > 2.4 million measurements covering 23 countries from all WHO regions (Africa, Americas, Eastern Mediterranean, South-East Asia, Europe, and Western Pacific). The target population in all 88 included studies was from major ISCO groups 3 (Technicians and Associate Professionals), 6 (Skilled Agricultural, Forestry and Fishery Workers), 7 (Craft and Related Trades Workers), 8 (Plant and Machine Operators and Assemblers), and 9 (Elementary Occupations), hereafter called manual workers. Most studies were performed in Construction, Manufacturing and Mining. For occupational exposure to silica, 65 studies (61 cross-sectional studies and 4 longitudinal studies) were included with > 2.3 million measurements collected in 22 countries in all six WHO regions. For occupational exposure to asbestos, 18 studies (17 cross-sectional studies and 1 longitudinal) were included with > 20,000 measurements collected in eight countries in five WHO regions (no data for Africa). For occupational exposure to coal dust, eight studies (all cross-sectional) were included comprising > 100,000 samples in six countries in five WHO regions (no data for Eastern Mediterranean). Occupational exposure to silica, asbestos and coal dust was assessed with personal or stationary active filter sampling; for silica and asbestos, gravimetric assessment was followed by technical analysis. Risk of bias profiles varied between the bodies of evidence looking at asbestos, silica and coal dust, as well as between industrial sectors. However, risk of bias was generally highest for the domain of selection of participants into the studies. The largest bodies of evidence for silica related to the industrial sectors of Construction (ISIC 41-43), Manufacturing (ISIC 20, 23-25, 27, 31-32) and Mining (ISIC 05, 07, 08). For Construction, the pooled prevalence estimate was 0.89 (95% CI 0.84 to 0.93, 17 studies, I2 91%, moderate quality of evidence) and the level estimate was rated as of very low quality of evidence. For Manufacturing, the pooled prevalence estimate was 0.85 (95% CI 0.78 to 0.91, 24 studies, I2 100%, moderate quality of evidence) and the pooled level estimate was rated as of very low quality of evidence. The pooled prevalence estimate for Mining was 0.75 (95% CI 0.68 to 0.82, 20 studies, I2 100%, moderate quality of evidence) and the pooled level estimate was 0.04 mg/m3 (95% CI 0.03 to 0.05, 17 studies, I2 100%, low quality of evidence). Smaller bodies of evidence were identified for Crop and animal production (ISIC 01; very low quality of evidence for both prevalence and level); Professional, scientific and technical activities (ISIC 71, 74; very low quality of evidence for both prevalence and level); and Electricity, gas, steam and air conditioning supply (ISIC 35; very low quality of evidence for both prevalence and level). For asbestos, the pooled prevalence estimate for Construction (ISIC 41, 43, 45,) was 0.77 (95% CI 0.65 to 0.87, six studies, I2 99%, low quality of evidence) and the level estimate was rated as of very low quality of evidence. For Manufacturing (ISIC 13, 23-24, 29-30), the pooled prevalence and level estimates were rated as being of very low quality of evidence. Smaller bodies of evidence were identified for Other mining and quarrying (ISIC 08; very low quality of evidence for both prevalence and level); Electricity, gas, steam and air conditioning supply (ISIC 35; very low quality of evidence for both prevalence and level); and Water supply, sewerage, waste management and remediation (ISIC 37; very low quality of evidence for levels). For coal dust, the pooled prevalence estimate for Mining of coal and lignite (ISIC 05), was 1.00 (95% CI 1.00 to 1.00, six studies, I2 16%, moderate quality of evidence) and the pooled level estimate was 0.77 mg/m3 (95% CI 0.68 to 0.86, three studies, I2 100%, low quality of evidence). A small body of evidence was identified for Electricity, gas, steam and air conditioning supply (ISIC 35); with very low quality of evidence for prevalence, and the pooled level estimate being 0.60 mg/m3 (95% CI -6.95 to 8.14, one study, low quality of evidence). CONCLUSIONS Overall, we judged the bodies of evidence for occupational exposure to silica to vary by industrial sector between very low and moderate quality of evidence for prevalence, and very low and low for level. For occupational exposure to asbestos, the bodies of evidence varied by industrial sector between very low and low quality of evidence for prevalence and were of very low quality of evidence for level. For occupational exposure to coal dust, the bodies of evidence were of very low or moderate quality of evidence for prevalence, and low for level. None of the included studies were population-based studies (i.e., covered the entire workers' population in the industrial sector), which we judged to present serious concern for indirectness, except for occupational exposure to coal dust within the industrial sector of mining of coal and lignite. Selected estimates of the prevalences and levels of occupational exposure to silica by industrial sector are considered suitable as input data for the WHO/ILO Joint Estimates, and selected estimates of the prevalences and levels of occupational exposure to asbestos and coal dust may perhaps also be suitable for estimation purposes. Protocol identifier: https://doi.org/10.1016/j.envint.2018.06.005. PROSPERO registration number: CRD42018084131.
Collapse
Affiliation(s)
- Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark.
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Robert A Cohen
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Thomas Göen
- University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - Watinee Kunpuek
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Jianlin Lou
- Institute of Occupational Diseases, Hangzhou Medical College, Zhejiang Academy of Medical Sciences, Hangzhou, People's Republic of China
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milano, Milan, Italy; International Centre for Rural Health, San Paolo Hospital, Milan, Italy
| | - Federica Masci
- Department of Health Sciences, University of Milano, Milan, Italy; International Centre for Rural Health, San Paolo Hospital, Milan, Italy
| | - Ben Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Madalina Popa
- Center for Diabetes Research, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Somkiat Siriruttanapruk
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Xin Sun
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Repeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand; Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Panithee Thammawijaya
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland; Decent Work Technical Support Team for East and South-East Asia and the Pacific, International Labour Organization, Thailand
| | - Stevie van der Mierden
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy; Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Katya Vangelova
- National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria
| | - Meng Ye
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Muzimkhulu Zungu
- National Institute for Occupational Health, South Africa, Johannesburg, Gauteng Province, South Africa
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands; Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| |
Collapse
|
15
|
Butsch Kovacic M, Elshaer S, Baker TA, Hill V, Morris E, Mabisi K, Snider I, Gertz S, Hershberger S, Martin LJ. The Eyewitness Community Survey: An Engaging Citizen Science Tool to Capture Reliable Data while Improving Community Participants' Environmental Health Knowledge and Attitudes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6374. [PMID: 37510606 PMCID: PMC10379192 DOI: 10.3390/ijerph20146374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
Many youths and young adults have variable environmental health knowledge, limited understanding of their local environment's impact on their health, and poor environmentally friendly behaviors. We sought to develop and test a tool to reliably capture data, increase environmental health knowledge, and engage youths as citizen scientists to examine and take action on their community's challenges. The Eyewitness Community Survey (ECS) was developed through several iterations of co-design. Herein, we tested its performance. In Phase I, seven youths audited five 360° photographs. In Phase II, 27 participants works as pairs/trios and audited five locations, typically 7 days apart. Inter-rater and intra-rater reliability were determined. Changes in participants' knowledge, attitudes, behaviors, and self-efficacy were surveyed. Feedback was obtained via focus groups. Intra-rater reliability was in the substantial/near-perfect range, with Phase II having greater consistency. Inter-rater reliability was high, with 42% and 63% of Phase I and II Kappa, respectively, in the substantial/near-perfect range. Knowledge scores improved after making observations (p ≤ 0.032). Participants (85%) reported the tool to be easy/very easy to use, with 70% willing to use it again. Thus, the ECS is a mutually beneficial citizen science tool that rigorously captures environmental data and provides engaging experiential learning opportunities.
Collapse
Affiliation(s)
- Melinda Butsch Kovacic
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
- Department of Rehabilitation, Exercise, and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Shereen Elshaer
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Mansoura University, Mansoura City 35516, Egypt
| | - Theresa A Baker
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Vincent Hill
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
- Seven Hills Neighborhood Houses, Cincinnati, OH 45214, USA
| | - Edith Morris
- Evaluation Services Center, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Keren Mabisi
- Evaluation Services Center, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Ian Snider
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Susan Gertz
- Center for Chemistry Education, Department of Chemistry and Biochemistry, Miami University, Oxford, OH 45056, USA
| | - Susan Hershberger
- Center for Chemistry Education, Department of Chemistry and Biochemistry, Miami University, Oxford, OH 45056, USA
| | - Lisa J Martin
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
| |
Collapse
|
16
|
Stewart AG, Shepherd W, Jarvis R, Ghebrehewet S. Environmental Public Health practice: designing and delivering a locally desirable service. Public Health 2023; 221:150-159. [PMID: 37454405 DOI: 10.1016/j.puhe.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES We reviewed environmental public health practice at a local level (roles, responsibilities, interaction with partner agencies) to establish what and how an integrated approach to the service, as found in Cheshire and Merseyside, North West England, should be delivered, if at all, and at what footprint. STUDY DESIGN Mixed methods approach. METHODS We triangulated: qualitative interviews with relevant professionals to gain an in-depth understanding of their interest and vision for any health protection input to health risks and outcomes from environmental issues; an electronic questionnaire assessing experience, interest, vision and comfort zones of a wider range of professionals involved in environmental health issues; a half-day workshop to review study findings and agree ways forward. RESULTS Stakeholders value their local health protection team's input, but environmental public-health knowledge and skills also exist in local authority teams. Regional health protection teams can provide environmental public-health expertise to local partners and agencies. They harness national input and evidence with local frontline professionals practice, enabling locally grounded approaches, integrating science into local contexts, to answer difficult, often incorrigible, problems. CONCLUSIONS Specialist leadership by experienced Consultants in Health Protection is of value to local authority public health and environmental teams and should be based on a footprint that is appropriate to enhance local relationships without compromising available expert knowledge and skills.
Collapse
Affiliation(s)
- A G Stewart
- Consultant in Health Protection, North West Health Protection Team, Public Health England, Liverpool, L3 1DS, UK.
| | - W Shepherd
- Consultant in Health Protection, North West Health Protection Team, Public Health England, Liverpool, L3 1DS, UK.
| | - R Jarvis
- Consultant in Health Protection, North West Health Protection Team, Public Health England, Liverpool, L3 1DS, UK.
| | - S Ghebrehewet
- Consultant in Health Protection, North West Health Protection Team, Public Health England, Liverpool, L3 1DS, UK.
| |
Collapse
|
17
|
Liu J, Hansen A, Varghese BM, Dear K, Tong M, Prescott V, Dolar V, Gourley M, Driscoll T, Zhang Y, Morgan G, Capon A, Bi P. Estimating the burden of disease attributable to high ambient temperature across climate zones: methodological framework with a case study. Int J Epidemiol 2023; 52:783-795. [PMID: 36511334 PMCID: PMC10244055 DOI: 10.1093/ije/dyac229] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 11/30/2022] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND With high temperature becoming an increasing health risk due to a changing climate, it is important to quantify the scale of the problem. However, estimating the burden of disease (BoD) attributable to high temperature can be challenging due to differences in risk patterns across geographical regions and data accessibility issues. METHODS We present a methodological framework that uses Köppen-Geiger climate zones to refine exposure levels and quantifies the difference between the burden observed due to high temperatures and what would have been observed if the population had been exposed to the theoretical minimum risk exposure distribution (TMRED). Our proposed method aligned with the Australian Burden of Disease Study and included two parts: (i) estimation of the population attributable fractions (PAF); and then (ii) estimation of the BoD attributable to high temperature. We use suicide and self-inflicted injuries in Australia as an example, with most frequent temperatures (MFTs) as the minimum risk exposure threshold (TMRED). RESULTS Our proposed framework to estimate the attributable BoD accounts for the importance of geographical variations of risk estimates between climate zones, and can be modified and adapted to other diseases and contexts that may be affected by high temperatures. CONCLUSIONS As the heat-related BoD may continue to increase in the future, this method is useful in estimating burdens across climate zones. This work may have important implications for preventive health measures, by enhancing the reproducibility and transparency of BoD research.
Collapse
Affiliation(s)
- Jingwen Liu
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Alana Hansen
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Blesson M Varghese
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Keith Dear
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Michael Tong
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Vanessa Prescott
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Vergil Dolar
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Ying Zhang
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| |
Collapse
|
18
|
Hosseini SA, Abtahi M, Dobaradaran S, Hassankhani H, Koolivand A, Saeedi R. Assessment of health risk and burden of disease induced by exposure to benzene, toluene, ethylbenzene, and xylene in the outdoor air in Tehran, Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27889-z. [PMID: 37233938 DOI: 10.1007/s11356-023-27889-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023]
Abstract
The health risk and burden of disease induced by exposure to benzene, toluene, ethylbenzene, and xylene (BTEX) in the outdoor air in Tehran, 2019 were assessed based on the data of five fixed stations with weekly BTEX measurements. The non-carcinogenic risk, carcinogenic risk, and disease burden from exposure to BTEX compounds were determined by hazard index (HI), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average annual concentrations of benzene, toluene, ethylbenzene, and xylene in the outdoor air in Tehran were 6.59, 21.62, 4.68, and 20.88 μg/m3, respectively. The lowest seasonal BTEX concentrations were observed in spring and the highest ones occurred in summer. The HI values of BTEX in the outdoor air in Tehran by district ranged from 0.34 to 0.58 (less than one). The average ILCR values of benzene and ethylbenzene were 5.37 × 10-5 and 1.23 × 10-5, respectively (in the range of probable increased cancer risk). The DALYs, death, DALY rate (per 100,000 people) and death rate (per 100,000 people) induced by BTEX exposure in the outdoor air in Tehran were determined to be 180.21, 3.51, 2.07, and 0.04, respectively. The five highest attributable DALY rates in Tehran by district were observed in the districts 10 (2.60), 11 (2.43), 17 (2.41), 20 (2.32), and 9 (2.32), respectively. The corrective measures such as controlling road traffic and improving the quality of vehicles and gasoline in Tehran could reduce the burden of disease from BTEX along with the health effects of other outdoor air pollutants.
Collapse
Affiliation(s)
- Seyed Arman Hosseini
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrnoosh Abtahi
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sina Dobaradaran
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
- Instrumental Analytical Chemistry and Centre for Water and Environmental Research (ZWU), Faculty of Chemistry, University of Duisburg-Essen, Essen, Germany
| | | | - Ali Koolivand
- Department of Environmental Health Engineering, Faculty of Health, Arak University of Medical Sciences, Arak, Iran
| | - Reza Saeedi
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Health and Safety, and Environment (HSE), School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
19
|
Simanjuntak DF, Kusumawati RL, Bader O, Lüder CGK, Zimmermann O, Groß U. A comparative pilot study on Gram-negative bacteria contaminating the hands of children living in urban and rural areas of Indonesia versus Germany – A suitable monitoring strategy for diarrhea risk assessment? Front Microbiol 2023; 14:1152411. [PMID: 37077245 PMCID: PMC10106674 DOI: 10.3389/fmicb.2023.1152411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023] Open
Abstract
Diarrhea is the second leading cause of death mainly effecting young children. Often it is the result of fecal-oral pathogen transmission. We aimed to investigate whether monitoring the prevalence of Gram-negative bacteria on the hands of asymptomatic children is suitable as an indicator of fecal contamination of the environment in their playground. We compared the prevalence of Gram-negative bacteria on the hands of children, who live in the German city of Göttingen, an urban area in a high-income country, with the situation in Medan as an urban area and Siberut as a rural area both in the middle-income country Indonesia. A total of 511 children at the age of 3 months to 14 years were asked to put their thumb print on MacConkey agar, which was used to screen for the presence of Gram-negative bacteria. These were subsequently identified by using MALD-TOF mass spectrometry and classified into the order Enterobacterales, Pseudomonadales, and others. The highest burden of hand contamination was found in children from rural Siberut (66.7%) followed by children from urban Medan (53.9%), and from urban Göttingen (40.6%). In all three study sites, hand contamination was lower in the youngest (<1 year) and oldest age groups (10–14 years) and highest in the age group 5–9 years. Bacteria of the order Enterobacterales possibly indicating fecal contamination were most prevalent in Siberut (85.1%) followed by Medan (62.9%) and Göttingen (21.5%). Most facultative and obligate gastrointestinal pathogens such as Escherichia coli (n = 2) and Providencia rettgeri (n = 7), both being members of the order Enterobacterales, as well as Aeromonas caviae (n = 5), and Vibrio cholerae (n = 1) both belonging to other orders were nearly exclusively identified on the hands of children in Siberut. This result was not surprising, because hygienic conditions were lowest in Siberut. Only one isolate of A. caviae was found in Medan, and no facultative gastrointestinal pathogen was identified on the hands of children from Göttingen. Our pilot study therefore indicates that investigating hands of children for the prevalence of Gram-negative bacteria using selective media are a helpful method to monitor hygienic conditions, and thereby assess the risk for diarrhea-causing bacterial pathogens in the environment.
Collapse
Affiliation(s)
- Debi Frina Simanjuntak
- Institute for Medical Microbiology and Virology, University Medical Center Göttingen, Göttingen, Germany
| | - R. Lia Kusumawati
- Department of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Oliver Bader
- Institute for Medical Microbiology and Virology, University Medical Center Göttingen, Göttingen, Germany
| | - Carsten G. K. Lüder
- Institute for Medical Microbiology and Virology, University Medical Center Göttingen, Göttingen, Germany
| | - Ortrud Zimmermann
- Institute for Medical Microbiology and Virology, University Medical Center Göttingen, Göttingen, Germany
| | - Uwe Groß
- Institute for Medical Microbiology and Virology, University Medical Center Göttingen, Göttingen, Germany
- *Correspondence: Uwe Groß,
| |
Collapse
|
20
|
Rübsam ML, Kruse P, Dietzler Y, Kropf M, Bette B, Zarbock A, Kim SC, Hönemann C. A call for immediate climate action in anesthesiology: routine use of minimal or metabolic fresh gas flow reduces our ecological footprint. Can J Anaesth 2023; 70:301-312. [PMID: 36814057 PMCID: PMC10066075 DOI: 10.1007/s12630-022-02393-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 02/24/2023] Open
Abstract
PURPOSE Climate change is a global threat, and inhalational anesthetics contribute to global warming by altering the photophysical properties of the atmosphere. On a global perspective, there is a fundamental need to reduce perioperative morbidity and mortality and to provide safe anesthesia. Thus, inhalational anesthetics will remain a significant source of emissions in the foreseeable future. It is, therefore, necessary to develop and implement strategies to minimize the consumption of inhalational anesthetics to reduce the ecological footprint of inhalational anesthesia. SOURCE We have integrated recent findings concerning climate change, characteristics of established inhalational anesthetics, complex simulative calculations, and clinical expertise to propose a practical and safe strategy to practice ecologically responsible anesthesia using inhalational anesthetics. PRINCIPAL FINDINGS Comparing the global warming potential of inhalational anesthetics, desflurane is about 20 times more potent than sevoflurane and five times more potent than isoflurane. Balanced anesthesia using low or minimal fresh gas flow (≤ 1 L·min-1) during the wash-in period and metabolic fresh gas flow (0.35 L·min-1) during steady-state maintenance reduces CO2 emissions and costs by approximately 50%. Total intravenous anesthesia and locoregional anesthesia represent further options for lowering greenhouse gas emissions. CONCLUSION Responsible anesthetic management choices should prioritize patient safety and consider all available options. If inhalational anesthesia is chosen, the use of minimal or metabolic fresh gas flow reduces the consumption of inhalational anesthetics significantly. Nitrous oxide should be avoided entirely as it contributes to depletion of the ozone layer, and desflurane should only be used in justified exceptional cases.
Collapse
Affiliation(s)
- Marie-Luise Rübsam
- Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, University Medicine of Greifswald, Greifswald, Germany
| | - Philippe Kruse
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Yvonne Dietzler
- Department of Anaesthesia, St. Marienhospital Vechta, Marienstraße 6-8, 49377, Vechta, Germany
| | - Miriam Kropf
- Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, BG Klinikum Hamburg, Hamburg, Germany
| | - Birgit Bette
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Alexander Zarbock
- Department of Anesthesiology and Critical Care, University Hospital of Muenster, Münster, Germany
| | - Se-Chan Kim
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Christian Hönemann
- Department of Anaesthesia, St. Marienhospital Vechta, Marienstraße 6-8, 49377, Vechta, Germany.
- Department of Anesthesiology and Critical Care, University Hospital of Muenster, Münster, Germany.
| |
Collapse
|
21
|
Naser AM, Rahman SM, Kippler M. Editorial: Role of toxicants, pollutants, and trace elements in health and nutrition. Front Nutr 2023; 10:1142959. [PMID: 36776606 PMCID: PMC9910449 DOI: 10.3389/fnut.2023.1142959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/27/2023] Open
Affiliation(s)
- Abu Mohd Naser
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, United States
| | | | - Maria Kippler
- Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden,*Correspondence: Maria Kippler ✉
| |
Collapse
|
22
|
Abtahi M, Dobaradaran S, Koolivand A, Jorfi S, Saeedi R. Assessment of cause-specific mortality and disability-adjusted life years (DALYs) induced by exposure to inorganic arsenic through drinking water and foodstuffs in Iran. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:159118. [PMID: 36181805 DOI: 10.1016/j.scitotenv.2022.159118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/27/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
The health risk and burden of disease induced by exposure to inorganic arsenic (iAs) through drinking water and foodstuffs in Iran were assessed. The iAs levels in drinking water and foodstuffs (15 food groups) in the country were determined through systematic review of three international databases (PubMed, Scopus, and Web of Science) and meta-analysis. Based on the results of the systematic review and meta-analysis, the average iAs levels in drinking water and all the food groups at the national level were lower than the maximum permissible levels. The total average non-carcinogenic risk of dietary exposure to iAs in terms of hazard index (HI) was 3.4. The average incremental lifetime cancer risk (ILCR) values of dietary exposure to iAs were determined to be 1.5 × 10-3 for skin cancer, 1.0 × 10-3 for lung cancer, and 4.0 × 10-4 for bladder cancer. Over two-thirds of the non-carcinogenic and carcinogenic risk of dietary exposure to iAs was attributed to bread and cereals, drinking water, and rice. The total annual cancer incidence, deaths, disability-adjusted life years (DALYs), death rate, and DALY rate (per 100,000 people) were assessed to be 3347 (95 % uncertainty interval: 1791 to 5999), 1302 (697 to 2336), 72,606 (38,833 to 130,228), 1.6 (0.87 to 2.9), and 91 (49 to 160). The contribution of mortality in the attributable burden of disease was 95.1 %. The contributions of the causes in the attributable burden of disease were 72 % for lung cancer, 16 % for bladder cancer, and 12 % for skin cancer. Due to the significant attributable burden of disease, national and subnational action plans consisting of multi-disciplinary approaches for risk management of dietary exposure to iAs, especially for the higher arsenic-affected areas and high-risk population groups in the country are recommended.
Collapse
Affiliation(s)
- Mehrnoosh Abtahi
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sina Dobaradaran
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran; Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran; Instrumental Analytical Chemistry and Centre for Water and Environmental Research (ZWU), Faculty of Chemistry, University of Duisburg-Essen, Essen, Germany
| | - Ali Koolivand
- Department of Environmental Health Engineering, Faculty of Health, Arak University of Medical Sciences, Arak, Iran
| | - Sahand Jorfi
- Environmental Technology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Saeedi
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Health and Safety, and Environment (HSE), School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
23
|
Gherscovici ED, Mayer JM. Relationship of Healthy Building Determinants With Back and Neck Pain: A Systematic Review. Am J Health Promot 2023; 37:103-131. [PMID: 35815341 PMCID: PMC9755707 DOI: 10.1177/08901171221112571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Back pain and neck pain are very common, costly, and disabling. Healthy building determinants within the built environment have not been adequately assessed as contributors to these conditions. The objective of this study was to systematically review the literature on the relationship of healthy building determinants with back and neck pain. DATA SOURCE PubMed, CINAHL, EMBASE, Google Scholar, and PEDRo. Study Inclusion and Exclusion Criteria: Studies were included if they met the following criteria: Adults, comparison of healthy building determinants (air quality, ventilation, dust and pests, lighting and views, moisture, noise, safety/security, thermal health, water quality) with back and neck pain, original research, English. Studies were excluded if full text articles were unavailable and if the focus was patient and materials handling or ergonomics. DATA EXTRACTION Data extraction and other review procedures were elaborated according to PRISMA guidelines. Data Synthesis: Data were synthesized with an approach adapted from Oxford Centre for Evidence-Based Medicine and American Physical Therapy Association. RESULTS 37 articles enrolling 46,223 participants were eligible. Most articles were cross-sectional (31/37) and fair quality (28/37). None were interventional. Evidence was found to generally support a relationship indicating that as healthy building determinants worsen, the risk of back and neck pain increases. CONCLUSION Although the available evidence precludes interpretations about causality, the study's findings are starting points to guide future research, knowledge creation, and health promotion initiatives about the relationships of the built environment with back and neck pain.
Collapse
Affiliation(s)
- Ezequiel D. Gherscovici
- Healthy Buildings LLC, Malibu, CA, USA,Ezequiel D. Gherscovici, Healthy Buildings LLC, 23307 West Bocana Street, Malibu, CA 90265, USA,
| | | |
Collapse
|
24
|
Pope ND, Gibson A, Engelhardt E, Ratliff S, Lewinson T, Loeffler DN. Conversations about Community, Connection to Place, and Housing Preferences among Aging Adults in Lexington, Kentucky. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:64-82. [PMID: 35815714 DOI: 10.1080/01634372.2022.2097756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
While many researchers have called for housing to be addressed in age-friendly cities and communities, little research exists to guide communities through this process. To maximize the potential for adults to age in place, researchers partnered with a local Age-Friendly community initiative to conduct focus groups and learn more about residents' preferences related to housing and residential space. The focus group data offered a glimpse into aging residents' perspectives on housing to inform planning and development of housing in a mid-size city. This second phase of a sequential mixed methods study included qualitative focus groups with 19 aging individuals. Focus group sessions sought to better understand previously identified housing preferences, aging adults' sense of community, and their connection to place. Findings suggest that aging participants cared not only about the physical structure of their home, but also the community-based aspects of where they live. Study implications suggest that social workers, working with and alongside community members and aging-service providers who have local knowledge, can support age-friendly housing models that consider the housing preferences of older residents, as well as the resources and limitations of their community.
Collapse
Affiliation(s)
- Natalie D Pope
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | - Allison Gibson
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | - Ethan Engelhardt
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | - Stephanie Ratliff
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | - Terri Lewinson
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA
| | - Diane N Loeffler
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
25
|
Zheng J, Liu S, Peng J, Peng H, Wang Z, Deng Z, Li C, Li N, Tang L, Xu J, Li J, Li B, Zhou Y, Ran P. Traffic-related air pollution is a risk factor in the development of chronic obstructive pulmonary disease. Front Public Health 2022; 10:1036192. [PMID: 36568772 PMCID: PMC9769455 DOI: 10.3389/fpubh.2022.1036192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Background Outdoor traffic-related air pollution has negative effects on respiratory health. In this study, we aimed to explore the effect of outdoor traffic-related air pollution on chronic obstructive pulmonary disease (COPD) in Guangzhou. Methods We enrolled 1,460 residents aged 40 years or older between 21 January 2014 and 31 January 2018. We administered questionnaires and spirometry tests. The distance of participants' residences or locations of outdoor activities from busy roads (as indicators of outdoor traffic-related air pollution), indoor air pollution, and smoking history were queried in the questionnaires. Results Of the 1,460 residents with valid survey and test results, 292 were diagnosed with COPD, with a detection rate of 20%. Participants who lived and did their outdoor activities near busy roads had a higher detection rate of COPD. Among residents living at distances of <50 meters, 50-199 meters, and more than 200 meters from busy roads, the detection rates were 20.6, 21.2, and 14.8%, respectively; the rates for outdoor activities at these distances were 23.8, 24.5, and 13.7%, respectively (p < 0.05). After adjusting for sex, age, smoking status, family history, and smoking index, the distance of outdoor activities from busy roads was an independent risk factor for COPD. Participants whose outdoor activities were conducted <50 meters and 50-199 meters of main roads had odds ratios of 1.54 (95% confidence interval 1.01-2.36) and 1.84 (95% interval 1.23-2.76) for the risk of COPD in comparison with a distance of more than 200 meters from busy roads. Conclusions Residents of Guangzhou whose outdoor activities were close to busy roads had a high risk of COPD. Traffic-related air pollution presents a risk to human health and a risk of COPD.
Collapse
Affiliation(s)
- Jinzhen Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China,Department of Pulmonary and Critical Care Medicine, Shantou Central Hospital, Shantou, Guangdong, China
| | - Sha Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China,The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Jieqi Peng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China,Guangzhou Laboratory, Bio Island, Guangzhou, Guangdong, China
| | - Huanhuan Peng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China,Department of Pulmonary and Critical Care Medicine, The Fourth People's Hospital of Chenzhou, Chenzhou, Hunan, China
| | - Zihui Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Zhishan Deng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Chenglong Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Naijian Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Longhui Tang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China,Department of Pulmonary and Critical Care Medicine, Chenzhou Third People's Hospital, Chenzhou, Hunan, China
| | - Jianwu Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Jingwen Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Bing Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China,College of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yumin Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China,Guangzhou Laboratory, Bio Island, Guangzhou, Guangdong, China,Yumin Zhou
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, The Guangzhou Institute of Respiratory Health, and The First Affiliated Hospital of Guangzhou Medical University, Guangdong, China,Guangzhou Laboratory, Bio Island, Guangzhou, Guangdong, China,*Correspondence: Pixin Ran
| |
Collapse
|
26
|
Mbazima SJ, Mbonane TP, Masekameni MD. A SWOT analysis of contemporary gaps and a possible diagnostic tool for environmental health in an upper-middle income country: a case study of South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2820-2842. [PMID: 34719301 DOI: 10.1080/09603123.2021.1994527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
This study evaluated the state of environmental health in the Republic of South Africa using the strengths, weaknesses, opportunities, and threats (SWOT) analysis framework. The internal and external factor evaluations were conducted by reviewing existing literature searched using a combination of keywords and boolean functions. The weighted score for the strengths and weaknesses was 0.79 and 1.04, respectively. The external factor evaluations findings revealed that environmental health has an equal amount of threats and opportunities, however, the threats outweigh the opportunities. The total weighted score for the internal and external factor evaluations was 1.83 and 2.25, respectively, which were below the average value of 2.5. The internal-external factors matrix indicated that environmental health in the Republic of South Africa needs to be refocused and re-aligned to public health protection. Failure to address the weaknesses and threats and optimise the strengths and opportunities may further weaken the provision of environmental health services.
Collapse
Affiliation(s)
- Setlamorago Jackson Mbazima
- Occupational Health Division, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Thokozani Patrick Mbonane
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Masilu Daniel Masekameni
- Occupational Health Division, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
27
|
Freudenberg N. Integrating Social, Political and Commercial Determinants of Health Frameworks to Advance Public Health in the twenty-first Century. INTERNATIONAL JOURNAL OF HEALTH SERVICES : PLANNING, ADMINISTRATION, EVALUATION 2022; 53:207314221125151. [PMID: 36113468 DOI: 10.1177/00207314221125151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Existing frameworks seek to elucidate the social, political, and commercial determinants of health in order to inform practice, policy, and research that can improve health and reduce health inequities. Each approach has widened the scope of public health practice and research and identified new partners and targets for intervention. But as the public health crises of the past decade have shown, these frameworks have not yet yielded insights that have enabled the public health profession and movement to prevent or overcome dominant threats to global health and health equity. This report explores the value of an integrated framework that combines insights from previous scholarship and practice using the social, political, and commercial determinants of health. It proposes the questions such an integration would need to answer and suggests processes and tasks that could lead to the creation of a blended framework.
Collapse
Affiliation(s)
- Nicholas Freudenberg
- Distinguished Professor of Public Health, 2009City University of New York School of Public Health and Health Policy, New York, NY, USA
| |
Collapse
|
28
|
Dambha-Miller H, Cheema S, Saunders N, Simpson G. Multiple Long-Term Conditions (MLTC) and the Environment: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811492. [PMID: 36141763 PMCID: PMC9517156 DOI: 10.3390/ijerph191811492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 05/31/2023]
Abstract
Background: Multiple Long Term conditions (MLTC) are a major health care challenge associated with high service utilisation and expenditure. Once established, the trajectory to an increased number and severity of conditions, hospital admission, increased social care need and mortality is multifactorial. The role of wider environmental determinants in the MLTC sequelae is unclear. Aim: the aim of this review was to summarise and collate existing evidence on environmental determinants on established MLTC. Methods: comprehensive search of Medline, Embase, Cochrane, CINAHL and Bielefeld Academic Search Engine (BASE), from inception to 4th June 2022 in addition to grey literature. Two authors independently screened and extracted papers. Disagreements were resolved with a third author. Results: searches yielded 9079 articles, 12 of which met the review's inclusion criteria. Evidence of correlations between some environmental determinants and increased or decreased risks of MLTC were found, including the quality of internal housing/living environments, exposure to airborne environmental hazards and a beneficial association with socially cohesive, accessible and greener neighbourhood environments. Conclusions: The majority of the 12 included papers focused on the built and social environments. The review uncovered very limited evidence, indicating a need for further research to understand the role of environmental determinants in MLTC.
Collapse
Affiliation(s)
- Hajira Dambha-Miller
- Primary Care Research Centre, University of Southampton, Southampton SO16 5ST, UK
| | - Sukhmani Cheema
- Primary Care Research Centre, University of Southampton, Southampton SO16 5ST, UK
| | - Nile Saunders
- Swansea Medical School, University of Swansea, Swansea SA2 8PP, UK
| | - Glenn Simpson
- Primary Care Research Centre, University of Southampton, Southampton SO16 5ST, UK
| |
Collapse
|
29
|
Owusu C, Flanagan B, Lavery AM, Mertzlufft CE, McKenzie BA, Kolling J, Lewis B, Dunn I, Hallisey E, Lehnert EA, Fletcher K, Davis RT, Conn M, Owen LR, Smith MM, Dent A. Developing a granular scale environmental burden index (EBI) for diverse land cover types across the contiguous United States. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:155908. [PMID: 35588849 DOI: 10.1016/j.scitotenv.2022.155908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/15/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
Critical to identifying the risk of environmentally driven disease is an understanding of the cumulative impact of environmental conditions on human health. Here we describe the methodology used to develop an environmental burden index (EBI). The EBI is calculated at U.S. census tract level, a finer scale than many similar national-level tools. EBI scores are also stratified by tract land cover type as per the National Land Cover Database (NLCD), controlling for urbanicity. The EBI was developed over the course of four stages: 1) literature review to identify potential indicators, 2) data source acquisition and indicator variable construction, 3) index creation, and 4) stratification by land cover type. For each potential indicator, data sources were assessed for completeness, update frequency, and availability. These indicators were: (1) particulate matter (PM2.5), (2) ozone, (3) Superfund National Priority List (NPL) locations, (4) Toxics Release Inventory (TRI) facilities, (5) Treatment, Storage, and Disposal (TSD) facilities, (6) recreational parks, (7) railways, (8) highways, (9) airports, and (10) impaired water sources. Indicators were statistically normalized and checked for collinearity. For each indicator, we computed and summed percentile ranking scores to create an overall ranking for each tract. Tracts having the same plurality of land cover type form a 'peer' group. We re-ranked the tracts into percentiles within each peer group for each indicator. The percentile scores were combined for each tract to obtain a stratified EBI. A higher score reveals a tract with increased environmental burden relative to other tracts of the same peer group. We compared our results to those of related indices, finding good convergent validity between the overall EBI and CalEnviroScreen 4.0. The EBI has many potential applications for research and use as a tool to develop public health interventions at a granular scale.
Collapse
Affiliation(s)
- Claudio Owusu
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Barry Flanagan
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Amy M Lavery
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA; Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Emergency Management, USA.
| | - Caitlin E Mertzlufft
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Benjamin A McKenzie
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Jessica Kolling
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA
| | - Brian Lewis
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Ian Dunn
- The Ohio Colleges of Medicine Government Resource Center, Columbus, OH, USA.
| | - Elaine Hallisey
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Erica Adams Lehnert
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Kelly Fletcher
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Ryan T Davis
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Michel Conn
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Lance R Owen
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Melissa M Smith
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| | - Andrew Dent
- Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, National Center for Environmental Health, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, USA.
| |
Collapse
|
30
|
Palacios A, Gabosi J, Williams CR, Rojas-Roque C. Social vulnerability, exposure to environmental risk factors, and accessibility of healthcare services: Evidence from 2,000+ informal settlements in Argentina. Soc Sci Med 2022; 309:115290. [PMID: 35985244 DOI: 10.1016/j.socscimed.2022.115290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 07/14/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022]
Abstract
Globally, the question of how to improve the living standards of the inhabitants of informal settlements is a key political concern. These neighborhoods are characterized by economic vulnerability, social marginalization, and inaccessibility of basic services. The aim of this study is to provide evidence about the environmental risk factors faced by these populations in Argentina, and to identify whether their greater exposure to risk factors is associated with greater accessibility of healthcare services. We analyzed an original database that provides information about basic characteristics of the neighborhood, environmental risk factors (proximity to garbage dumps, industrial waste, and high-voltage towers), and accessibility of basic healthcare services on over 2000 informal settlements in Argentina. We calculated descriptive statistics and developed multivariate econometric models to estimate the probability of accessibility of healthcare services. On average, 31% of informal settlements were close to a garbage dump, 19% were close to a high-voltage tower, and 10% were close to industrial waste. In addition, 39% of these neighborhoods do not have a healthcare center nearby, 65% do not have an accessible hospital, and 39% are not consistently served by ambulances in the event of an emergency. The econometric estimates suggest that the accessibility of hospital healthcare service and to an ambulance service is positively associated with the age of the neighborhood, and whether the neighborhood is a slum, but there is no evidence of association with the exposure to environmental risk factors. In short, the populations living in informal settlements in Argentina are exposed to harmful environmental risk factors. Access to basic healthcare services is limited and does not reflect the elevated exposure to environmental risks. Health, environmental, and economic dimensions should be considered when designing and implementing public policies for vulnerable populations.
Collapse
Affiliation(s)
- Alfredo Palacios
- Institute for Clinical Effectiveness and Health Policy (IECS), Dr. Emilio Ravignani, 2024, Ciudad Autónoma de Buenos Aires, Argentina; Department of Economics, University of Buenos Aires (UBA), Córdoba, 2122, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Julia Gabosi
- Facultad Latinoamericana de Ciencias Sociales (FLACSO), Tucuman, 1966, Ciudad Autónoma de Buenos Aires, Argentina
| | - Caitlin R Williams
- Institute for Clinical Effectiveness and Health Policy (IECS), Dr. Emilio Ravignani, 2024, Ciudad Autónoma de Buenos Aires, Argentina; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC, 27599, USA
| | - Carlos Rojas-Roque
- Institute for Clinical Effectiveness and Health Policy (IECS), Dr. Emilio Ravignani, 2024, Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
31
|
Li X, He F, Wang Z, Xing B. Roadmap of environmental health research on emerging contaminants: Inspiration from the studies on engineered nanomaterials. ECO-ENVIRONMENT & HEALTH (ONLINE) 2022; 1:181-197. [PMID: 38075596 PMCID: PMC10702922 DOI: 10.1016/j.eehl.2022.10.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 01/25/2024]
Abstract
Research on the environmental health of emerging contaminants is critical to understand their risks before causing severe harm. However, the low environmental concentrations, complex behaviors, and toxicology of emerging contaminants present enormous challenges for researchers. Here, we reviewed the research on the environmental health of engineered nanomaterials (ENMs), one of the typical emerging contaminants, to enlighten pathways for future research on emerging contaminants at their initial exploratory stage. To date, some developed pretreatment methods and detection technologies have been established for the determination of ENMs in natural environments. The mechanisms underlying the transfer and transformation of ENMs have been systematically explored in laboratory studies. The mechanisms of ENMs-induced toxicity have also been preliminarily clarified at genetic, cellular, individual, and short food chain levels, providing not only a theoretical basis for revealing the risk change and environmental health effects of ENMs in natural environments but also a methodological guidance for studying environmental health of other emerging contaminants. Nonetheless, due to the interaction of multiple environmental factors and the high diversity of organisms in natural environments, health effects observed in laboratory studies likely differ from those in natural environments. We propose a holistic approach and mesocosmic model ecosystems to systematically carry out environmental health research on emerging contaminants, obtaining data that determine the objectivity and accuracy of risk assessment.
Collapse
Affiliation(s)
- Xiaona Li
- Institute of Environmental Processes and Pollution Control, and School of Environment and Civil Engineering, Jiangnan University, Wuxi 214122, China
- Jiangsu Engineering Laboratory for Biomass Energy and Carbon Reduction Technology, Jiangnan University, Wuxi 214122, China
| | - Feng He
- Institute of Environmental Processes and Pollution Control, and School of Environment and Civil Engineering, Jiangnan University, Wuxi 214122, China
- Jiangsu Engineering Laboratory for Biomass Energy and Carbon Reduction Technology, Jiangnan University, Wuxi 214122, China
| | - Zhenyu Wang
- Institute of Environmental Processes and Pollution Control, and School of Environment and Civil Engineering, Jiangnan University, Wuxi 214122, China
- Jiangsu Engineering Laboratory for Biomass Energy and Carbon Reduction Technology, Jiangnan University, Wuxi 214122, China
| | - Baoshan Xing
- Stockbridge School of Agriculture, University of Massachusetts, Amherst, MA 01003, United States
| |
Collapse
|
32
|
Protozoa as the “Underdogs” for Microbiological Quality Evaluation of Fresh Vegetables. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The monitoring of the microbial quality of fresh products in the industrial environment has mainly focused on bacterial indicators. Protozoa, such as Giardia duodenalis, Cryptosporidium spp., Toxoplasma gondii, and Cyclospora cayetanensis, are routinely excluded from detection and surveillance systems, despite guidelines and regulations that support the need for tracking and monitoring these pathogens in fresh food products. Previous studies performed by our laboratory, within the scope of the SafeConsume project, clearly indicated that consumption of fresh produce may be a source of T. gondii, thus posing a risk for the contraction of toxoplasmosis for susceptible consumers. Therefore, preliminary work was performed in order to assess the microbiological quality of vegetables, highlighting not only bacteria (Escherichia. coli, Listeria monocytogenes, and Salmonella spp.), but also the zoonotic protozoa G. duodenalis and Cryptosporidium spp. Although all samples were found to be acceptable based on bacteriological parameters, cysts of G. duodenalis and oocysts of Cryptosporidium spp. were observed in vegetables. Moreover, it was possible to genetically characterize G. duodenalis positive samples as assemblage A, a genotype that poses risks to human health. Although these are preliminary results, they highlight the need to include protozoa in the microbiological criteria for foodstuffs, as required by EU Law No. 1441/2007, and to improve inactivation and removal procedures of (oo)cysts in fresh produce and water.
Collapse
|
33
|
Nuño N, Mäusezahl D, Hattendorf J, Verastegui H, Ortiz M, Hartinger SM. Effectiveness of a home-environmental intervention package and an early child development intervention on child health and development in high-altitude rural communities in the Peruvian Andes: a cluster-randomised controlled trial. Infect Dis Poverty 2022; 11:66. [PMID: 35668472 PMCID: PMC9169326 DOI: 10.1186/s40249-022-00985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unsafe drinking water, poor sanitation and hygiene, exposure to household air pollution and low cognitive and socio-emotional stimulation are risk factors affecting children in low- and middle-income countries. We implemented an integrated home-environmental intervention package (IHIP), comprising a kitchen sink, hygiene education and a certified improved biomass cookstove, and an early child development (ECD) programme to improve children´s health and developmental outcomes in the rural high-altitude Andes of Peru. METHODS We conducted a one-year cluster-randomised controlled trial among 317 children < 36 months divided into 4 arms (IHIP + ECD, IHIP, ECD, and Control) and 40 clusters (10 clusters per arm). ECD status (socio-emotional, fine and gross motor, communication, cognitive skills, and an overall performance) measured with the Peruvian Infant Development Scale and the occurrence of self-reported child diarrhoea from caretakers were primary outcomes. Secondary outcomes included the occurrence of acute respiratory infections and the presence of thermo-tolerant faecal bacteria in drinking water. The trial was powered to compare each intervention against its control arm but it did not allow pairwise comparisons among the four arms. Primary analysis followed the intention-to-treat principle. For the statistical analysis, we employed generalised estimating equation models with robust standard errors and an independent correlation structure. RESULTS We obtained ECD information from 101 children who received the ECD intervention (individually and combined with IHIP) and 102 controls. Children who received the ECD intervention performed better in all the domains compared to controls. We found differences in the overall performance (64 vs. 39%, odd ratio (OR): 2.8; 95% confidence interval (CI): 1.6-4.9) and the cognitive domain (62 vs 46%, OR: 1.9; 95% CI: 1.1-3.5). Data analysis of child morbidity included 154 children who received the IHIP intervention (individually and combined with ECD) and 156 controls. We recorded 110,666 child-days of information on diarrhoea morbidity and observed 1.3 mean episodes per child-year in the children who received the IHIP intervention and 1.1 episodes in the controls. This corresponded to an incidence risk ratio of 1.2 (95% CI: 0.8-1.7). CONCLUSIONS Child stimulation improved developmental status in children, but there was no health benefit associated with the home-environmental intervention. Limited year-round access to running water at home and the possible contamination of drinking water after boiling were two potential factors linked to the lack of effect of the home-environmental intervention. Potential interactions between ECD and home-environmental interventions need to be further investigated. TRIAL REGISTRATION ISRCTN, ISRCTN-26548981. Registered 15 January 2018-Retrospectively registered, https://doi.org/10.1186/ISRCTN26548981 .
Collapse
Affiliation(s)
- Néstor Nuño
- Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.,University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland
| | - Daniel Mäusezahl
- Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland. .,University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland.
| | - Jan Hattendorf
- Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.,University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland
| | - Hector Verastegui
- Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.,University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland.,Unidad de Investigación en Desarrollo Integral, Ambiente y Salud, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Urb. Ingeniería, S.M.P., Lima, Peru
| | | | - Stella M Hartinger
- Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.,University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland.,Unidad de Investigación en Desarrollo Integral, Ambiente y Salud, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Urb. Ingeniería, S.M.P., Lima, Peru
| |
Collapse
|
34
|
Real de Asua D, Fins JJ. Should healthcare workers be prioritised during the COVID-19 pandemic? A view from Madrid and New York. JOURNAL OF MEDICAL ETHICS 2022; 48:397-400. [PMID: 33910974 PMCID: PMC8103555 DOI: 10.1136/medethics-2020-107050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/09/2021] [Accepted: 04/01/2021] [Indexed: 05/30/2023]
Abstract
While COVID-19 has generated a massive burden of illness worldwide, healthcare workers (HCWs) have been disproportionately exposed to SARS-CoV-2 coronavirus infection. During the so-called 'first wave', infection rates among this population group have ranged between 10% and 20%, raising as high as one in every four COVID-19 patients in Spain at the peak of the crisis. Now that many countries are already dealing with new waves of COVID-19 cases, a potential competition between HCW and non-HCW patients for scarce resources can still be a likely clinical scenario. In this paper, we address the question of whether HCW who become ill with COVID-19 should be prioritised in diagnostic, treatment or resource allocation protocols. We will evaluate some of the proposed arguments both in favour and against the prioritisation of HCW and also consider which clinical circumstances might warrant prioritising HCW and why could it be ethically appropriate to do so. We conclude that prioritising HCW's access to protective equipment, diagnostic tests or even prophylactic or therapeutic drug regimes and vaccines might be ethically defensible. However, prioritising HCWs to receive intensive care unit (ICU) beds or ventilators is a much more nuanced decision, in which arguments such as instrumental value or reciprocity might not be enough, and economic and systemic values will need to be considered.
Collapse
Affiliation(s)
- Diego Real de Asua
- Department of Internal Medicine, Hospital Universitario de la Princesa, Madrid, Spain
- Division of Medical Ethics, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
| | - Joseph J Fins
- Division of Medical Ethics, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
- CASBI, Consortium for the Advanced Study of Brain Injury, Weill Cornell Medicine and Rockefeller University, New York, New York, USA
| |
Collapse
|
35
|
Hampshire K, Islam N, Kissel B, Chase H, Gundling K. The Planetary Health Report Card: a student-led initiative to inspire planetary health in medical schools. Lancet Planet Health 2022; 6:e449-e454. [PMID: 35461572 DOI: 10.1016/s2542-5196(22)00045-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/03/2022] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
The warming of our planet and destruction of our ecosystems have created grave new threats to human health, such as food insecurity, physical and mental trauma from extreme weather events, and heat-related illness. In the 21st century, medical schools should be training physicians who, as researchers, can advance evidence-based linkages between environment and health; who, as clinicians, can recognise, prevent, and treat associated diseases; and who, as healers, can advocate for a healthy biosphere as an indelible precondition for a healthy humanity. To address the substantial gap between existing and needed curricular content that reflects the realities of the health impacts of environmental degradation, medical students have developed the Planetary Health Report Card (PHRC), a metric-based tool for evaluating and improving planetary health content in medical schools. The PHRC spans five topic areas-curriculum, research, community outreach and advocacy, support for student-led initiatives, and sustainability. Since its creation in 2019, the PHRC has expanded rapidly to evaluate more than 60 medical schools in five countries. Although evaluation results reveal inadequate engagement in all topic areas, application of the PHRC is already spawning transformative dialogue between students, faculty, and administrators, serving as a platform to advance the curricular innovations that will hopefully fulfil the learning needs of medical students in a rapidly changing world.
Collapse
Affiliation(s)
- Karly Hampshire
- University of California, San Francisco School of Medicine, San Francisco, CA, USA.
| | - Nuzhat Islam
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Bennett Kissel
- Department of Psychiatry, University of Hawaii, Honolulu, HI, USA
| | - Hannah Chase
- Medical Sciences Divisional Office, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Katherine Gundling
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| |
Collapse
|
36
|
Measuring Environmental Justice in Real Time: A Pilot Study Using Digital Participatory Method in the Global South, Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084752. [PMID: 35457618 PMCID: PMC9024717 DOI: 10.3390/ijerph19084752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022]
Abstract
Individuals' perceived fairness or justice beliefs are related to health in numerous ways. However, environment justice research to date has given little attention to perceived fairness of environmental exposures as experienced by individuals. This study explored the feasibility of a bottom-up digital participatory (via mobile phones) approach using ecological momentary assessment (EMA) to capture individuals' subjective experience of environmental exposures and the subjective evaluation of fairness by those affected in the context of Nepal. In total, 22 individuals participated in the study for 28 days. The results show high rates of study retention and adherence. Individuals' justice perception was found to vary within and between individuals, but also substantially depending on the types of environmental exposures. Nevertheless, the study indicates that uncertainties are inevitable as study design and timing may conflict participants' daily lives and priorities. The method allows us to consider multiple geographic contexts of individuals' everyday lives beyond residential environment. This pilot study proved the possibility to assess perceptions of environmental justice issues and demonstrated the necessary steps to using digital participatory method for assessing subjective perception of fairness of individuals.
Collapse
|
37
|
Gutierrez AM, Frazar EM, X Klaus MV, Paul P, Hilt JZ. Hydrogels and Hydrogel Nanocomposites: Enhancing Healthcare through Human and Environmental Treatment. Adv Healthc Mater 2022; 11:e2101820. [PMID: 34811960 PMCID: PMC8986592 DOI: 10.1002/adhm.202101820] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/08/2021] [Indexed: 12/11/2022]
Abstract
Humans are constantly exposed to exogenous chemicals throughout their life, which can lead to a multitude of negative health impacts. Advanced materials can play a key role in preventing or mitigating these impacts through a wide variety of applications. The tunable properties of hydrogels and hydrogel nanocomposites (e.g., swelling behavior, biocompatibility, stimuli responsiveness, functionality, etc.) have deemed them ideal platforms for removal of environmental contaminants, detoxification, and reduction of body burden from exogenous chemical exposures for prevention of disease initiation, and advanced treatment of chronic diseases, including cancer, diabetes, and cardiovascular disease. In this review, three main junctures where the use of hydrogel and hydrogel nanocomposite materials can intervene to positively impact human health are highlighted: 1) preventing exposures to environmental contaminants, 2) prophylactic treatments to prevent chronic disease initiation, and 3) treating chronic diseases after they have developed.
Collapse
Affiliation(s)
- Angela M Gutierrez
- Department of Chemical and Materials Engineering, University of Kentucky, 177 F Paul Anderson Tower, Lexington, KY, 40506, USA
- Superfund Research Center, University of Kentucky, Lexington, KY, 40506, USA
| | - Erin Molly Frazar
- Department of Chemical and Materials Engineering, University of Kentucky, 177 F Paul Anderson Tower, Lexington, KY, 40506, USA
- Superfund Research Center, University of Kentucky, Lexington, KY, 40506, USA
| | - Maria Victoria X Klaus
- Department of Chemical and Materials Engineering, University of Kentucky, 177 F Paul Anderson Tower, Lexington, KY, 40506, USA
- Superfund Research Center, University of Kentucky, Lexington, KY, 40506, USA
| | - Pranto Paul
- Department of Chemical and Materials Engineering, University of Kentucky, 177 F Paul Anderson Tower, Lexington, KY, 40506, USA
- Superfund Research Center, University of Kentucky, Lexington, KY, 40506, USA
| | - J Zach Hilt
- Department of Chemical and Materials Engineering, University of Kentucky, 177 F Paul Anderson Tower, Lexington, KY, 40506, USA
- Superfund Research Center, University of Kentucky, Lexington, KY, 40506, USA
| |
Collapse
|
38
|
van der Vliet N, den Broeder L, Romeo-Velilla M, Staatsen B, Kruize H, Friedrich B, Schuit AJ. Facilitators and barriers of intersectoral co-operation to promote healthier and more environmentally friendly behaviour: a qualitative evaluation through focus groups for the INHERIT project. BMC Public Health 2022; 22:617. [PMID: 35351055 PMCID: PMC8966286 DOI: 10.1186/s12889-022-12974-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Tackling challenges related to health, environmental sustainability and equity requires many sectors to work together. This “intersectoral co-operation” can pose a challenge on its own. Research commonly focuses on one field or is conducted within one region or country. The aim of this study was to investigate facilitators and barriers regarding intersectoral co-operative behaviour as experienced in twelve distinct case studies in ten European countries. The COM-B behavioural system was applied to investigate which capabilities, opportunities and motivational elements appear necessary for co-operative behaviour. Method Twelve focus groups were conducted between October 2018 and March 2019, with a total of 76 participants (policymakers, case study coordinators, governmental institutes and/or non-governmental organisations representing citizens or citizens). Focus groups were organised locally and held in the native language using a common protocol and handbook. One central organisation coordinated the focus groups and analysed the results. Translated data were analysed using deductive thematic analysis, applying previous intersectoral co-operation frameworks and the COM-B behavioural system. Results Amongst the main facilitators experienced were having highly motivated partners who find common goals and see mutual benefits, with good personal relationships and trust (Motivation). In addition, having supportive environments that provide opportunities to co-operate in terms of support and resources facilitated co-operation (Opportunity), along with motivated co-operation partners who have long-term visions, create good external visibility and who have clear agreements and clarity on roles from early on (Capability). Barriers included not having necessary and/or structural resources or enough time, and negative attitudes from specific stakeholders. Conclusions This study on facilitators and barriers to intersectoral co-operation in ten European countries confirms findings of earlier studies. This study also demonstrates that the COM-B model can serve as a relatively simple tool to understand co-operative behaviour in terms of the capability, opportunity and motivation required amongst co-operation partners from different sectors. Results can support co-operators’ and policymakers’ understanding of necessary elements of intersectoral co-operation. It can help them in developing more successful intersectoral co-operation when dealing with challenges of health, environmental sustainability and equity.
Collapse
Affiliation(s)
- Nina van der Vliet
- National Institute for Public Health and the Environment, Bilthoven, Netherlands. .,Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.
| | - Lea den Broeder
- National Institute for Public Health and the Environment, Bilthoven, Netherlands.,Achieve, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Maria Romeo-Velilla
- EuroHealthNet, Brussels, Belgium.,University College Leuven-Limburg, Leuven, Belgium
| | - Brigit Staatsen
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Hanneke Kruize
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | | | - A Jantine Schuit
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| |
Collapse
|
39
|
Marble Dust Effect on the Air Quality: An Environmental Assessment Approach. SUSTAINABILITY 2022. [DOI: 10.3390/su14073831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
All over the world, increasing anthropogenic activities, industrialization, and urbanization have intensified the emissions of various pollutants that cause air pollution. Marble quarries in Pakistan are abundant and there is a plethora of small- and large-scale industries, including mining and marble-based industries. The air pollution caused by the dust generated in the process of crushing and extracting marble can cause serious problems to the general physiological functions of plants and it affects human life as well. Therefore, the objectives of this study were to assess the air quality of areas with marble factories and areas without marble factories, where the concentration of particulate matter in terms of total suspended particles (TSP) was determined. For this purpose, EPAM-5000 equipment was used to measure the particulate levels. Besides this, a spectrophotometer was used to analyze the presence of PM2.5 and PM10 in the chemical composition of marble dust. It was observed that the TSP concentrations in Darmangi and Malagori areas of Peshawar, Pakistan—having marble factories—were 626 µg/m3 and 5321 µg/m3 respectively. The (PM2.5, PM10) concentration in Darmangi was (189 µg/m3, 520 µg/m3) and in Malagori, it was recorded as (195 µg/m3, 631 µg/m3), which was significantly higher than the non-marble dust areas and also exceeded WHO recommended standards. It was concluded that the areas with the marble factories were more susceptible to air pollution as the concentration of TSP was significantly higher than the recommended TSP levels. It is recommended that marble factories should be shifted away from residential areas along with strict enforcement. People should be instructed to use protective equipment and waste management should be ensured along with control mechanisms to monitor particulate levels.
Collapse
|
40
|
Tang PP, Tam IL, Jia Y, Leung SW. Big Data Reality Check (BDRC) for public health: to what extent the environmental health and health services research did meet the 'V' criteria for big data? A study protocol. BMJ Open 2022; 12:e053447. [PMID: 35318232 PMCID: PMC8943752 DOI: 10.1136/bmjopen-2021-053447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Big data technologies have been talked up in the fields of science and medicine. The V-criteria (volume, variety, velocity and veracity, etc) for defining big data have been well-known and even quoted in most research articles; however, big data research into public health is often misrepresented due to certain common misconceptions. Such misrepresentations and misconceptions would mislead study designs, research findings and healthcare decision-making. This study aims to identify the V-eligibility of big data studies and their technologies applied to environmental health and health services research that explicitly claim to be big data studies. METHODS AND ANALYSIS Our protocol follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Scoping review and/or systematic review will be conducted. The results will be reported using PRISMA for Scoping Reviews (PRISMA-ScR), or PRISMA 2020 and Synthesis Without Meta-analysis guideline. Web of Science, PubMed, Medline and ProQuest Central will be searched for the articles from the database inception to 2021. Two reviewers will independently select eligible studies and extract specified data. The numeric data will be analysed with R statistical software. The text data will be analysed with NVivo wherever applicable. ETHICS AND DISSEMINATION This study will review the literature of big data research related to both environmental health and health services. Ethics approval is not required as all data are publicly available and involves confidential personal data. We will disseminate our findings in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021202306.
Collapse
Affiliation(s)
- Pui Pui Tang
- State Key Laboratory of Quality Research in Chinese Medicine, University of Macau Institute of Chinese Medical Science, Macau, China
| | - I Lam Tam
- State Key Laboratory of Quality Research in Chinese Medicine, University of Macau Institute of Chinese Medical Science, Macau, China
| | - Yongliang Jia
- BGI College & Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Siu-Wai Leung
- Edinburgh Bayes Centre for AI Research in Shenzhen, College of Science and Engineering, University of Edinburgh, Scotland, UK
- Center for Machine Learning and Intelligent Applications, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, People's Republic of China
| |
Collapse
|
41
|
Risk Assessment and Prediction of Air Pollution Disasters in Four Chinese Regions. SUSTAINABILITY 2022. [DOI: 10.3390/su14053106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Evaluating the regional trends of air pollution disaster risk in areas of heavy industry and economically developed cities is vital for regional sustainable development. Until now, previous studies have mainly adopted a traditional weighted comprehensive evaluation method to analyze the air pollution disaster risk. This research has integrated principal component analysis (PCA), a genetic algorithm (GA) and a backpropagation (BP) neural network to evaluate the regional disaster risk. Hazard risk, hazard-laden environment sensitivity, hazard-bearing body vulnerability and disaster resilience were used to measure the degree of disaster risk. The main findings were: (1) the air pollution disaster risk index of Liaoning Province, Beijing, Shanghai and Guangdong Province increased year by year from 2010 to 2019; (2) the mean absolute error (MAE), root mean square error (RMSE) and mean absolute percentage error (MAPE) of each regional air pollution disaster risk index in 2019, as predicted by the PCA-GA-BP neural network, were 0.607, 0.317 and 20.3%, respectively; (3) the predicted results were more accurate than those using a PCA-BP neural network, GA-BP neural network, traditional BP neural network, support vector regression (SVR) or extreme gradient boosting (XGBoost), which verified that machine learning could be used as a method of air pollution disaster risk assessment to a considerable extent.
Collapse
|
42
|
Naddafi K, Mesdaghinia A, Abtahi M, Hassanvand MS, Beiki A, Shaghaghi G, Shamsipour M, Mohammadi F, Saeedi R. Assessment of burden of disease induced by exposure to heavy metals through drinking water at national and subnational levels in Iran, 2019. ENVIRONMENTAL RESEARCH 2022; 204:112057. [PMID: 34529973 DOI: 10.1016/j.envres.2021.112057] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 06/13/2023]
Abstract
The burden of disease attributable to exposure to heavy metals via drinking water in Iran (2019) was assessed at the national and regional levels. The non-carcinogenic risk, carcinogenic risk, and attributable burden of disease of heavy metals in drinking water were estimated in terms of hazard quotient (HQ), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average drinking water concentrations of arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), and nickel (Ni) in Iran were determined to be 2.3, 0.4, 12.1, 2.5, 0.7, and 19.7 μg/L, respectively, which were much lower than the standard values. The total average HQs of heavy metals in drinking water in the entire country, rural, and urban communities were 0.48, 0.65 and 0.45, respectively. At the national level, the average ILCRs of heavy metal in the entire country were in the following order: 1.06 × 10-4 for As, 5.89 × 10-5 for Cd, 2.05 × 10-5 for Cr, and 3.76 × 10-7 for Pb. The cancer cases, deaths, death rate (per 100,000 people), DALYs, and DALY rate (per 100,000 people) attributed to exposure to heavy metals in drinking water at the national level were estimated to be 213 (95% uncertainty interval: 180 to 254), 87 (73-104), 0.11 (0.09-0.13), 4642 (3793-5489), and 5.81 (4.75-6.87), respectively. The contributions of exposure to As, Cd, Cr, and Pb in the attributable burden of disease were 14.7%, 65.7%, 19.3%, and 0.2%, respectively. The regional distribution of the total attributable DALY rate for all heavy metals was as follows: Region 5> Region 4> Region 1> Region 3> Region 2. The investigation and improvement of relatively high exceedance of As levels in drinking water from the standard value, especially in Regions 5 and 3 as well as biomonitoring of heavy metals throughout the country were recommended.
Collapse
Affiliation(s)
- Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoosh Abtahi
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Ayoub Beiki
- Center of Environmental and Occupational Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Gholamreza Shaghaghi
- Center of Environmental and Occupational Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mohammadi
- Department of Health and Safety, and Environment (HSE), School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Saeedi
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Health and Safety, and Environment (HSE), School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
43
|
Situating curriculum in context: Using Glatthorn's Standards-Based Curriculum Development Model to contextualize food safety learning competencies. Food Control 2022. [DOI: 10.1016/j.foodcont.2021.108538] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
44
|
Marcus G, Siri J, Gatzweiler F, Dora C, Aerts J, Nandudu S, Claeson A, Carbajal P, Roebbel N, Petrella L, de Sá TH. Supporting a Healthy Planet, Healthy People and Health Equity through Urban and Territorial Planning. PLANNING, PRACTICE & RESEARCH 2022; 37:111-130. [PMID: 35153364 PMCID: PMC8827622 DOI: 10.1080/02697459.2021.2000144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The form of human settlements impacts on planetary health, population health and health equity. Yet goals for urban and territorial planning are only tangentially linked to public health outcomes. The WHO and UN-Habitat support actions to bring health to the fore in planning and design of human settlements, recently publishing 'Integrating Health in Urban and Territorial Planning: a sourcebook' focusing on 'why' action is needed, 'how' to initiate it; and curating several existing resources on 'what' to do. Recommendations for research, policy and practice include calls for rapid development of closer relationships between public health and spatial planning.
Collapse
Affiliation(s)
| | | | - Franz Gatzweiler
- Urban Health and Wellbeing Programme, International Science Council (ISC), China
| | - Carlos Dora
- International Society of Urban Health (ISUH), USA
| | - Jens Aerts
- International Society of City and Regional Planners (Isocarp, The Hague, The Netherlands
| | - Sarah Nandudu
- Slum Dwellers International, Cape Town, South Africa
| | - Alice Claeson
- Department of Emergency Medicine , Vrinnevi Hospital, Norrköping, Sweden
| | | | | | | | | |
Collapse
|
45
|
Levy CR, Phillips LM, Murray CJ, Tallon LA, Caron RM. Addressing Gaps in Public Health Education to Advance Environmental Justice: Time for Action. Am J Public Health 2022; 112:69-74. [PMID: 34936391 PMCID: PMC8713638 DOI: 10.2105/ajph.2021.306560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Carly R Levy
- Carly R. Levy and Lindsay A. Tallon are with the Master of Public Health Program, School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston. Lynelle M. Phillips is with the Department of Public Health, School of Health Professions, University of Missouri, Columbia. Carolyn J. Murray is with the Master of Public Health Program, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH. Rosemary M. Caron is with the Department of Health Management and Policy, Master of Public Health Program, College of Health and Human Services, University of New Hampshire, Durham
| | - Lynelle M Phillips
- Carly R. Levy and Lindsay A. Tallon are with the Master of Public Health Program, School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston. Lynelle M. Phillips is with the Department of Public Health, School of Health Professions, University of Missouri, Columbia. Carolyn J. Murray is with the Master of Public Health Program, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH. Rosemary M. Caron is with the Department of Health Management and Policy, Master of Public Health Program, College of Health and Human Services, University of New Hampshire, Durham
| | - Carolyn J Murray
- Carly R. Levy and Lindsay A. Tallon are with the Master of Public Health Program, School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston. Lynelle M. Phillips is with the Department of Public Health, School of Health Professions, University of Missouri, Columbia. Carolyn J. Murray is with the Master of Public Health Program, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH. Rosemary M. Caron is with the Department of Health Management and Policy, Master of Public Health Program, College of Health and Human Services, University of New Hampshire, Durham
| | - Lindsay A Tallon
- Carly R. Levy and Lindsay A. Tallon are with the Master of Public Health Program, School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston. Lynelle M. Phillips is with the Department of Public Health, School of Health Professions, University of Missouri, Columbia. Carolyn J. Murray is with the Master of Public Health Program, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH. Rosemary M. Caron is with the Department of Health Management and Policy, Master of Public Health Program, College of Health and Human Services, University of New Hampshire, Durham
| | - Rosemary M Caron
- Carly R. Levy and Lindsay A. Tallon are with the Master of Public Health Program, School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston. Lynelle M. Phillips is with the Department of Public Health, School of Health Professions, University of Missouri, Columbia. Carolyn J. Murray is with the Master of Public Health Program, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH. Rosemary M. Caron is with the Department of Health Management and Policy, Master of Public Health Program, College of Health and Human Services, University of New Hampshire, Durham
| |
Collapse
|
46
|
McGaw J, Vance A, White S, Mongta S. Whose place? Lessons from a case study of a guardianship determination for an Australian Indigenous child. Health Place 2021; 73:102739. [PMID: 34963070 DOI: 10.1016/j.healthplace.2021.102739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/24/2022]
Abstract
Whose values matter when considering which environment is healthier for a child whose guardianship is contested? The biological mother from a remote Australian Aboriginal community, who voluntarily relinquished her but has now requested her return? The foster mother who has cared for her in a metropolitan centre in another State of Australia, thousands of kilometres away? The welfare professionals who also live in that city? Or the child herself, who left her birth home and community five years earlier at the age of two? Drawing on a case study of a seven-year old Aboriginal girl, the authors argue that non-Indigenous values trumped Indigenous values without the realisation of key players who were empowered to make such determinations. The article uses Manuel DeLanda's neo-assemblage theory to consider the range of processes that exert themselves to shape place-values and social identity in colonised nations. It will also draw on Erik Erikson's and Lev Vygotsky's theories of psychosocial development to consider competing sets of values that raised feelings of dissonance within the child. Beliefs about what makes a place health-giving are revealed to be complex in colonised nations. Despite policy and legislative changes to better support Aboriginal people and their right to difference, non-Indigenous professionals can continue to be driven by an unrecognised systemic racism. While place-values are not, of course, the only (or perhaps even the most significant) consideration in guardianship determinations, this article will argue they can play a significant and covert role.
Collapse
Affiliation(s)
| | - Alasdair Vance
- The University of Melbourne and The Royal Children's Hospital, Australia.
| | - Selena White
- Wadja Aboriginal Family Place, The Royal Children's Hospital, Australia.
| | | |
Collapse
|
47
|
National and subnational burden of disease attributable to occupational exposure to solar ultraviolet radiation (SUVR) in Iran, 2005-2019. Int J Hyg Environ Health 2021; 240:113897. [PMID: 34861595 DOI: 10.1016/j.ijheh.2021.113897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/24/2021] [Accepted: 11/27/2021] [Indexed: 11/22/2022]
Abstract
Overexposure to solar ultraviolet radiation (SUVR) can cause skin and eye adverse effects for outdoor workers. In this study, the burden of disease induced by occupational exposure to SUVR and its spatiotemporal trend at national and sub-national levels in Iran, 2005-2019 were assessed. The attributable burden of disease was assessed using the following five datasets: (1) distribution of occupational exposure to SUVR, (2) total incidences and deaths of health outcomes of SUVR exposure, (3) population attributable fractions of the health outcomes of SUVR exposure, (4) age-gender distribution of outdoor workers, and (5) disability-adjusted life year (DALY) calculation constants. During 2005-2019, the attributable DALYs increased from 2442 to 2907 and the attributable DALY rate (per 100,000 workers) slightly decreased from 11.94 to 11.91. The share of YLL in the attributable burden of disease was in the range of 43%-46%. Out of nine causes, about 90% of the attributable burden of disease in 2019 was related to cataracts (29.9%), malignant skin melanoma (27.4%), squamous-cell carcinoma (18.6%), and sunburn (17.2%). During the study period, the attributable DALY rate in women increased by 60.95% (from 5.04 to 8.11) and in men decreased by 2.06% (from 13.03 to 12.76). The total attributable DALYs and DALY rate rose by age during 2005-2019. The contributions of population growth, risk-deleted DALY rates, exposure risk, and population age structure in temporal changes of the attributable burden of disease were 19.27%, 9.13%, -1.35%, and -14.8%, respectively. The three highest attributable DALY rates in 2019 were observed in South Khorasan (21.28), Chahar Mahal and Bakhtiari (17.42), and Kordestan (17.26), respectively. The preventive interventions against SUVR overexposure, regular screenings, and early treatments with an emphasis on occupations with continuous sun exposure and provinces with increasing attributable DALY rates should be considered in the occupational health action plan in the country.
Collapse
|
48
|
Abstract
Once one of the largest saline lakes, the Aral Sea, was recognized as a significant environmental disaster as the water level decreased dramatically. Water level decrease increases water salinity, affecting biodiversity. Exposed lake beds become the source for fine dust picked up by the dust storms and spread across a long distance, affecting people’s health in surrounding areas. This review paper attempts to evaluate the potential links between the Aral Sea shrinking and the existing health issues in the case of Kazakhstan. The literature-based research revealed that the population of the Aral Sea basin region has been suffering from exposure to various pollutant residues for a long time. There is an apparent increase in morbidity and mortality rates in the region, especially in people suffering from chronic illness. Furthermore, the catastrophic desiccation of the Aral Sea has led to the sharp deterioration in living conditions and negative trends in the socio-economic situation of the region’s population. While the dust storms spread the polluted salts from the exposed bottom across the Aral Sea region, specific contaminants define the relevance and importance of public health problems linked to the basin rather than the Aral Sea drying process. There is, however, no clear evidence that associated dust storms are the only primary source of the deterioration of people’s health. Moreover, One Health approach seems to play a crucial role in achieving better outcomes in the health of people and the health of the environment.
Collapse
|
49
|
Chatterjee N, Zhang X. CRISPR approach in environmental chemical screening focusing on population variability. J Toxicol Sci 2021; 46:499-507. [PMID: 34719552 DOI: 10.2131/jts.46.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
A significant barrier to include population variability in risk assessment is our incomplete understanding of inter-individual variability and the differential susceptibility to environmental exposures induced adverse outcomes. By combining genome editing tools with the population diversity model, this article intended to highlight a potential strategy to identify and characterize the inter-individual variability factors, the determinant gene anchoring to a particular phenotype. The goal could be achieved by integrating the perturbed CRISPR-based unbiased functional genomics screening, genome-wide or a focused subset of genes, in a population-based in vitro model system (such as the lymphoblastoid cell lines, LCL, available from HapMap and 1000 Genomes project). Then data can be translated to genetic variability and individual (or subpopulation) susceptibility by incorporating ethnicity and corresponding genome-wide association studies (GWAS) with functional genomics screening results. This approach can provide complementary data for next-generation risk assessment, in particular, for environmental stressors. The current paper outlined the previous work conducted with a population-based in vitro model system, perturbed CRISPR-based functional toxicogenomic screening of environmental chemicals, and finally, the potential strategies to combine these two platforms with their opportunities and challenges to achieve a mechanistic understanding of population variability.
Collapse
Affiliation(s)
- Nivedita Chatterjee
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, China.,INL-International Iberian Nanotechnology Laboratory, Portugal
| | - Xiaowei Zhang
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, China
| |
Collapse
|
50
|
Claassen L, Hartmann J, Wuijts S. How to Address Consumers' Concerns and Information Needs about Emerging Chemical and Microbial Contaminants in Drinking Water; The Case of GenX in The Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10615. [PMID: 34682361 PMCID: PMC8535398 DOI: 10.3390/ijerph182010615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/21/2021] [Accepted: 10/05/2021] [Indexed: 12/02/2022]
Abstract
The perceived safety of tap water is an important condition for consumers to drink it. Therefore, addressing consumers' concerns should be included in the roadmap towards the UN SDG 6 on safe drinking water for all. This paper studies consumers' information needs regarding emerging contaminants in drinking water using a mental model approach for the development of targeted risk communication. As most consumers expect safe drinking water, free of contamination, communication on emerging contaminants may increase concerns. Here, we showed that communication strategies better tailored to consumers' information needs result in smaller increases in risk perception compared with existing strategies.
Collapse
Affiliation(s)
- Liesbeth Claassen
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands; (L.C.); (S.W.)
| | - Julia Hartmann
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands; (L.C.); (S.W.)
- Faculty of Civil Engineering and Geosciences, Delft University of Technology, P.O. Box 5048, 2600 GA Delft, The Netherlands
| | - Susanne Wuijts
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands; (L.C.); (S.W.)
- Utrecht Centre for Water, Oceans and Sustainability Law, Utrecht University, Newtonlaan 231, 3584 BH Utrecht, The Netherlands
| |
Collapse
|