Environmental health, economy, and amenities interactively drive migration patterns among China's older people

The increasing number of older adult migrants is rapidly changing regional demographic and social structures in China. There is an urgent need to understand the spatial patterns and factors that influence older adults to migrate, especially the role of environmental health. However, this issue has been under-studied. This study focused on intra-provincial and inter-provincial older adult migrants as research subjects, estimated their spatial concentration index based on the iterative proportional fitting approach, and explored the factors influencing their migration using the GeoDetector Model. The results showed the following: (1) In 2015, more than 76% of inter-provincial older adult migrants were distributed in Eastern China, and most intra-provincial older adult migrants were scattered in sub-provincial cities. (2) Compared to factors relating to economy and amenities, environmental health by itself played a relatively weak role in the migration of older adults, but the interaction among environmental health, economy, and amenities was a key driving force of older adult migration. (3) There were significant differences in the dominant environmental health factors between inter-provincial migration and intra-provincial migration, which were temperature and altitude, respectively. Our findings can help policymakers focus on the composition of older adult migrants based on urban environmental health characteristics and rationally optimize older adult care facilities to promote supply-demand matching.

Spatial clustering patterns and regional variations for food and physical activity environments across the United States

This study examined spatial patterns of obesogenic environments for US counties. We mapped the geographic dispersion of food and physical activity (PA) environments, assessed spatial clustering, and identified food and PA environment differences across U.S. regions and rurality categories. Substantial low food score clusters were located in the South and high score clusters in the Midwest and West. Low PA score clusters were located in the South and high score clusters in the Northeast and Midwest (p < .0001). For region, the South had significantly lower food and PA environment scores. For rurality, rural counties had significantly higher food environment scores and metropolitan counties had significantly higher PA environment scores (p < .0001). This study highlights geographic clustering and disparities in food and PA access nationwide. State and region-wide environmental inequalities may be targeted using structural interventions and policy initiatives to improve food and PA access.

Machine Learning Within Studies of Early-Life Environmental Exposures and Child Health: Review of the Current Literature and Discussion of Next Steps

PURPOSE OF REVIEW

The goal of this article is to review the use of machine learning (ML) within studies of environmental exposures and children's health, identify common themes across studies, and provide recommendations to advance their use in research and practice.

RECENT FINDINGS

We identified 42 articles reporting upon the use of ML within studies of environmental exposures and children's health between 2017 and 2019. The common themes among the articles were analysis of mixture data, exposure prediction, disease prediction and forecasting, analysis of complex data, and causal inference. With the increasing complexity of environmental health data, we anticipate greater use of ML to address the challenges that cannot be handled by traditional analytics. In order for these methods to beneficially impact public health, the ML techniques we use need to be appropriate for our study questions, rigorously evaluated and reported in a way that can be critically assessed by the scientific community.

Fungal spores and pollen are correlated with meteorological variables: effects in human health at Hermosillo, Sonora, Mexico

We conducted the first study of air pollen and fungal spores for Hermosillo, Sonora, where the human population is exposed to high temperatures and high levels of dust and suffers from diseases related to air quality. We sampled pollen and fungal spores daily in the air during 2016 using a volumetric spore trap Hirst-type sampler. We used simple linear correlation to investigate the association between pollen and spore counts and daily weather conditions. We found an Annual Pollen Integral of 16,243 pollen day/m³ and an Annual Spore Integral higher 222,365 spore day/m³. We identified 32 pollen taxa and 15 different spores. We found two periods of higher pollen and spore concentrations: March to May and August to October, the latter was the most severe. Spore and pollen concentrations in the air increased at higher temperature and higher relative humidity but decreased at higher precipitation. We detected negative impacts during summer and fall on population health, with 13,454 cases of people who presented diseases related to allergies. A peak in allergies is centered during October and correlates well with our peaks in pollen and spore concentrations; it seems that pollen of Poaceae is the one that generates most effects in allergic people.

Environmental health literacy and household air pollution-associated symptoms in Kenya: a cross-sectional study

BACKGROUND

Household air pollution (HAP) is a significant source of the global burden of disease. Our objective was to evaluate the association between environmental health literacy (EHL), a domain of health literacy (HL) that describes the ability to use environmental health information to reduce health risks, and symptoms associated with HAP.

METHODS

We performed a cross-sectional population-based study of 353 households in Kasarani, Kenya. One individual from each household was surveyed using our novel EHL survey tool. Baseline characteristics were compared between individuals who were symptomatic (i.e., experiencing cough, shortness of breath, phlegm production, wheeze, chest tightness, headache, eye irritation, or burns from cooking at least 5 times per month) versus individuals who were asymptomatic (i.e., experiencing none or symptoms no more than once per month). Multivariate logistic regression was used to determine the odds ratios (OR) of self-reported symptoms associated with HL, stratified by median EHL, adjusting for education, self-perceived health and solid fuel use.

RESULTS

A total of 100 individuals (28%) reported experiencing one or more symptoms at least 5 times per month, including 31.2% of solid fuel users and 30.3% of non-solid fuel users. Among individuals with high EHL, higher HL was associated with lower risk of experiencing symptoms (OR = 0.26; 95% CI 0.10-0.67), however, there was no association among individuals with low EHL (OR = 0.85; 95% CI 0.34-2.13). Among solid fuel users, the association between HL and risk of experiencing symptoms was driven by individuals with high EHL (OR = 0.30; 95% CI 0.05-1.84), rather than those with low EHL (OR = 1.22; 95% CI 0.36-4.16).

CONCLUSIONS

To the best of our knowledge, this was the first study to assess the association between EHL, HL, and HAP-associated symptoms. Our findings highlight the potential importance of EHL in promoting sustainable interventions to reduce symptoms associated with HAP from solid fuel use among communities in Kenya.

The healthiness and sustainability of national and global food based dietary guidelines: modelling study

OBJECTIVE

To analyse the health and environmental implications of adopting national food based dietary guidelines (FBDGs) at a national level and compared with global health and environmental targets.

DESIGN

Modelling study.

SETTING

85 countries.

PARTICIPANTS

Population of 85 countries.

MAIN OUTCOME MEASURES

A graded coding method was developed and used to extract quantitative recommendations from 85 FBDGs. The health and environmental impacts of these guidelines were assessed by using a comparative risk assessment of deaths from chronic diseases and a set of country specific environmental footprints for greenhouse gas emissions, freshwater use, cropland use, and fertiliser application. For comparison, the impacts of adopting the global dietary recommendations of the World Health Organization and the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems were also analysed. Each guideline's health and sustainability implications were assessed by modelling its adoption at both the national level and globally, and comparing the impacts to global health and environmental targets, including the Action Agenda on Non-Communicable Diseases, the Paris Climate Agreement, the Aichi biodiversity targets related to land use, and the sustainable development goals and planetary boundaries related to freshwater use and fertiliser application.

RESULTS

Adoption of national FBDGs was associated with reductions in premature mortality of 15% on average (95% uncertainty interval 13% to 16%) and mixed changes in environmental resource demand, including a reduction in greenhouse gas emissions of 13% on average (regional range -34% to 35%). When universally adopted globally, most of the national guidelines (83, 98%) were not compatible with at least one of the global health and environmental targets. About a third of the FBDGs (29, 34%) were incompatible with the agenda on non-communicable diseases, and most (57 to 74, 67% to 87%) were incompatible with the Paris Climate Agreement and other environmental targets. In comparison, adoption of the WHO recommendations was associated with similar health and environmental changes, whereas adoption of the EAT-Lancet recommendations was associated with 34% greater reductions in premature mortality, more than three times greater reductions in greenhouse gas emissions, and general attainment of the global health and environmental targets. As an example, the FBDGs of the UK, US, and China were incompatible with the climate change, land use, freshwater, and nitrogen targets, and adopting guidelines in line with the EAT-Lancet recommendation could increase the number of avoided deaths from 78 000 (74 000 to 81 000) to 104 000 (96 000 to 112 000) in the UK, from 480 000 (445 000 to 516 000) to 585 000 (523 000 to 646 000) in the USA, and from 1 149 000 (1 095 000 to 1 204 000) to 1 802 000 (1 664 000 to 1 941 000) in China.

CONCLUSIONS

This analysis suggests that national guidelines could be both healthier and more sustainable. Providing clearer advice on limiting in most contexts the consumption of animal source foods, in particular beef and dairy, was found to have the greatest potential for increasing the environmental sustainability of dietary guidelines, whereas increasing the intake of whole grains, fruits and vegetables, nuts and seeds, and legumes, reducing the intake of red and processed meat, and highlighting the importance of attaining balanced energy intake and weight levels were associated with most of the additional health benefits. The health results were based on observational data and assuming a causal relation between dietary risk factors and health outcomes. The certainty of evidence for these relations is mostly graded as moderate in existing meta-analyses.

Benefits of basic research from the Superfund Research Program

The National Institutes of Health (NIH), National Institute of Environmental Health Sciences (NIEHS) Hazardous Substances Basic Research and Training Program [Superfund Research Program (SRP)] funds transdisciplinary research projects spanning the biomedical and environmental sciences to address issues related to potentially hazardous substances. We used a case study approach to identify how SRP-funded basic biomedical research has had an impact on society. We examined how transdisciplinary research projects from the SRP have advanced knowledge and led to additional clinical, public health, policy, and economic benefits. SRP basic biomedical research findings have contributed to the body of knowledge and influenced a broad range of scientific disciplines. It has informed the development of policies and interventions to reduce exposure to environmental contaminants to improve public health. Research investments by the SRP have had a significant impact on science, health, and society. Documenting the benefits of these investments provides insight into how basic research is translated to real-world applications.

Sharing SRP data to reduce environmentally associated disease and promote transdisciplinary research

The National Institute of Environmental Health Sciences (NIEHS) Superfund Basic Research and Training Program (SRP) funds a wide range of projects that span biomedical, environmental sciences, and engineering research and generate a wealth of data resulting from hypothesis-driven research projects. Combining or integrating these diverse data offers an opportunity to uncover new scientific connections that can be used to gain a more comprehensive understanding of the interplay between exposures and health. Integrating and reusing data generated from individual research projects within the program requires harmonization of data workflows, ensuring consistent and robust practices in data stewardship, and embracing data sharing from the onset of data collection and analysis. We describe opportunities to leverage data within the SRP and current SRP efforts to advance data sharing and reuse, including by developing an SRP dataset library and fostering data integration through Data Management and Analysis Cores. We also discuss opportunities to improve public health by identifying parallels in the data captured from health and engineering research, layering data streams for a more comprehensive picture of exposures and disease, and using existing SRP research infrastructure to facilitate and foster data sharing. Importantly, we point out that while the SRP is in a unique position to exploit these opportunities, they can be employed across environmental health research. SRP research teams, which comprise cross-disciplinary scientists focused on similar research questions, are well positioned to use data to leverage previous findings and accelerate the pace of research. Incorporating data streams from different disciplines addressing similar questions can provide a broader understanding and uncover the answers to complex and discrete research questions.

Assessing the national capacity for disaster research response (DR2) within the NIEHS Environmental Health Sciences Core Centers

INTRODUCTION

Disaster research response (DR2) is necessary to answer scientific questions about the environmental health impacts of disasters and the effectiveness of response and recovery strategies. This research explores the preparedness and capacity of National Institute of Environmental Health Sciences (NIEHS) P30 Core Centers (CCs) to conduct DR2 and engage with communities in the context of disasters.

METHODS

In early 2018, we conducted an online survey of CC Directors (n = 16, 69.5% response rate) to identify their DR2 relevant scientific assets, capabilities, and activities. Summary statistics were calculated. We also conducted in-depth, semi-structured interviews with 16 (69.5%) CC Community Engagement Core directors to identify facilitators and barriers of DR2 community engagement. Interview notes were coded and thematically analyzed.

RESULTS

Survey: While 56% of responding CCs reported prior participation in DR2 and preparedness to repurpose funding to support DR2, less than one third reported development of a disaster-specific data collection protocol, deployment plan, or concept of operations plan, participation in an exercise to test DR2 capacity, development of academic partnerships to conduct DR2, development of a process for fast-tracking institutional review board approvals for DR2, or maintenance of formal agreements with state, local, or community-based partner(s). A number of CCs reported developing or considering developing capacity in these areas. Barriers to, and tools and resources to enhance, CC engagement in DR2 were identified. Interviews: Four key components for community engaged DR2 were identified: pre-existing community relationships, responsive research that benefits communities, coordination among researchers, and coordination with community response partners. Several roles for, benefits of, and barriers to Community Engagement Rapid Response Teams (CERRT) were described.

CONCLUSIONS

CCs have significant scientific assets and community partnerships that can be leveraged for DR2; however, additional planning is necessary to ensure that these scientific assets and community partnerships are leveraged when disasters strike.

Using machine learning to examine the relationship between asthma and absenteeism

In this study, we found that machine learning was able to effectively estimate student learning outcomes geo-spatially across all the campuses in a large, urban, independent school district. The machine learning showed that key factors in estimating the student learning outcomes included the number of days students were absent from school. In turn, one of the most important factors in estimating the number of days a student was absent was whether or not the student had asthma. This highlights the importance of environmental public health for student learning outcomes.

Environmental and health impacts of industrial wastewater effluents in Pakistan: a review

In developing countries, one of the most severe modern-day dilemmas is the management of industrial wastewater. In these countries, industrial wastewater effluents are directly discharged into the natural drain, a sewer system, an internal septic tank or a nearby field. Some of these industrial wastewater effluents are inadequately treated or untreated before being discharged. In recent years, in developing countries, urbanization and industrial activities have led to environmental deterioration. This paper was designed to review the health and environmental impacts of inadequately treated or untreated industrial wastewater effluents in Pakistan. The quality of industrial wastewater effluents is responsible for the degradation of the receiving water bodies. This is due to the reason that inadequately treated or untreated industrial wastewater effluents may cause eutrophication in the receiving water bodies and also form a favorable condition for toxin-producing waterborne pathogens. In order to comply with the wastewater guidelines and legislations, there is a need for proper treatment before discharge. In order to minimize the risk to the environment and public health, there is a need for proper treatment processes for industrial wastewater effluents. To achieve unpolluted discharge of industrial wastewater into the receiving water bodies, regular monitoring, proper and suitable treatment, careful planning and appropriate legislation are recommended.

Cohort profile: Beyond birth cohort study - The Korean CHildren's ENvironmental health Study (Ko-CHENS)

The Korean CHildren's ENvironmental health Study (Ko-CHENS) is a nationwide prospective birth cohort showing the correlation between the environmental exposures and the health effects to prevent the environmental diseases in children, and it provides the guidelines for the environmental hazardous factors, applying the life-course approach to the environmental-health management system. The Ko-CHENS consists of 5000 Core and 65,000 Main Cohorts. The children in the Core Cohort are followed up at 6 months, every year before their admission into the elementary school, and every 3 years from the first year after this admission. The children in the Cohort will be followed up through the data links (Statistics Korea, National Health Insurance Service [NHIS], and Ministry of Education). The individual biospecimens will be analyzed for 19 substances. The long-term-storage biological samples will be used for the further substance analysis. The Ko-CHENS will investigate whether the environmental variables including the perinatal outdoor and indoor factors and the greenness contribute causally to the health outcomes in the children and adolescents. In addition to the individual surveys, the assessments of the outdoor exposures and health outcomes will use the national air-quality monitoring data and claim data of the NHIS, respectively. The two big-data forms of the Ko-CHENS are as follows: The Ko-CHENS data that can be linked with the nationally registered NHIS health-related database, including the medical utilization and the periodic health screening, and the birth/mortality database in the Statistics; the other is the Big-CHENS dataset that is based on the NHIS mother delivery code, for which the follow-up of almost 97% of the total birth population is expected. The Ko-CHENS is a very cost-effective study that fully exploits the existing national big-data systems with the data linkage.

Causal Modeling in Environmental Health

The field of environmental health has been dominated by modeling associations, especially by regressing an observed outcome on a linear or nonlinear function of observed covariates. Readers interested in advances in policies for improving environmental health are, however, expecting to be informed about health effects resulting from, or more explicitly caused by, environmental exposures. The quantification of health impacts resulting from the removal of environmental exposures involves causal statements. Therefore, when possible, causal inference frameworks should be considered for analyzing the effects of environmental exposures on health outcomes.

The need for community-led, integrated and innovative monitoring programmes when responding to the health impacts of climate change

In Northern Canada, climate change has led to many acute and interrelated health and environmental impacts experienced among Inuit populations. Community-based monitoring, in which community members participate in monitoring initiatives using various forms of technology, is a key strategy increasingly used to detect, monitor and respond to climate change impacts. To better understand the landscape of existing environmental and health monitoring programmes mobilising different technologies and operating in the North we conducted a review that used environmental scan methodologies to explore and contextualise these programmes. We consulted with academic researchers with experience in community-led monitoring, conducted systematic searches of grey and peer-reviewed literature, and conducted a secondary search for environment-health mobile-phone applications. Following specific criteria, we identified 18 monitoring programmes using information and communication technologies in the North, and three global monitoring mobile-phone applications, which cumulatively monitored 74 environment and health indicators. Several themes emerged, including the need for: (1) community leadership, (2) indicators of environment and/or human health and (3) innovative technology. This synthesis supports the development of community-led, environment-health monitoring programmes that use innovative technology to monitor and share information related to the health implications of climate change in and around Indigenous communities throughout the Circumpolar North.

A class of semiparametric tests of treatment effect robust to confounder measurement error

When assessing the presence of an exposure causal effect on a given outcome, measurement error of a confounder can inflate the type I error rate of a treatment effect in even the simplest of settings. In this paper, we develop a large class of semiparametric test statistics of an exposure causal effect, which are completely robust to additive unbiased measurement error of a subset of confounders. A unique and appealing feature of our proposed methodology is that it requires no external information such as validation data or replicates of error-prone confounders. We present a doubly robust form of this test that requires the exposure mean model to be linear in the mismeasured confounders, and only one of two models involving error-free confounders to be correctly specified for the resulting test statistic to have correct type I error rate. We demonstrate validity within our class of test statistics through simulation studies. We apply the methods to a multi-US-city time-series data set to test for an effect of temperature on mortality while adjusting for atmospheric particulate matter with diameter of 2.5 micrometres or less, which is known to be measured with error.

Situation of Occupational and Environmental Health in Mexico

BACKGROUND

Mexico has a great diversity and richness of natural resources, but evaluations of the quality of life of Mexicans show the deep inequalities and the gap between rich and poor. While 5% of families concentrate 58% of the wealth, the health spending in environment and health is 0.2 and 2.7 of the GDP respectively. This has repercussions both on the gradual deterioration of the environment and on the insufficient health and social security coverage of the working population.

OBJECTIVE

To describe the current situation of occupational and environmental health in Mexico.

METHODS

A bibliographic review was performed on the socioeconomic, demographic, environmental, legal and health status of the Economically Active Population (EAP).

FINDINGS

There is a constant deterioration of terrestrial and marine ecosystems, accompanied by an increase in environmental pollution in large cities. The unemployment rate of the EAP has decreased in one year to 3.4%, but the informal labor rate reached 57.3%, which translates into population without social security. Compliance with legislation for the protection of workers' health is insufficient. The recent amendments to the law have meant a setback in these respects. The reported information on accidents and occupational diseases corresponds to only 34% of workers. There has been a decrease in the rate of work accidents in the last six years, but an increase in diseases and permanent disabilities. During 2016, the first cause of occupational illness was hearing loss, but the profile was dominated by musculoskeletal diseases, which together reached 36.5%.

CONCLUSIONS

To improve the occupational and environmental health situation, it is necessary to implement general and particular measures against inequalities, increase the budget in health and environment, enforce legislation and expand social security coverage to the population. These measures should be part of public policies as well as actions of academics and researchers.

Cohort profile: the Geoscience and Health Cohort Consortium (GECCO) in the Netherlands

PURPOSE

In the Netherlands, a great variety of objectively measured geo-data is available, but these data are scattered and measured at varying spatial and temporal scales. The centralisation of these geo-data and the linkage of these data to individual-level data from longitudinal cohort studies enable large-scale epidemiological research on the impact of the environment on public health in the Netherlands. In the Geoscience and Health Cohort Consortium (GECCO), six large-scale and ongoing cohort studies have been enriched with a variety of existing geo-data. Here, we introduce GECCO by describing: (1) the phenotypes of the involved cohort studies, (2) the collected geo-data and their sources, (3) the methodology that was used to link the collected geo-data to individual cohort studies, (4) the similarity of commonly used geo-data between our consortium and the nationwide situation in the Netherlands and (5) the distribution of geo-data within our consortium.

PARTICIPANTS

GECCO includes participants from six prospective cohort studies (eg, 44 657 respondents (18-100 years) in 2006) and it covers all municipalities in the Netherlands. Using postal code information of the participants, geo-data on the address-level, postal code-level as well as neighbourhood-level could be linked to individual-level cohort data.

FINDINGS TO DATE

The geo-data could be successfully linked to almost all respondents of all cohort studies, with successful data-linkage rates ranging from 97.1% to 100.0% between cohort studies. The results show variability in geo-data within and across cohorts. GECCO increases power of analyses, provides opportunities for cross-checking and replication, ensures sufficient geographical variation in environmental determinants and allows for nuanced analyses on specific subgroups.

FUTURE PLANS

GECCO offers unique opportunities for (longitudinal) studies on the complex relationships between the environment and health outcomes. For example, GECCO will be used for further research on environmental determinants of physical/psychosocial functioning and lifestyle behaviours.

Economic impacts from PM2.5 pollution-related health effects in China's road transport sector: A provincial-level analysis

Economic impact assessments of air pollution-related health effects from a sectoral perspective in China is still deficient. This study evaluates the PM_2.5 pollution-related health impacts of the road transport sector on China's economy at both national and provincial levels in 2030 under various air mitigation technologies scenarios. Health impacts are estimated using an integrated approach that combines the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model, a computable general equilibrium (CGE) model and a health model. Results show that at a national level, the road transport sector leads to 163.64 thousand deaths per year, increases the per capita risk of morbidity by 0.37% and accounts for 1.43 billion Yuan in health care expenditures. We estimate 442.90 billion Yuan of the value of statistical life loss and 2.09 h/capita of work time loss in 2015. Without additional control measures, air pollution related to the transport sector will cause 177.50 thousand deaths in 2030, a 0.40% per capita increase in the risk of morbidity, accounting for 4.12 billion Yuan in health care expenditures, 737.15 billion Yuan of statistical life loss and 2.23 h/capita of work time loss. Based on our model, implementing the most strict control strategy scenario would decrease mortality by 42.14%, morbidity risk by 42.14%, health care expenditures by 41.94%, statistical life loss by 26.22% and hours of work time loss by 42.65%, comparing with the no control measure scenario. In addition, PM_2.5 pollution from the road transport sector will cause 0.68% GDP loss in 2030. At a provincial level, GDP losses in 14 out of 30 provinces far exceed the national rate. Henan (1.20%), Sichuan (1.07%), Chongqing (0.99%), Hubei (0.94%), and Shandong (0.90%) would experience the highest GDP loss in 2030. Implementing control strategies to reduce PM_2.5 pollution in the road transport sector could bring positive benefits in half of the Chinese provinces especially in provinces that suffer greater health impacts from the road transport sector (such as Henan and Sichuan).

The National Institute of Environmental Health Sciences Superfund Research Program: a model for multidisciplinary training of the next generation of environmental health scientists

The National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) funds university-based, multidisciplinary research on human health and environmental science and engineering with the central goals to understand how hazardous substances contribute to disease and how to prevent exposures to these environmental chemicals. This multi-disciplinary approach allows early career scientists (e.g. graduate students and postdoctoral researchers) to gain experience in problem-based, solution-oriented research and to conduct research in a highly collaborative environment. Training the next generation of environmental health scientists has been an important part of the SRP since its inception. In addition to basic research, the SRP has grown to include support of broader training experiences such as those in research translation and community engagement activities that provide opportunities to give new scientists many of the skills they will need to be successful in their field of research. Looking to the future, the SRP will continue to evolve its training component by tracking and analyzing outcomes from its trainees by using tools such as the NIEHS CareerTrac database system, by increasing opportunities for trainees interested in research that goes beyond US boundaries, and in the areas of bioinformatics and data integration. These opportunities will give them the skills needed to be competitive and successful no matter which employment sector they choose to enter after they have completed their training experience.

Effect of air quality alerts on human health: a regression discontinuity analysis in Toronto, Canada

BACKGROUND

Ambient air pollution is a major health risk globally. To reduce adverse health effects on days when air pollution is high, government agencies worldwide have implemented air quality alert programmes. Despite their widespread use, little is known about whether these programmes produce any observable public-health benefits. We assessed the effectiveness of such programmes using a quasi-experimental approach.

METHODS

We assembled a population-based cohort comprising all individuals who resided in the city of Toronto (Ontario, Canada) from 2003 to 2012 (about 2·6 million people). We ascertained seven health outcomes known to be affected by short-term elevation of air pollution, using provincial health administrative databases. These health outcomes were cardiovascular-related mortality, respiratory-related mortality, and hospital admissions or emergency-department visits for acute myocardial infarction, heart failure, stroke, asthma, and chronic obstructive pulmonary disease (COPD). We applied a regression discontinuity design to assess the effectiveness of an intervention (ie, the air quality alert programme). To quantify the effect of the air quality alert programme, we estimated for each outcome both the absolute rate difference and the rate ratio attributable to programme eligibility (by intention-to-treat analysis) and the alerts themselves (by two-stage regression approach), respectively.

FINDINGS

Between Jan 1, 2003, and Dec 31, 2012, on average between three and 27 daily cardiovascular or respiratory events were reported in Toronto (depending on the outcome). Alert announcements reduced asthma-related emergency-department visits by 4·73 cases per 1 000 000 people per day (95% CI 0·55-9·38), or in relative terms by 25% (95% CI 1-47). Programme eligibility also led to 2·05 (95% CI 0·07-4·00) fewer daily emergency-department visits for asthma. We did not detect a significant reduction in any other health outcome as a result of alert announcements or programme eligibility. However, a non-significant trend was noted towards decreased asthma-related and COPD-related admissions.

INTERPRETATION

In this population-based cohort, the air quality alert programme was related to some reductions in respiratory morbidity, but not any other health outcome examined. This finding suggests that issuing air quality alerts alone has a limited effect on public health and that implementing enforced public actions to reduce air pollution on high pollution days could be warranted. Together with accumulating evidence of substantial burden from long-term air pollution exposure, this study underscores the need for further strengthening of global efforts that can lead to long-term improvement of overall air quality.

FUNDING

Public Health Ontario, Canadian Institutes for Health Research.

"These Power Lines Make Me Ill": A Typology of Residents' Health Responses to a New High-Voltage Power Line

Little attention has been devoted to the potential diversity in residents' health responses when exposed to an uncertain environmental health risk. The present study explores whether subgroups of residents respond differently to a new high-voltage power line (HVPL) being put into operation. We used a quasi-experimental prospective field study design with two pretests during the construction of a new HVPL, and two posttests after it was put into operation. Residents living nearby (0-300 m, n = 229) filled out questionnaires about their health and their perception of the environment. We applied latent class growth models to investigate heterogeneity in the belief that health complaints were caused by a power line. Classes were compared on a wide range of variables relating to negative-oriented personality traits, perceived physical and mental health, and perceptions of the environment. We identified five distinct classes of residents, of which the largest (49%) could be described as emotionally stable and healthy with weak responses to the introduction of a new power line. A considerable minority (9%) responded more strongly to the new line being activated. Residents in this class had heard more about the health effects of power lines beforehand, were more aware of the activation of the new line, and reported a decrease in perceived health afterwards. Based on our findings we can conclude that there is a considerable heterogeneity in health responses to a new HVPL. Health risk perceptions appear to play an important role in this typology, which has implications for risk management.

A multifactorial study on duration of temporary disabilities in Spain

The extreme variability of temporary disability duration has a deep effect in public health. We tried to understand what factors duration of disability depends on. Through cohort study with data of temporary disabilities collected by Ibermutuamur from 2008 to 2012, we used statistical multivariate methods. The most reliable and convenient algorithm to predict duration was a categorical classification tree that distinguished between brief and long disabilities, taking into account both medical-biological and socioeconomic factors. The influence of socioeconomic factors in the disability process made numeric predictive models not accurate enough. Some of these socioeconomic factors were isolated and their influences were quantified. In particular, the one we named factor unemployment could explain a huge increase in duration for certain common diagnoses such as anxiety, low back pain, headache, and depression.

Health assessment of future PM2.5 exposures from indoor, outdoor, and secondhand tobacco smoke concentrations under alternative policy pathways in Ulaanbaatar, Mongolia

INTRODUCTION

Winter air pollution in Ulaanbaatar, Mongolia is among the worst in the world. The health impacts of policy decisions affecting air pollution exposures in Ulaanbaatar were modeled and evaluated under business as usual and two more-strict alternative emissions pathways through 2024. Previous studies have relied on either outdoor or indoor concentrations to assesses the health risks of air pollution, but the burden is really a function of total exposure. This study combined projections of indoor and outdoor concentrations of PM2.5 with population time-activity estimates to develop trajectories of total age-specific PM2.5 exposure for the Ulaanbaatar population. Indoor PM2.5 contributions from secondhand tobacco smoke (SHS) were estimated in order to fill out total exposures, and changes in population and background disease were modeled. The health impacts were derived using integrated exposure-response curves from the Global Burden of Disease Study.

RESULTS

Annual average population-weighted PM2.5 exposures at baseline (2014) were estimated at 59 μg/m3. These were dominated by exposures occurring indoors, influenced considerably by infiltrated outdoor pollution. Under current control policies, exposures increased slightly to 60 μg/m3 by 2024; under moderate emissions reductions and under a switch to clean technologies, exposures were reduced from baseline levels by 45% and 80%, respectively. The moderate improvement pathway decreased per capita annual disability-adjusted life year (DALY) and death burdens by approximately 40%. A switch to clean fuels decreased per capita annual DALY and death burdens by about 85% by 2024 with the relative SHS contribution increasing substantially.

CONCLUSION

This study demonstrates a way to combine estimated changes in total exposure, background disease and population levels, and exposure-response functions to project the health impacts of alternative policy pathways. The resulting burden analysis highlights the need for aggressive action, including the elimination of residential coal burning and the reduction of current smoking rates.

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND

The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context.

METHODS

We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined.

FINDINGS

Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9-11·6) decline in deaths and a 10·8% (8·3-13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7-17·5) of deaths and 6·2% (3·9-8·7) of DALYs, and population growth for 12·4% (10·1-14·9) of deaths and 12·4% (10·1-14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9-29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks.

INTERPRETATION

Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade.

FUNDING

The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.

[SCREENING LEVEL ENVIRONMENTAL HEALTH RISK ASSESSMENT BY HEALTH DATA IN SOME SMALL AREAS OF UPPER IMERETI (CHIATURA DISTRICT)]

The article presents the results of a comparative analysis of health data in villages Rgani, Perevisa and Khreiti population (Chiatura municipality), Which were obtained by the initiative group of the ak. N. Kipshidze Republican Hospital within the framework of the universal healthcare program of population insurance. The villages differ as by their remoteness from sources of ecological danger - manganese quarries, and scales of its achievement, which gives grounds to rank them according to the degree of ecological tension The purpose of the research is to develop optimal for Georgia approach to obtain and analyze information for site-specific environmental health risks assessment The analysis of the data was carried out using exploratory and evidentiary statistics: Cluster analysis, Logarithmic linear analysis and 2x2 conjugacy tables, correlation analysis, nonparametric statistics methods. As a measure of the adverse environmental impact on the health of the population, the ratio of the chances of developing pathologies was used. Statistical analysis and graphical visualization of the results were carried out using the STATISTICA-10 SPSS software. It was found that in the villages the surveyed population differ statistically significantly in the levels of chronic obstructive pulmonary disease (J44) and chronic bronchitis (J42), which according to the recommendations of the World Health Organization are among the direct indices of indoor and outdoor air pollution. It was found that the values of the odds ratio (by prevalence) of the development of chronic lung diseases in the samples are associated with the degree of possible external exposure to them. A subsample (a population of people over 50 years old) representative of the corresponding population group was identified and on the basis of which it was established that the chance of developing chronic obstructive lung diseases in the village of Ragani is about 5-7 times higher than in the village of Khreiti. The obtained results testify to the high information content of the survey data for site-specific assessments of environmental health risks. Specific directions for increasing their information content are outlined.

Islam and Environmental Consciousness: A New Scale Development

This research proposed a new construct, Islamic environmental consciousness (IEC), and developed a measurement scale to support this construct. Churchill's (J Mark Res 16(1):64-73, 1979) paradigm, adapted by Negra and Mzoughi (Internet Res 22(4):426-442, 2012), was utilized. A total of 32 items were generated based on the verses of the Qur'an from nine interviews with teachers in an Islamic seminary. This set of items was reduced to 19 after dropping redundant or non-representative items. In a pilot study, factor analysis of the 19-item scale yielded a two-factor structure scale of seven items with a reliability ranging from 0.7 to 0.8. The Islamic environmental consciousness scale (IECS) was statistically confirmed and validated in a subsequent investigation. The proposed measurement scale warrants further exploratory study. Future research should assess the IECS's validity across different Muslim countries, locales, and various Islamic schools of thought and practice. IEC is proposed as a new construct that focuses primarily on the Qur'an and seeks to achieve acceptance by both Sunni and Shia denominations. In this study, both cognitive attitudes and behavioral aspects were considered in the design of the IECS.

Neuropsychological state of the population living in the Aral Sea region (zone of ecological crisis)

Background The Aral Sea crisis has led to harmful effects on human habitat. In recent years, mild cognitive impairment is a growing problem. Objectives This article provides the results of studying the neuropsychological state of residents living in the crisis zone of the Aral Sea region in the case of Shalkar city. We have provided an assessment of the neuropsychological state of examined population and determined the leading pathology in this region. Methods The survey sample included 344 persons of reproductive age from 21 to 45 years. We have obtained results in biochemical studies, indicating perturbations of proteometabolism and lipid metabolism. Results A correlation analysis showed dependence between a decrease of albumin and high-density lipoproteins, an increase of low-density lipoproteins and parameters of cognitive function. Conclusions The research suggests a high prevalence of cerebrovascular pathology among the population, changes in cognitive function parameters, long-term and short-term memory problems and high levels of depression.

A cross-sectional survey of environmental health in remote Aboriginal communities in Western Australia

INTRODUCTION

The Australian Aboriginal population experiences significantly poorer health than the non-Aboriginal population. The contribution of environmental risk factors in remote communities to this health disparity is poorly understood.

OBJECTIVE

To describe and quantify major environmental risk factors and associated health outcomes in remote Aboriginal communities in Western Australia.

METHODS

The association between environmental health indicators, community infrastructure and reported health outcomes was analysed using linear and logistic regression of survey data.

RESULTS

Housing/overcrowding was significantly associated with increased reports of hearing/eyesight (OR 3.01 95 % CI 1.58-5.73), skin (OR 2.71 95 % CI 1.31-5.60), gastrointestinal (OR 3.51 95 % CI 1.49-8.26) and flu/colds (OR 2.47 95 % CI 1.27-4.78) as health concerns. Dust was significantly associated with hearing/eyesight (OR 3.16 95 % CI 1.82-5.48), asthma/respiratory (OR 2.48 95 % CI 1.43-4.29) and flu/colds (OR 3.31 95 % CI 1.88-5.86) as health concerns.

CONCLUSION

Poor environmental health is prevalent in remote Aboriginal communities and requires further delineation to inform environmental health policy.

The Importance of the Biological Impact of Exposure to the Concept of the Exposome

BACKGROUND

The term "exposome" was originally coined in 2005 and defined as the totality of exposures throughout the lifetime. The exposome provides an excellent scientific framework for studying human health and disease. Recently, it has been suggested that how exposures affect our biology and how our bodies respond to such exposures should be part of the exposome.

OBJECTIVES

The authors describe the biological impact of the exposome and outline many of the targets and processes that can be assessed as part of a comprehensive analysis of the exposome.

DISCUSSION

The processes that occur downstream from the initial interactions with exogenous and endogenous compounds determine the biological impact of exposures. If the effects are not considered in the same context as the exposures, it will be difficult to determine cause and effect. The exposome and biology are interactive-changes in biology due to the environment change one's vulnerability to subsequent exposures. Additionally, highly resilient individuals are able to withstand environmental exposures with minimal effects to their health. We expect that the vast majority of exposures are transient, and chemicals underlying exposures that occurred weeks, months, or years ago are long gone from the body. However, these past chemical exposures often leave molecular fingerprints that may be able to provide information on these past exposures.

CONCLUSIONS

Through linking exposures to specific biological responses, exposome research could serve to improve understanding of the mechanistic connections between exposures and health to help mitigate adverse health outcomes across the lifespan.

CITATION

Dennis KK, Auerbach SS, Balshaw DM, Cui Y, Fallin MD, Smith MT, Spira A, Sumner S, Miller GW. 2016. The importance of the biological impact of exposure to the concept of the exposome. Environ Health Perspect 124:1504-1510; http://dx.doi.org/10.1289/EHP140.

Children's environmental health indicators in Australia: are we collecting the right information?

In order to assess progress in improving children's health objectively standardized measurements are required. The World Health Organization (WHO) undertook a pilot project to develop and implement a series of children's environmental health indicators (CEHI) to facilitate this process. No countries in Oceania were included in this pilot. This project was undertaken to determine whether data collected and publicly available in Australia were sufficient to address the CEHI. Government documents and websites were searched to obtain publicly available data. These data adequately reflected outcome indicators but data addressing many exposure indicators were either missing or not available in a child-specific format. Australia does collect data on child health and well-being but not in a form compatible with the WHO CEHI.

[FEATURES OF THE CONTENT OF MOVABLE FORMS OF HEAVY METALS AND SELENIUM IN SOILS OF THE YAROSLAVL REGION]

With the use of the method of inversion voltammetry there was analyzed the content of movableforms of trace elements: (selenium, zinc, copper lead, cadmium) in soils in the Yaroslavl district of the Yaroslavl region, and also content of zinc, copper lead, cadmium in soils and snow cover in the city of Yaroslavl. According to values of concentrations of movable compounds in soils determined trace elements can be ranked into the following row: zinc > lead > copper > selenium > cadmium. There was revealed insufficient if compared with literature data concentrations, content of movable compounds of selenium, copper and zinc in examined explored soils. The maximal concentrations of lead are revealed in the close proximity to both the city of Yaroslavl and large highways of the city. It indicates to the anthropogenic pollution of soils by this element.

[EVALUATION OF MIGRATION ABILITY OF POLYCHLORINATED BIPHENYLS IN THE "SOIL-PLANT" AND "SOIL-EARTHWORMS"]

In the article there is given a hygienic assessment ofpolychlorinated biphenyls (PCBs) contamination of soils of the city of Serpukhov of the Moscow region. For the first time there was investigated the PCB's ability to migrate in the system "soil-earthworms", and were calculated bioaccumulation factors at the different level of soil contamination. There was performed a comparative evaluation of the accumulation of given contaminants by higher terrestrial plants and representatives of soil paedobionts (Lumbricidae worms), and revealed clear differences in these processes. There was shown the possibility of the use of earthworms as a highly sensitive bio-indicators in monitoring for soil contamination by persistent organic pollutants, even at low concentrations.

Statistically Non-significant Papers in Environmental Health Studies included more Outcome Variables

OBJECTIVE

The number of analyzed outcome variables is important in the statistical analysis and interpretation of research findings. This study investigated published papers in the field of environmental health studies. We aimed to examine whether differences in the number of reported outcome variables exist between papers with non-significant findings compared to those with significant findings. Articles on the maternal exposure to mercury and child development were used as examples.

METHODS

Articles published between 1995 and 2013 focusing on the relationships between maternal exposure to mercury and child development were collected from Medline and Scopus.

RESULTS

Of 87 extracted papers, 73 used statistical significance testing and 38 (43.7%) of these reported 'non-significant' (P>0.05) findings. The median number of child development outcome variables in papers reporting 'significant' (n=35) and 'non-significant' (n=38) results was 4 versus 7, respectively (Mann-Whitney test P-value=0.014). An elevated number of outcome variables was especially found in papers reporting non-significant associations between maternal mercury and outcomes when mercury was the only analyzed exposure variable.

CONCLUSION

Authors often report analyzed health outcome variables based on their P-values rather than on stated primary research questions. Such a practice probably skews the research evidence.

Children's health and vulnerability in outdoor microclimates: A comprehensive review

BACKGROUND

Children are routinely identified as a vulnerable population in environmental health risk assessments, experiencing adverse health outcomes due to exposure to a suite of atmospheric constituents.

OBJECTIVE

To provide a substantive overview of the research literature pertaining to biometeorological effects on children. Key information areas within urban environmental health research related to atmospheric variables (heat, air pollution, radiation) are assessed and integrated to better understand health outcomes and vulnerabilities in children. Critical avenues for improvement and understanding of children's health related to such biophysical parameters are also identified.

METHODS

This comprehensive review assesses past and current primary studies, organizational reports, educational books, and review articles. Emphasis is placed on the differential ambient exposures to temperature, air pollution, and radiation within urban microclimates commonly used by children (e.g., schoolyards, urban parks), and the resulting health impacts.

DISCUSSION

Exposure to heat, air pollution, and radiation are often enhanced in urban areas, specifically under the current design of the majority of outdoor child play places. Many heat indices, energy budget models, and health outcome studies fail to adequately parameterize children, yet those that do find enhanced vulnerability to ambient stressors, particularly heat and air pollution. Such environmental exposures relate strongly to behavior, activity, asthma, obesity, and overall child well-being. Current research indicates that a changing climate, growing urban population, and unsustainable design are projected to pose increasing complications.

CONCLUSIONS

Evidence-based research to link children's health, physiology, and behavior to atmospheric extremes is an important future research avenue, underscoring the fact that children are among the population groups disproportionately affected by ambient extremes. However, current methods and population-based models lack child-specific inputs and outputs, as well as designated thresholds for accurate predictions of child health impacts. More substantive evidence is needed for applicable child-specific policies and guidelines.

National-level differences in the adoption of environmental health technologies: a cross-border comparison from Benin and Togo

Environmental health problems such as malaria, respiratory infections, diarrhoea and malnutrition pose very high burdens on the poor rural people in much of the tropics. Recent research on key interventions-the adoption and use of relatively cheap and effective environmental health technologies-has focused primarily on the influence of demand-side household-level drivers. Relatively few studies of the promotion and use of these technologies have considered the role of contextual factors such as governance, the enabling environment and national policies because of the challenges of cross-country comparisons. We exploit a natural experimental setting by comparing household adoption across the Benin-Togo national border that splits the Tamberma Valley in West Africa. Households across the border share the same culture, ethnicity, weather, physiographic features, livelihoods and infrastructure; however, they are located in countries at virtually opposite ends of the institutional spectrum of democratic elections, voice and accountability, effective governance and corruption. Binary choice models and rigorous non-parametric matching estimators confirm that households in Benin are more likely than households in Togo to plant soybeans, build improved cookstoves and purchase mosquito nets, ceteris paribus. Although we cannot identify the exact mechanism for the large and significant national-level differences in technology adoption, our findings suggest that contextual institutional factors can be more important than household characteristics for technology adoption.

[RELATIONSHIP BETWEEN THE PREVALENCE OF CHRONIC NONINFECTIOUS DISEASES AND ELECTROPHYSICAL STATE OF THE ENVIRONMENT]

In the paper there is evaluated the relationship of features of electronic state of the environment with a level of chronic, noninfectious diseases (CNID) in the regions of Russia, obtained on the basis of the monitoring measurements of the intensity of natural background electronic Bose condensate (BEBC) of natural ecosystems in a number of Russian regions and seas of the Arctic Ocean. The assessment of BEBC was implemented on results of measurements of redox state of distilled water being in the contact with natural water. The equilibrium redox state of distilled water, determined by the influx of electrons (quantum reduction) outside, is proportional to the intensity of BEBC. The obtained data attest to an increase in the intensity of the background of EBC in Siberia regions and, especially, within the limits ofwaters of Lake Baikal (the redox potential of the surface water in the lake ~ -70mV). Also there is observed a strong dependence of the background EBC in the latitudinal direction. Low levels of background EBC were noted in the Arkhangelsk region and the north-eastern Chukotka. Functioning of international systems of plasma sounding of ionosphere (such systems as HAARP) were established to have a detrimental effect on the background EBC in these regions. According to the results of measurements of the relative values of intensities of natural background of Bose condensate of electrons there was constructed the dependence reflecting the relationship of the prevalence of noninfectious diseases in the regions of Russia with the redox state of distilled water which can be characterized as a significant (regression coefficient R2 = 0.78). The relationship between noninfectious diseases (NID, %) with the intensity of the background of EBC (Ib rel. units) is estimated by the equation: NID [%] = 0.24Eh [mV]-25, where Eh ~ I/Ib. Numerical evaluations show that an increase in the biosphere redox potential of water by 90mV leads to an increase of the primary incidence by 20% (relatively to the average values for Russia). Analysis of results attests to the relationship of CNID with the electrophysical state of the environment that allows from different positions to arrive to true causes of their emergence, associated with changes in the electrophysical conditions of habitation and human activities that lead to the nascency of cellular metabolic disturbances.

[Influence of ecologic factors on respiratory diseases in urban residents of Kazakhstan Republic]

The authors studied influence of ecologic factors on respiratory diseases development in urban residents of Kazakhstan Republic. Multivariate (correlation and regression) analysis demonstrates that chronic obstructive lung disease development is contributed by high concentration of nitrogen oxide in ambient air (r = -0.75; p = 0.005) in Temirtau, Kamenogorsk and Aktau cities, high lead content of sedimented dust (r = 0.64; p = 0.02) in Temirtau, Ust'-Kamenogorsk and Ekibastuz cities.

Data inconsistencies from states with unconventional oil and gas activity

The quality and availability of unconventional oil and gas (O&G) data in the United States have never been compared methodically state-to-state. By conducting such an assessment, this study seeks to better understand private and publicly sourced data variability and to identify data availability gaps. We developed an exploratory data-grading tool - Data Accessibility and Usability Index (DAUI) - to guide the review of O&G data quality. Between July and October 2013, we requested, collected, and assessed 5 categories of unconventional O&G data (wells drilled, violations, production, waste, and Class II disposal wells) from 10 states with active drilling activity. We based our assessment on eight data quality parameters (accessibility, usability, point location, completeness, metadata, agency responsiveness, accuracy, and cost). Using the DAUI, two authors graded the 10 states and then averaged their scores. The average score received across all states, data categories, and parameters was 67.1 out of 100, largely insufficient for proper data transparency. By state, Pennsylvania received the highest average ( = 93.5) and ranked first in all but one data category. The lowest scoring state was Texas ( = 44) largely due to its policy of charging for certain data. This article discusses the various reasons for scores received, as well as methodological limitations of the assessment metrics. We argue that the significant variability of unconventional O&G data-and its availability to the public-is a barrier to regulatory and industry transparency. The lack of transparency also impacts public education and broader participation in industry governance. This study supports the need to develop a set of data best management practices (BMPs) for state regulatory agencies and the O&G industry, and suggests potential BMPs for this purpose.

[REAL AND UNREAL BACKLASHES OF AEROSPACE ACTIVITY FOR THE HEALTH OF POPULATION RESIDING NEAR AREAS OF FALL OF BEING SEPARATED PARTS OF CARRIER ROCKETS]

Since the late 1990s, the ongoing debate about the consequences of the rocket-space activities for the health of people residing near areas offall ofseparatingfrom parts of rockets. Some scientists (Kolyado IB et al., 2001, 2013; Shoikhet YN et al., 2005, 2008; Skrebtsova NV 2005, 2006, Sidorov PI et al., 2007) argue that the main cause of morbidity is the effect of unsymmetrical dimethyl hydrazine (UDMH). However, environmentalists find it only in areas offalling fragments of separated parts of carrier rockets. Presented in the article data were obtained as a result of perennial epidemiological and hygienic research. There was performed a hygienic assessment of the content of chemical substances in water soil andfood, nutritional status and health risk near areas of the district of falling 310 and 326. There were studied conditions of work and the health of military personnel at the sites of storage of propellant components. The relationship between revealed diseases and UDMH was not established, but there was their causality due to the influence of environmental factors characteristic of territories and living conditions. In the settlements near the area of falling district 310 the share of extremely anxious persons was shown to be 1.8 times higher than in controls, which is caused by cases of falling fragments stages of carrier rockets in the territory of settlements.

Data Curation: Improving Environmental Health Data Quality

With the growing recognition of the influence of climate change on human health, scientists' attention to analyzing the relationship between meteorological factors and adverse health effects. However, the paucity of high quality integrated data is one of the great challenges, especially when scientific studies rely on data-intensive computing. This paper aims to design an appropriate curation process to address this problem. We present a data curation workflow that: (i) follows the guidance of DCC Curation Lifecycle Model; (ii) combines manual curation with automatic curation; (iii) and solves environmental health data curation problem. The workflow was applied to a medical knowledge service system and showed that it was capable of improving work efficiency and data quality.

[Influence of industrial pollution with mercury on levels of its accumulation in populated area objects and foods]

The article deals with results of study covering influence of industrial pollution with mercury on its accumulation level in populated area objects and foods. Mercury content was measured in ambient air, snow, water, bed silt and regional foods of vegetable and animal origin--that is a potential health hazard for Central Kazakhstan population. The data obtained prove that high levels of mercury were detected in all the studied objects.

The population-based Occupational and Environmental Health Prospective Cohort Study (AMIGO) in The Netherlands

PURPOSE

Occupational and environmental exposures remain important modifiable risk factors of public health. Existing cohort studies are often limited by the level of detail of data collected on these factors and health. It is also often assumed that the more healthy group is over-represented in cohort studies, which is of concern for their external validity. In this cohort profile, we describe how we set up the population-based Occupational and Environmental Health Cohort Study (AMIGO) to longitudinally study occupational and environmental determinants of diseases and well-being from a multidisciplinary and life course point of view. Reviewed by the Medical Ethics Research Committee of the University Medical Center Utrecht (protocol 10-268/C). All cohort members participate voluntarily and gave informed consent prior to their inclusion.

PARTICIPANTS

14,829 adult cohort members (16% of those invited) consented and filled in the online baseline questionnaire. Determinants include chemical, biological, physical (eg, electromagnetic fields), and psychosocial factors. Priority health outcomes include cancer, neurological, cardiovascular and respiratory diseases and non-specific symptoms. Owing to the recruitment strategy via general practitioners of an established network, we also collect longitudinal data registered in their electronic medical records including symptoms, diagnosis and treatments. Besides the advantage of health outcomes that cannot be easily captured longitudinally by other means, this created a unique opportunity to assess health-related participation bias by comparing general practitioner-registered prevalence rates in the cohort and its source population.

FINDINGS TO DATE

We found no indications of such a systematic bias. The major assets of the AMIGO approach are its detailed occupational and environmental determinants in combination with the longitudinal health data registered in general practice besides linkage to cancer and mortality registries and self-reported health.

FUTURE PLANS

We are now in the phase of prospective follow-up, with the aim of continuing this for as long as possible (20+ years), pending future funding. Findings will be disseminated through scientific conferences and peer-reviewed journals, and through newsletters and the project website to participants, stakeholders and the wider public.

An empirical assessment of exposure measurement error and effect attenuation in bipollutant epidemiologic models

BACKGROUND

Using multipollutant models to understand combined health effects of exposure to multiple pollutants is becoming more common. However, complex relationships between pollutants and differing degrees of exposure error across pollutants can make health effect estimates from multipollutant models difficult to interpret.

OBJECTIVES

We aimed to quantify relationships between multiple pollutants and their associated exposure errors across metrics of exposure and to use empirical values to evaluate potential attenuation of coefficients in epidemiologic models.

METHODS

We used three daily exposure metrics (central-site measurements, air quality model estimates, and population exposure model estimates) for 193 ZIP codes in the Atlanta, Georgia, metropolitan area from 1999 through 2002 for PM2.5 and its components (EC and SO4), as well as O3, CO, and NOx, to construct three types of exposure error: δspatial (comparing air quality model estimates to central-site measurements), δpopulation (comparing population exposure model estimates to air quality model estimates), and δtotal (comparing population exposure model estimates to central-site measurements). We compared exposure metrics and exposure errors within and across pollutants and derived attenuation factors (ratio of observed to true coefficient for pollutant of interest) for single- and bipollutant model coefficients.

RESULTS

Pollutant concentrations and their exposure errors were moderately to highly correlated (typically, > 0.5), especially for CO, NOx, and EC (i.e., "local" pollutants); correlations differed across exposure metrics and types of exposure error. Spatial variability was evident, with variance of exposure error for local pollutants ranging from 0.25 to 0.83 for δspatial and δtotal. The attenuation of model coefficients in single- and bipollutant epidemiologic models relative to the true value differed across types of exposure error, pollutants, and space.

CONCLUSIONS

Under a classical exposure-error framework, attenuation may be substantial for local pollutants as a result of δspatial and δtotal with true coefficients reduced by a factor typically < 0.6 (results varied for δpopulation and regional pollutants).

Ecohealth approach to urban waste management: exposure to environmental pollutants and health risks in Yamoussoukro, Côte d'Ivoire

Poor waste management is a key driver of ill-health in urban settlements of developing countries. The current study aimed at assessing environmental and human health risks related to urban waste management in Yamoussoukro, the political capital of Côte d'Ivoire. We undertook trans-disciplinary research within an Ecohealth approach, comprised of a participatory workshop with stakeholders and mapping of exposure patterns. A total of 492 randomly selected households participated in a cross-sectional survey. Waste deposit sites were characterised and 108 wastewater samples were subjected to laboratory examinations. The physico-chemical parameters of the surface water (temperature, pH, conductivity, potential oxidise reduction, BOD5, COD, dissolved oxygen, nitrates, ammonia and total Kendal nitrogen) did not comply with World Health Organization standards of surface water quality. Questionnaire results showed that malaria was the most commonly reported disease. Diarrhoea and malaria were associated with poor sanitation. Households having dry latrines had a higher risk of diarrhoea (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.2-2.7) compared to latrines with septic tanks and also a higher risk for malaria (OR = 1.9, 95% (CI) 1.1-3.3). Our research showed that combining health and environmental assessments enables a deeper understanding of environmental threats and disease burdens linked to poor waste management. Further study should investigate the sanitation strategy aspects that could reduce the environmental and health risks in the study area.

Evaluating the application of multipollutant exposure metrics in air pollution health studies

BACKGROUND

Health effects associated with air pollution are typically evaluated using a single pollutant approach, yet people are exposed to mixtures consisting of multiple pollutants that may have independent or combined effects on human health. Development of exposure metrics that represent the multipollutant environment is important to understand the impact of ambient air pollution on human health.

OBJECTIVES

We reviewed existing multipollutant exposure metrics to evaluate how they can be applied to understand associations between air pollution and health effects.

METHODS

We conducted a literature search using both targeted search terms and a relational search in Web of Science and PubMed in April and December 2013. We focused on exposure metrics that are constructed from ambient pollutant concentrations and can be broadly applied to evaluate air pollution health effects.

RESULTS

Multipollutant exposure metrics were identified in 57 eligible studies. Metrics reviewed can be categorized into broad pollutant grouping paradigms based on: 1) source emissions and atmospheric processes or 2) common health outcomes.

DISCUSSION

When comparing metrics, it is apparent that no universal exposure metric exists; each type of metric addresses different research questions and provides unique information on human health effects. Key limitations of these metrics include the balance between complexity and simplicity as well as the lack of an existing "gold standard" for multipollutant health effects and exposure.

CONCLUSIONS

Future work on characterizing multipollutant exposure error and joint effects will inform development of improved multipollutant metrics to advance air pollution health effects research and human health risk assessment.