Actual Exposure Research Articles

Primary nonadherence to drugs prescribed by general practitioners: A Dutch database study.

Primary nonadherence (PNA) is defined as not filling the first prescription for a drug treatment. PNA can lead not only to poor patient outcomes but also to exposure misclassification in written prescription databases. This study aims to estimate PNA in primary care in the Netherlands and to investigate associated factors. Patients from the Nivel Primary Care Database (Nivel-PCD) who received a new prescription (>1year not prescribed) from a general practitioner in 2012 were linked to pharmacy dispensing information of consenting pharmacies based on sex, year of birth, four-digit postal code and at least 50% matching Anatomical Therapeutic Classification codes. PNA was defined as not having a prescription dispensed within 30 days from the prescribing date. PNA was assessed overall and per drug class. The associations between PNA and several patient- and prescription-related characteristics were assessed using mixed-effects logistic regression models. After matching 86 361 of 396 251 subjects (21.8%) in the Nivel-PCD records to the pharmacy records, this study included 65 877 subjects who received 181 939 new drug prescriptions. Overall, PNA was 11.5%. PNA was lowest for thyroid hormones (5.5%) and highest for proton pump inhibitors (12.8%). Several factors were associated with PNA, such as having comorbidities (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.37-1.56 for >3 active diagnoses, compared to no active diagnoses) or reimbursement status (OR 2.78, 95% CI 2.65-2.92 for not reimbursed drugs compared to fully reimbursed drugs). A total of 11.5% of newly prescribed drugs were not dispensed. This can lead to overestimation of the actual drug exposure status when using written prescription databases.

Occupational exposure and risk assessment for agricultural workers of thiamethoxam in vineyards

Dermal & inhalation exposure was examined and according to these results, risk assessment of agricultural workers to thiamethoxam was performed during pesticide mixing/loading and hand-held sprayer application (11 replicates, each of about 1000 L of spray suspension) in vineyards. For the whole body dosimetry (WBD), clothing (Outer and inner), gauze, and nitrile gloves were analyzed to determine dermal exposure using whole-body dosimetry exposure protocol. The inhalation exposure was measured using a glass fiber filter with an IOM sampler. Analytical method validation of exposure matrices was evaluated including the field recovery and breakthrough test. The dermal exposure amount during mixing/loading was 0.163 mg (0.0004% of the total mixed/loaded active ingredient [a.i.]), whereas there was no inhalation exposure. The gloves (0.154 mg, 94.5%) were the most exposed body parts followed by the chest and stomach (0.009 mg, 5.5%). During application, the dermal and inhalation exposure amounts were 32.3 mg (0.07% of the total applied a.i.) and 10.8 µg (2.4 × 10−6% of the total applied a.i), respectively. The shin (35.1%) had the highest exposure to pesticides, followed by the chest & stomach (15.6%) and pelvis (12.6%). In case of mixing/loading, the amounts of actual dermal exposure (ADE) and actual inhalation exposure (AIE) were 0.0 and 0.0 μg/day, while those of ADE and AIE were 4707.6 and 15.8 μg/day for application. In risk assessment of the two different scenarios, the risk index was much lower than 1 (mixing/loading:0.000, application:0.014), indicating that vineyard workers are at low risk of thiamethoxam exposure. To determine the validity of the risk assessment using WBD method, the urinary metabolite was analyzed. Comparison of biomonitoring data and WBD exposure data show a reliable correlation (r = 0.885, p = 0.0003), suggesting that these are suitable methods to estimate exposure.

Assessment of dermal exposure to pesticides among farmers using dosimeter and hand washing methods.

Inappropriate use of pesticides followed by unsafe handling practices to control the insect infestation among the farming groups in developing countries has resulted in a high exposure risk. The use of personal protective equipment is also negligible among Indian farmers due to their affordability to access the same. Very little research has been conducted to establish an exposure assessment procedure through dermal penetration of pesticide residues. Therefore, to quantify the contamination of pesticide residues through dermal exposure along with detailed field observations and pesticide management practices, a field study was conducted in Rangareddy district, Telangana, Southern India, to assess the dermal exposure based on dosimeter and hand washing methods. The analytical method was modified and validated in-house for performance parameters such as limit of detection, quantification, linear range, recovery, and precision. The potential dermal exposure values ranged from 0.15 to 13.45 μg, while a reduction was found in exposure levels as actual dermal exposure values ranged from 0 to 0.629 μg. Contamination through hand washing was the major contributor to overall dermal exposure. Statistical analysis revealed a significant difference in the exposed dermal regions of the leg and torso after the use of PPE. Penetration factor for each anatomical region and risk evaluation in terms of the Margin of Safety implies unsafe handling of pesticides. The findings of the present study confirm the increased exposure to organophosphate pesticides among operators and highlight the importance of the use of protective measures, especially among those that focus on dermal exposure mitigation.

Using community science for detailed pollution research: a case-study approach in Indianapolis, IN, USA.

Heavy metal contamination in urban environments, particularly lead (Pb) pollution, is a health hazard both to humans and ecological systems. Despite wide recognition of urban metal pollution in many cities, there is still relatively limited research regarding heavy metal distribution and transport at the household-scale between soils and indoor dusts-the most important scale for actual human interaction and exposure. Thus, using community-scientist-generated samples in Indianapolis, IN (USA), we applied bulk chemistry, Pb isotopes, and scanning electron microscopy (SEM) to illustrate how detailed analytical techniques can aid in interpretation of Pb pollution distribution at the household-scale. Our techniques provide definitive evidence for Pb paint sourcing in some homes, while others may be polluted with Pb from past industrial/vehicular sources. SEM revealed anthropogenic particles suggestive of Pb paint and the widespread occurrence of Fe-rich metal anthropogenic spherules across all homes, indicative of pollutant transport processes. The variability of Pb pollution at the household scale evident in just four homes is a testament to the heterogeneity and complexity of urban pollution. Future urban pollution research efforts would do well to utilize these more detailed analytical methods on community-sourced samples to gain better insight into where the Pb came from and how it currently exists in the environment. However, these methods should be applied after large-scale pollution screening techniques such as portable X-ray fluorescence (XRF), with more detailed analytical techniques focused on areas where bulk chemistry alone cannot pinpoint dominant pollution mechanisms and where community scientists can also give important metadata to support geochemical interpretations.

Development of an observational exposure human biomonitoring study to assess Canadian children's DEET exposure during protective use.

Biomonitoring data of N,N-diethyl-meta-toluamide (DEET) in children is scarce and limited to controlled exposure and surveillance studies. We conducted a 24-hour observational exposure and human biomonitoring study designed to estimate use of and exposure to DEET-based insect repellents by Canadian children in an overnight summer camp setting. Here, we present our study design and methodology. In 2019, children between the ages of 7 and 13 took part in the study (n = 126). Children controlled their use of DEET-based insect repellents, and provided an account of their activities at camp that could impact insect repellent absorption. Children provided a total of 389 urine samples throughout the study day, and reported the time that they applied insect repellent, which allowed us to contextualize urinary DEET and metabolite concentrations with respect to the timing of insect repellent application. DEET (2.3% <Limits of detection (LOD)) and two metabolites, N,N-diethyl-m-(hydroxymethyl)benzamide (DHMB) (0% <LOD) and 3-diethylcarbamoyl benzoic acid (DCBA) (0% <LOD), were measured in urine samples. Three time difference scenarios were established for the data and analysed to account for these complex time-dependent data, which demonstrated the need for DEET biomonitoring to be done in context with the timing of a known DEET exposure or over the course of at least 14 to 24 hours to better capture the excretion curve. To our knowledge, this is the first field-based study of real-world exposure to DEET in children. Our experience and results suggest that this type of real-world observational exposure study with a human biomonitoring component can generate data reflective of actual exposure, but is not without significant logistic, practical, and analytical challenges.

Benchmarking unhealthy food marketing to children and adolescents in Canada: a scoping review.

Unhealthy food and beverage marketing in various media and settings contributes to children's poor dietary intake. In 2019, the Canadian federal government recommended the introduction of new restrictions on food marketing to children. This scoping review aimed to provide an up-to-date assessment of the frequency of food marketing to children and youth in Canada as well as children's exposure to this marketing in various media and settings in order to determine where gaps exist in the research. For this scoping review, detailed search strategies were used to identify relevant peer-reviewed and grey literature published between October 2016 and November 2021. Two reviewers screened all results. A total of 32 relevant and unique articles were identified; 28 were peer reviewed and 4 were from the grey literature. The majority of the studies (n = 26) examined the frequency of food marketing while 6 examined actual exposure to food marketing. Most research focussed on children from Ontario and Quebec and television and digital media. There was little research exploring food marketing to children by age, geographical location, sex/gender, race/ethnicity and/or socioeconomic status. Our synthesis suggests that unhealthy food marketing to children and adolescents is extensive and that current self-regulatory policies are insufficient at reducing the presence of such marketing. Research assessing the frequency of food marketing and preschooler, child and adolescent exposure to this marketing is needed across a variety of media and settings to inform future government policies.

The prospects for radiofrequency electromagnetic fields control approaches improvement under 5G wireless communication technologies introduction

5G mobile communication system networks improvement leads to scenarios for the use of electromagnetic energy in various sectors of the economy variety increase and radiofrequency electromagnetic fields (EMF) person’ exposure with expansion of the exposed by occupational and non-occupational exposure contingent including. Base station EMF distinctive feature is its complex frequency-time and spatial dynamics with constant control signals that should be taken into account in modern EMF control methods. International practice in case of cellular base stations EMF assessment uses maximal values determination: theoretical and actual levels. EMF theoretical maximal values characterize base station operation mode under highest network load, highest data traffic and time-frequency radio channel resource full usage at the maximum permitted transmission power. Actual maximum EMF levels determination approach is base stations EMF evaluation alternative principle and is based on practically achievable maximum EMF emission, stochastic nature of base station signals with taking into account. The approaches to statistical assessment of actual maximum exposure levels are becoming a priority for international practice of base station EMF assessment and control due to adaptive antenna technologies in 5G cellular networks development. This approach to realistic EMF exposure assessment is fundamentally new for Russian practice and will require methodological updating of regulatory framework as well as comprehensive researches with network operators, including approaches to selective measurement results extrapolation for implementation. Ethics. The study did not require the ethics committee conclusion.

On the Geographic Balance of Risk and Amenity: Changes in Evacuation Zones and Their Ripples in Housing Prices in Pinellas County, FL

This study considers the balance of amenities and coastal hazards on housing prices between 2000 and 2015. We test whether risk communication via hurricane evacuation zone (a proxy for storm-surge risk and coastal flooding) affects sales price while controlling for relevant property characteristics, beach frontage, flood zones, and proximity to the coast. Additionally, we employ a difference-in-difference technique to test whether two highly publicized updates to evacuation zone maps, which changed the status of many homes in the county, led to price penalties for homes. We focus our study on areas of the new evacuation zone maps that reclassified parcels into zones associated with higher coastal surge exposure. This approach allows us to isolate the effects of risk communication about a property independent of changes to its insurance premiums or actual hazard exposure. We find that amenities are associated with significant bonuses and hazard variables correlated with price penalties, and homes in areas reclassified “up” in hazard zone classification have lost value. Our findings shed light on how information changes about hazards may affect coastal real estate markets as concerns about coastal hazards and exposure to storm-related surges increase along with climate change.

Author Response: Effect of Levetiracetam Use Duration on Overall Survival of Isocitrate Dehydrogenase Wild-Type Glioblastoma in Adults: An Observational Study.

Average leverage is often used as a measure of risk. However, average leverage in a limited liability context should not be computed as a simple arithmetic average of the underlying constituents. In fact, using a simple arithmetic average can give misleading results. For example, the simple arithmetic average leverage may give results which run counter to the actual risk exposure for certain portfolios. This article introduces a new measure, Limited Liability Leverage (<i>L</i>³), which corrects the simple average for the limited liability framework. This new measure is discussed in the context of a portfolio of hedge funds and compared to a multi-strategy hedge fund structure, where trading units do not have limited liability. This perspective can also be extended to reflect the lower risk of a financial system with many small institutions relative to a system with large, “too-big-to-fail” institutions. <b>TOPICS:</b>Real assets/alternative investments/private equity, legal/regulatory/public policy, risk management, portfolio construction

Underestimation of Radiation Doses by Compliance of Wearing Dosimeters among Fluoroscopically-Guided Interventional Medical Workers in Korea

This study aimed to estimate the level of underestimation of National Dose Registry (NDR) doses based on the workers’ dosimeter wearing compliance. In 2021, a nationwide survey of Korean medical radiation workers was conducted. A total of 989 medical workers who performed fluoroscopically-guided interventional procedures participated, and their NDR was compared with the adjusted doses by multiplying the correction factors based on the individual level of dosimeter compliance from the questionnaire. Ordinal logistic regression analysis was performed to identify the factors for low dosimeter wearing. Based on the data from the NDR, the average annual effective radiation dose was 0.95 mSv, while the compliance-adjusted dose was 1.79 mSv, yielding an 89% increase. The risks for low compliance with wearing a badge were significantly higher among doctors, professionals other than radiologists or cardiologists, workers not frequently involved in performing fluoroscopically-guided interventional procedures, and workers who did not frequently wear protective devices. This study provided quantitative information demonstrating that the NDR data may have underestimated the actual occupational radiation exposure. The underestimation of NDR doses may lead to biased risk estimates in epidemiological studies for radiation workers, and considerable attention on dosimetry wearing compliance is required to interpret and utilize NDR data.

Evaluation of hand-arm vibration(HAV) exposure levels among grounds maintenance workers: An observational human exposure measurement study.

Evaluation of hand-arm vibration(HAV) exposure levels among grounds maintenance workers: An observational human exposure measurement study.

Improving the Risk Assessment of Pesticides through the Integration of Human Biomonitoring and Food Monitoring Data: A Case Study for Chlorpyrifos.

The risk assessment of pesticide residues in food is a key priority in the area of food safety. Most jurisdictions have implemented pre-marketing authorization processes, which are supported by prospective risk assessments. These prospective assessments estimate the expected residue levels in food combining results from residue trials, resembling the pesticide use patterns, with food consumption patterns, according to internationally agreed procedures. In addition, jurisdictions such as the European Union (EU) have implemented large monitoring programs, measuring actual pesticide residue levels in food, and are supporting large-scale human biomonitoring programs for confirming the actual exposure levels and potential risk for consumers. The organophosphate insecticide chlorpyrifos offers an interesting case study, as in the last decade, its acceptable daily intake (ADI) has been reduced several times following risk assessments by the European Food Safety Authority (EFSA). This process has been linked to significant reductions in the use authorized in the EU, reducing consumers’ exposure progressively, until the final ban in 2020, accompanied by setting all EU maximum residue levels (MRL) in food at the default value of 0.01 mg/kg. We present a comparison of estimates of the consumer’s internal exposure to chlorpyrifos based on the urinary marker 3,5,6-trichloro-2-pyridinol (TCPy), using two sources of monitoring data: monitoring of the food chain from the EU program and biomonitoring of European citizens from the HB4EU project, supported by a literature search. Both methods confirmed a drastic reduction in exposure levels from 2016 onwards. The margin of exposure approach is then used for conducting retrospective risk assessments at different time points, considering the evolution of our understanding of chlorpyrifos toxicity, as well as of exposure levels in EU consumers following the regulatory decisions. Concerns are presented using a color code, and have been identified for almost all studies, particularly for the highest exposed group, but at different levels, reaching the maximum level, red code, for children in Cyprus and Israel. The assessment uncertainties are highlighted and integrated in the identification of levels of concern.

Relationship between maternal heavy metal exposure and congenital heart defects: a systematic review and meta-analysis.

Congenital heart defects (CHDs) are one of the major causes of death in infants and young children, and heavy metal exposure during pregnancy is one of the possible risk factors. However, the effect of heavy metal exposure on CHDs is still controversial. We searched English (PubMed, Web of Science) and Chinese (CNKI and WanFang database) databases for relevant articles. The summarized effect sizes and 95% confidence intervals (CIs) were calculated by pooling estimates using the random-effects model. Egger's test was used to estimate publication bias. Heterogeneity among studies was indicated by p-values and I2. Finally, we conducted subgroup analyses to elucidate the causes of heterogeneity. Thirteen studies were included in this meta-analysis. A positive association between maternal exposure to heavy metals and CHDs was found. Pooling odds ratios (ORs) for arsenic, cadmium, mercury, and lead were 2.12, 1.30, 1.22, and 2.30, respectively for total CHDs. Regarding CHD subtypes, arsenic was associated with an increased risk of septal defects (OR: 1.82), barium with left ventricular outflow tract obstruction (LVOTO) (OR: 1.15) and septal defects (OR: 1.21), and lead with conotruncal defects (OR: 2.34) and LVOTO (OR: 1.93). A heterogeneous relationship was found between studies using different methods of measurement, which were mainly due to differences in actual exposure levels to heavy metals. This meta-analysis suggests significant associations between arsenic, cadmium, mercury, and lead exposure during pregnancy and an increased risk of specific CHDs in offspring. These findings underscore the importance of heavy metal exposure during pregnancy in the risk of CHDs in offspring.

Climate change risk: Demands and expectations imposed on banks

For several years, there has been discussion about whether climate change risk is a fundamentally new type of risk or can be subsumed under market, credit, operational and systemic risk in the financial industry. The European Central Bank’s current ‘climate risk stress test’ is a milestone marking a shift in that discussion, from a normative one to a perspective on actual exposures and quantitative data. This shift is linked with regulatory guidelines about how climate change risk should be integrated into banks’ risk frameworks, but also comes with some expectations for banks to actively steer funding to the green transformation. We now understand climate change better than ever and are able to estimate the physical damages it will cause (ie the estimated probability distribution of damages from additional ‘extreme events’). This can be mapped to credit exposures by region (eg river valleys) and by industry segment (eg agriculture) as elaborated in the ‘climate risk stress test’. This paper provides a first step for extending the approach from actual exposures to expected losses by comparing the effects of ‘normal’ weather events with the additional climate-change-related events. However, sophisticated models are required to separate the climate-change-related excess of rare but severe events from extreme weather events that are not related to climate change. In contrast to the earlier static concept of ‘stranded assets’, a ‘transition risk’ would be the result of ‘disorderly’ pathways to a low carbon economy rather than a transparent and consistent road map. A sudden and abrupt increase in the price of carbon (or of greenhouse gas emissions in general) would travel along a transmission chain in the economy, eventually affecting banks’ credit and market risk exposure. Determining the effect of such a step function on an estimated loss distribution is methodologically challenging, especially because there are limited data on historical events. The actual transmission will be even more complicated as political decisions interact with social acceptance and there is a (new) risk of the lack of societal consensus. This paper discusses this challenge, using a schematic model of the political decision on and societal reaction to carbon prices and the consequences for carbon-intensive industry sectors and consumers and citizens. Finally, regulators have expectations of how banks should contribute to a ‘green deal’ and bridge the gap between political commitments and economic measures. This task for the financial services industry — ‘steering credit’ — turns out to be a new source of risk for the societal ‘licence to operate’, into which more insight is required. This paper disentangles the various elements as a step towards a better understanding of the challenges that climate-changerelated risk poses to banks.

TWAc-Check: A New Approach to Determine the Appropriate Use of Time-Weighted Average Concentration in Aquatic Risk Assessment.

In pesticide risk assessment, regulatory acceptable concentrations for surface water bodies (RACsw,ch) are used that are derived from standard studies with continuous exposure of organisms to a test compound for days or months. These RACsw,ch are compared with the maximum tested concentration of more realistic exposure scenarios. However, the actual exposure duration could be notably shorter (e.g., hours) than the standard study, which intentionally leads to an overly conservative Tier 1 risk assessment. This discrepancy can be addressed in a risk assessment using the time‐weighted average concentration (TWAc). In Europe, the applicability of TWAc for a particular risk assessment is evaluated using a complex decision scheme, which has been controversial; thus we propose an alternative approach: We used TWAc‐check (which is based on the idea that the TWAc concept is just a model for aquatic risk assessment) to test whether the use of a TWAc is appropriate for such assessment. The TWAc‐check method works by using predicted–measured diagrams to test how well the TWAc model predicts experimental data from peak exposure experiments. Overestimated effects are accepted because the conservatism of the TWAc model is prioritized over the goodness of fit. We illustrate the applicability of TWAc‐check by applying it to various data sets for different species and substances. We demonstrate that the applicability is case dependent. Specifically, TWAc‐check correctly identifies that the use of TWAc is not appropriate for early onset of effects or delayed effects. The proposed concept shows that the time window is a decisive factor as to whether or not the model is acceptable and that this concept can be used as a potential refinement option prior to the use of toxicokinetic‐toxicodynamic models. Environ Toxicol Chem 2022;41:1778–1787. © 2022 Bayer AG. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Practical application of international recommendations and safety standards in the systematic planning and implementation of remediation of sites or areas with residual radioactive material

The IAEA fundamental safety objective is ‘to protect people and the environment from harmful effects of ionizing radiation’ and this must be done ‘without unduly limiting the operation of facilities or the conduct of activities that give rise to radiation risks’, while ensuring that people and the environment, present and future are protected against radiation risks (IAEA 2006 Fundamental Safety Principles, Safety Fundamentals No. SF-1). In addition, ‘protective actions to reduce existing or unregulated radiation risks must be justified and optimized’ (IAEA 2006 Fundamental Safety Principles, Safety Fundamentals No. SF-1). An international system of radiological protection can be applied such that processes, such as remediation, can be systematically undertaken to address the wide range of ‘existing exposure situations’ present globally. In doing so, decisions made regarding actions undertaken can be demonstrated to be ‘justified’ and ‘optimized’ (i.e. balanced), such that the amount of effort should be commensurate with the risk (applying a ’graded approach’). In addition, protection of people and the environment can be demonstrated by comparing the actual exposure to appropriate criteria over the lifetime of remediation. This paper provides an overview of the current IAEA safety standards on remediation of sites or areas contaminated with residual radioactive material within the international system of radiological protection and provides practical examples of their application through case studies considered in IAEA international model validation programs.

Personal and household PM2.5 and black carbon exposure measures and respiratory symptoms in 8 low- and middle-income countries

BackgroundHousehold air pollution (HAP) from cooking with solid fuels has been associated with adverse respiratory effects, but most studies use surveys of fuel use to define HAP exposure, rather than on actual air pollution exposure measurements. ObjectiveTo examine associations between household and personal fine particulate matter (PM2.5) and black carbon (BC) measures and respiratory symptoms. MethodsAs part of the Prospective Urban and Rural Epidemiology Air Pollution study, we analyzed 48-h household and personal PM2.5 and BC measurements for 870 individuals using different cooking fuels from 62 communities in 8 countries (Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania, and Zimbabwe). Self-reported respiratory symptoms were collected after monitoring. Associations between PM2.5 and BC exposures and respiratory symptoms were examined using logistic regression models, controlling for individual, household, and community covariates. ResultsThe median (interquartile range) of household and personal PM2.5 was 73.5 (119.1) and 65.3 (91.5) μg/m3, and for household and personal BC was 3.4 (8.3) and 2.5 (4.9) x10−5 m−1, respectively. We observed associations between household PM2.5 and wheeze (OR: 1.25; 95%CI: 1.07, 1.46), cough (OR: 1.22; 95%CI: 1.06, 1.39), and sputum (OR: 1.26; 95%CI: 1.10, 1.44), as well as exposure to household BC and wheeze (OR: 1.20; 95%CI: 1.03, 1.39) and sputum (OR: 1.20; 95%CI: 1.05, 1.36), per IQR increase. We observed associations between personal PM2.5 and wheeze (OR: 1.23; 95%CI: 1.00, 1.50) and sputum (OR: 1.19; 95%CI: 1.00, 1.41). For household PM2.5 and BC, associations were generally stronger for females compared to males. Models using an indicator variable of solid versus clean fuels resulted in larger OR estimates with less precision. ConclusionsWe used measurements of household and personal air pollution for individuals using different cooking fuels and documented strong associations with respiratory symptoms.

Exploring a more reasonable temperature exposure calculation method based on individual exposure survey and city-scale heat exposure impact assessment

The inability to quantify the difference between ambient temperature (AT) and personal exposure temperature (PET) is a common limitation in environmental health research. The actual exposure variability is underestimated when we used measurements from fixed monitoring stations to estimate PET. The study aims to explore a more reasonable temperature exposure calculation method to relate PET to AT and links heat exposure to adverse health events. We measured hourly PET of 129 participants from July 8th to July 13th, 2021 in Xinyi City, China. The linear mixed-effects model was used to build the relationship between hourly PET and AT in rural and town. Several calculation methods that can capture the intensity, frequency and duration of daily exposure were used to calculate the daily PET and AT and establish the relationship between the two factors. A generalized linear model was used to establish the relationship between city-scale AT indicators and health endpoints from January 1st, 2013 to December 31st, 2015 in Shanghai, China. The result showed that the hourly PET was significantly related to AT, wind speed, air pressure, precipitation, outside time, and air-conditioning use. Among several daily temperature indicators, we found that ATDHAT (Degree Hours Above Threshold (27.4 °C)) was tight with the PETDHAT in different regions (R2 > 0.99). DHAT strengthened the relationship between daily AT and health endpoint in the urban-scale heat-related health impact study, especially in respiratory diseases. The method proposed in this study can improve the accuracy of future epidemiological studies on the effects of heat exposure.

Using aggregated mobile phone location data to compare the realised foodscapes of different socio-economic groups.

The foodscape (the built food environment) is considered one of the driving factors of the higher burden of obesity and chronic disease observed in low socio-economic status (SES) groups. Traditional data collection methods struggle to accurately capture actual access and exposure to the foodscape (realised foodscape). We assess the use of anonymised mobile phone location data (location data) in foodscape studies by applying them to a case study in Perth, Western Australia to test the hypothesis that lower SES groups have poorer realised foodscapes than high SES groups. Kernel density estimation was used to calculate realised foodscapes of different SES groups and home foodscape typologies, which were compared to home foodscapes of the different groups. The location data enabled us to measure realised foodscapes of multiple groups over an extended period and at the city scale. Low SES groups had poor availability of food outlets, including unhealthy outlets, in their home and realised foodscapes and may be more susceptible to a poor home foodscape because of low mobility.

The Ecological Association between Asbestos Consumption and Asbestos-Related Diseases 15 Years Later.

The Ecological Association between Asbestos Consumption and Asbestos-Related Diseases 15 Years Later.