Adverse Health Impact Research Articles

Secondhand smoke in childhood: The world-wide burden of a major public health-care problem.

Recent evidence attests that the health-care burden of secondhand smoke is particularly high in the childhood.1-3 Since little information is currently available on the epidemiologic relationship between secondhand smoke on health loss or mortality in childhood to the best of our knowledge, we planned this study to specifically address this question. An electronic search was carried out in Global Health Data Exchange registry, a large database of health-related data maintained by the Institute for Health Metrics and Evaluation,4 using the keywords ‘secondhand smoke’ and ‘all causes’ in the categories ‘DALYs’ (disability-adjusted life years) or ‘deaths’. The database search was then combined with the epidemiologic variables ‘year’ (from 1990 to 2017), ‘age’ (from <1 to 9 years old) and ‘location’ (SDI Regions, where SDI stands for socio-demographic index). The 2017 is the last searchable year in the Global Health Data Exchange registry, and was hence selected for reporting updated information on the adverse health impact of secondhand smoke in childhood world-wide. The output of the electronic search was downloaded in comma-separated values, imported into an Excel file (Microsoft, Redmond, WA, USA) and analysed with Analyse-it (Analyse-it Software Ltd., Leeds, UK). Simple (Pearson's correlation) regression analyses were used for assessing potential associations (and their relative 95% confidence interval (95% CI)) among epidemiologic measures. The study was performed in accordance with the Declaration of Helsinki and under the terms of relevant local legislation. Ethics board approval is unnecessary at the local institution (University Hospital of Verona) for articles based on free scientific databases searches. The values of world-wide childhood DALYs and deaths due to secondhand smoke exposure are currently estimated at 5.65 million (1.0% of all DALYs) and 63 823 (1.1% of all deaths), respectively, the vast majority of which (~75%) is in children aged <1 years. The last 28-year world-wide trend (i.e. between 1990 and 2017) is shown in Figure 1, which reveals that both health loss and mortality due to secondhand smoke have dramatically declined, by approximately 80%, during the last 28 years. The reduction of health loss and deaths has been very similar across age ranges, being comprised between 68 and 81% for DALYs and between 72 and 82% for mortality, respectively. Importantly, an inverse linear relationship can be observed between SDI and both childhood DALYs (r = −0.95; 95% CI −1.00 to −0.44; P = 0.012) or deaths (−0.95; 95% CI −1.00 to −0.43; P = 0.013) due to secondhand smoke. Although continuous exposure to secondhand smoke remains a serious public health-care issue in children, since it may cause or predispose to a vast array of health problems such as premature death, sudden infant death syndrome, respiratory infections and asthma, the results of our investigation are in keeping with those published in other reports, suggesting that passive smoking seems to have significantly declined in the past 40 years world-wide.5 This is most likely the result of effective policies of tobacco control and legislations prohibiting cigarette smoke in public spaces, which have been established and recently reinforced in many countries world-wide.5 The second important finding that has emerged from our analysis is that the burden of secondhand smoke on children heath is dramatically magnified in countries with low socio-economic status, which shall hence be targeted with more aggressive policies aimed at limiting secondhand smoke exposure in highly vulnerable subjects such as neonates and children.

Quantifying the impact of changing the threshold of New York City heat emergency plan in reducing heat-related illnesses

The adverse health impact of high heat is widely documented and can lead to a substantial public health burden. Although heat-related illness in western countries is largely preventable, extreme heat remains the main weather contributor to the burden of disease in the United States. In most US cities, local National Weather Service offices issue heat alerts in advance of forecast periods of high heat. In some locations, additional local heat emergency plans that include additional community-based actions to protect the public from the health impacts of heat are also triggered. In 2008, the NYC Health Department made changes in their local heat emergency plan by lowering the threshold for triggering heat advisories based on evidence from local epidemiological studies. This study aims to quantify the potential benefits associated with the change in the threshold the NYC Heat Emergency Plan in reducing heat-related illnesses for Medicare fee-for service beneficiaries aged 65 years or older. We apply a quasi-experimental study design using the Difference-in-Differences (DID) method coupled with the propensity-score matching and compare the difference in daily rates of heat-related illnesses between eligible and non-eligible days before and after implementing the threshold change (2006–2007 versus 2009–2010). We reveal that the change in threshold for the NYC Heat Emergency Plan is associated with reduced daily number of 0.80 (95%CI: 0.27; 1.33) Heat-related Illnesses during hot days as compared to a counterfactual scenario in which the original threshold did not change. This highlights the benefits of local epidemiological evidence in informing emergency heat action plans, in decreasing the health burden of high ambient heat.

Recent advancements in visible-light-assisted photocatalytic removal of aqueous pharmaceutical pollutants

Pharmaceuticals are one of the persistent emerging contaminants that are ubiquitous in the aquatic environment due to their extensive application as human and veterinary medicines. The ecotoxicity and microbial resistance are considered to be major adverse environmental and health impact of pharmaceuticals even in trace amounts, which raise global concern. The recalcitrant nature of these pollutants restricts the application of the conventional treatment system for their remediation and triggers extensive research on the various advanced oxidation processes as a promising treatment system. Among them, visible-light-assisted semiconductor photocatalysis has significant potential as an efficient, low-cost, and green technology, which can use even solar energy as a clean and sustainable light source. A comprehensive review on the application of various visible light photocatalysts on the degradation of aqueous pharmaceutical pollutants was attempted to highlight their physiochemical properties, reaction mechanism, and catalytic activity in the laboratory- as well as field-scale operations. The challenges and gaps in the current literature have been identified, and recommendations for prospective research opportunities have been placed based on the findings.

Role of Autophagy in Zinc Oxide Nanoparticles-Induced Apoptosis of Mouse LEYDIG Cells

Zinc oxide nanoparticles (ZnO NPs) have shown adverse health impact on the human male reproductive system, with evidence of inducing apoptosis. However, whether or not ZnO NPs could promote autophagy, and the possible role of autophagy in the progress of apoptosis, remain unclear. In the current study, in vitro and in vivo toxicological responses of ZnO NPs were explored by using a mouse model and mouse Leydig cell line. It was found that intragastrical exposure of ZnO NPs to mice for 28 days at the concentrations of 100, 200, and 400 mg/kg/day disrupted the seminiferous epithelium of the testis and decreased the sperm density in the epididymis. Furthermore, serum testosterone levels were markedly reduced. The induction of apoptosis and autophagy in the testis tissues was disclosed by up-regulating the protein levels of cleaved Caspase-8, cleaved Caspase-3, Bax, LC3-II, Atg 5, and Beclin 1, accompanied by down-regulation of Bcl 2. In vitro tests showed that ZnO NPs could induce apoptosis and autophagy with the generation of oxidative stress. Specific inhibition of autophagy pathway significantly decreased the cell viability and up-regulated the apoptosis level in mouse Leydig TM3 cells. In summary, ZnO NPs can induce apoptosis and autophagy via oxidative stress, and autophagy might play a protective role in ZnO NPs-induced apoptosis of mouse Leydig cells.

Adverse Health and Environmental Impacts of Poor Infrastructure Management in Local Market Facilities

Objectives: This study aims to suggest infrastructure management facilities for a well-planned slaughterhouse, furthermore, proposed a systematic slaughterhouse infrastructure with modernized facilities including orientation, circulation areas, waste disposal and effluent disposal methods. Methods/Analysis: The stratified research sample was taken in the form of focused group discussions and interviews. The qualitative data thus gathered from environmentalist, civil engineers, construction managers, architects and planners to workout facility management plan for slaughterhouse. Findings: The results outlined that poor slaughterhouse infrastructure planning and management poses great threat to the human health and society by disseminating several diseases. Thereof, study concluded that the infrastructure planning can play positive and effective role to mitigate the concerned issues. Novelty/Improvement: None of the work has focused on infrastructure planning to resolve the health and environmental issues arising from the slaughterhouse’s wastages. This research is novel contribution in recommending the infrastructure planning solutions. Keywords: Health and Environment, Hyderabad, Infrastructure, Slaughter House Waste (SHW)

Older People With Type 2 Diabetes-Individualizing Management With a Specialized (OPTIMISE) Community Team: Protocol for a Safety and Feasibility Mixed Methods Study.

BackgroundThe prevalence of diabetes is rising in older people. In 2018, over 574,000 Australians reported having diabetes. The highest prevalence (19.4%) of diabetes has been observed in people aged 85 years and older. Clinical guidelines recommend that diabetes management should be individualized; however, there is limited information regarding the current management patterns of diabetes in older people, given most clinical trials exclude participants from this age group. Available data identify that few individuals achieve optimal glycemic levels in the general population, potentially leading to adverse health outcomes and impact on quality of life. The data on glycemic profiles of older population are limited.ObjectiveThe aim of this study is to examine individualized diabetes management intervention for older people through home visits with a credentialed diabetes educator (CDE) and telehealth consultations with an endocrinologist located at a tertiary hospital.MethodsThis paper describes the design and methodology of a mixed methods feasibility and safety study to identify the current management of type 2 diabetes in people aged 65 years or older. We will implement and evaluate a personalized approach to management in the community of an Australian metropolitan city. This management approach will utilize flash glucose monitoring and home visits with the support of a community home nursing service CDE and telehealth consultation with an endocrinologist located at a local tertiary hospital.ResultsThe study commenced in February 2017 and has recruited 43 participants, with final data collection to be completed by July 2019. Data analysis will commence after final data collection, with results expected to be published by the end of 2019.ConclusionsThis study is the first of its kind to explore individualized diabetes management for community-dwelling older people, with an aim to achieve optimal glycemic levels (glycated hemoglobin between 53 and 69 mmol/mol [7%-8.5%] depending on the fitness and frailness of the older individual). The data drawn from this study may be used to inform policy makers, service providers, clinicians, and older adults living with diabetes.International Registered Report Identifier (IRRID)DERR1-10.2196/13986

Association between Weather Types based on the Spatial Synoptic Classification and All-Cause Mortality in Sweden, 1991⁻2014.

Much is known about the adverse health impact of high and low temperatures. The Spatial Synoptic Classification is a useful tool for assessing weather effects on health because it considers the combined effect of meteorological factors rather than temperature only. The aim of this study was to assess the association between oppressive weather types and daily total mortality in Sweden. Time-series Poisson regression with distributed lags was used to assess the relationship between oppressive weather (Dry Polar, Dry Tropical, Moist Polar, and Moist Tropical) and daily deaths over 14 days in the extended summer (May to September), and 28 days during the extended winter (November to March), from 1991 to 2014. Days not classified as oppressive weather served as the reference category. We computed relative risks with 95% confidence intervals, adjusting for trends and seasonality. Results of the southern (Skåne and Stockholm) and northern (Jämtland and Västerbotten) locations were pooled using meta-analysis for regional-level estimates. Analyses were performed using the dlnm and mvmeta packages in R. During summer, in the South, the Moist Tropical and Dry Tropical weather types increased the mortality at lag 0 through lag 3 and lag 6, respectively. Moist Polar weather was associated with mortality at longer lags. In the North, Dry Tropical weather increased the mortality at shorter lags. During winter, in the South, Dry Polar and Moist Polar weather increased mortality from lag 6 to lag 10 and from lag 19 to lag 26, respectively. No effect of oppressive weather was found in the North. The effect of oppressive weather types in Sweden varies across seasons and regions. In the North, a small study sample reduces precision of estimates, while in the South, the effect of oppressive weather types is more evident in both seasons.

Health risk assessment of heavy metals in soil samples from an abandoned industrial waste dumpsite in Ibadan, Nigeria.

This study was carried out to determine the concentrations of heavy metals in the soil samples collected from an abandoned lead acid battery (LAB) industrial waste dumpsite in Ibadan, southwestern Nigeria. This was to assess the potential risks of the heavy metals on human due to exposure among local residents (children and adults) of the area. Forty (40) soil samples were collected over the entire dumpsite at 0-20cm depth. The elemental concentrations of Pb, Cr, Cd, Zn, Cu, and Ni were measured using an atomic absorption spectrophotometer (AAS) technique. The contamination load was estimated by employing index of geoaccumulation (Igeo) and potential human health risks due to multiple exposure pathways (inhalation, dermal absorption, and ingestion) were estimated using the risk-based equations and exposure parameters developed by the United States Environmental Protection Agency (USEPA). The average concentrations (± standard deviation) of Pb, Cr, Cu, Mn, Cd, Ni, and Zn were 3.79 ± 2.16, 8.36 ± 3.90, 7.77 ± 2.70, 7.75 ± 3.10, 4.31 ± 0.82, 3.09 ± 2.29, and 3.07 ± 1.74μg/g, respectively. The mean values of Igeo follow the order of Mn < Cr < Pb = Ni < Zn < Cu < Cd. The dermal contact with the heavy metals appeared to be the major route of exposure to children followed by inhalation and ingestion. Inhalation is the main route of exposure for the adults. The hazard quotients (HQ) of all the heavy metals are lower than 1, implying that the adverse health impact on the children and adult exposed to heavy metals from the dumpsite was relatively moderate. The hazard index (HI) values of Cd were 2.0 and 1.2 for exposed adults and children, respectively. The carcinogen risks for inhalation exposure ranged from 2.3 × 10-6 to 6.4 × 10-6, which falls within the acceptable limit of 10-4 to 10-6. There is concern over the potential health risk of the local residents, most especially the children living in the vicinity of the dumpsite due to the possibility of dispersal of heavy metals to the entire community, leading to long-life exposure and residents' detrimental health.

In Plasma Catalytic Oxidation of Toluene Using Monolith CuO Foam as a Catalyst in a Wedged High Voltage Electrode Dielectric Barrier Discharge Reactor: Influence of Reaction Parameters and Byproduct Control.

Volatile organic compounds (VOCs) emission from anthropogenic sources has becoming increasingly serious in recent decades owing to the substantial contribution to haze formation and adverse health impact. To tackle this issue, various physical and chemical techniques are applied to eliminate VOC emissions so as to reduce atmospheric pollution. Among these methods, non-thermal plasma (NTP) is receiving increasing attention for the higher removal efficiency, non-selectivity, and moderate operation, whereas the unwanted producing of NO2 and O3 remains important drawback. In this study, a dielectric barrier discharge (DBD) reactor with wedged high voltage electrode coupled CuO foam in an in plasma catalytic (IPC) system was developed to remove toluene as the target VOC. The monolith CuO foam exhibits advantages of easy installation and controllable of IPC length. The influencing factors of IPC reaction were studied. Results showed stronger and more stable plasma discharge in the presence of CuO foam in DBD reactor. Enhanced performance was observed in IPC reaction for both of toluene conversion rate and CO2 selectivity compared to the sole NTP process at the same input energy. The longer the contributed IPC length, the higher the toluene removal efficiency. The toluene degradation mechanism under IPC condition was speculated. The producing of NO2 and O3 under IPC process were effectively removed using Na2SO3 bubble absorption.

The SMART Moms Program: A Randomized Trial of the Impact of Stress Management on Perceived Stress and Cortisol in Low-Income Pregnant Women

BackgroundDysregulations in maternal hypothalamus-pituitary-adrenal function and the end product, cortisol, have been associated with a heightened risk for stress-related health complications during pregnancy and post partum. Given the adverse health impact that maternal cortisol may have on expectant mothers and their infants, empirically-based prenatal interventions are needed to target optimal management of stress and its biological effects in at-risk pregnant women, a primary example of which is cognitive behavioral stress management (CBSM). This randomized-controlled trial examined the effects of a prenatal CBSM intervention on reduction in perceived stress and regulation of salivary cortisol patterns [i.e., overall cortisol output (area under the curve), cortisol awakening response (CAR), diurnal slope] during pregnancy and the early postpartum period, as compared to a control group. MethodsOne hundred low-income pregnant women (71% Latina; 76% annual income < $20 K) with low or high anxiety during pregnancy were randomized (stratified by anxiety) to either an eight-week CBSM group intervention (n = 55) or a control group (n = 45). They provided seven salivary cortisol samples (four am samples, 12 pm, 4 pm, and 8 pm samples on one collection day) at baseline (1st trimester; < 17 weeks of gestation), after their prenatal program (2nd trimester), and also in the third trimester and at three months post partum. ResultsWomen receiving CBSM had lower perceived stress levels throughout pregnancy and early post partum compared to women in the control group (p = .020). Among women with high prenatal anxiety, those in CBSM showed a steeper decline in their diurnal cortisol at three months post partum compared to those in the control group (p = .015). Further, non-Latina women in CBSM had a lower CAR at three months post partum compared to non-Latina women in the control group (p = .025); these randomization group differences on the CAR were not observed among Latina women. ConclusionsThese findings provide preliminary support for the efficacy of prenatal CBSM interventions in improving stress outcomes among low-income pregnant women and suggest the need to test the effects of these interventions on a larger scale for improving maternal and infant health outcomes long-term.

Appraisal of thermal comfort in rural household kitchens of Punjab, India and adaptation strategies for better health

There is increasing evidence of adverse health impact of solid biomass fuel, and its use may hinder thermal comfort, which may lead to lower quality of life. Hence, current study aims to assess the thermal comfort at a rural location of Punjab, India. The indoor air temperature and relative humidity in rural households during winter varied from 11.9–25.2 °C and 63.4–90.5% respectively, during pre-summer it ranged between 21.3 and 27.4 °C and 48.4–78.4% while during summer it ranged between 28.4 and 37.8 °C and 13.7–63.8% respectively. The PMV of the households ranged between −0.85 to 0.69 (winter), −0.32 to 0.4 (pre-summer) and 0.53 to 1.25 (summer) for American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) 55-2017 and −0.56 to 1.11 (winter), 0.04 to 0.99 (pre-summer) and 1.21–2.36 (summer) for European Committee for Standardization (CEN) European standard EN15251 while the Predicted Percentage of Dissatisfied ranged between 5 and 20% (winter), 5–8% (pre-summer) and 11–38% (summer) for ASHRAE 55-2017 and 5–31% (winter), 5–26% (pre-summer) and 36–90% (summer) for EN15251 guidelines. On the other hand, Adaptive thermal comfort (ATC) during winter and pre-summer was comfortable for 80 and 90% acceptable limits (ASHRAE-2017) and ranged between too cool to comfortable for EN15251 (Class I, II and III) while during summer thermal comfort for occupants was comfortable for ASHRAE 2017 and EN15251 (Class I, II, III) but did not comply with EN guidelines in some households using either clean fuel or chullah. Thermal comfort sensation was observed to be slightly cool to neutral during winter, neutral during pre-summer and slightly warm during summer according to Predicted Mean Vote method. The results were also compared using a thermal comfort and household survey and found to be similar with the model results. Climate change is leading to changes in temperature which may have an impact on the built environment. Hence, the current study suggests formulating policies on the uses of household fuel and design of kitchen with proper ventilation to increase thermal comfort which in turn will also reduce air pollutants.

Analysis of Mould Growth Causes in Higher Education Library Indoor Environment

This paper presents an analysis of mould growth causes that be found in an indoor library environment. The visual inspection had been conducted to identify visible mould in the indoor library environment. Three higher education institution libraries in Malaysia were selected as a case study. The identified mould species on the site were analysed using mould growth germination factors and possible causes that related to the growth. The result confirmed mould species such as Aspergillus, Penicillium, Stachybotrys’s identified as a common mould growth found in the three library buildings. The analysis of mould growth causes is important for this study as is to confirm the relationship with the mould found in this building which may result in adverse health impact, environment, material and archive in the library. The result also can become guidelines and best practices for library management regarding good indoor environmental quality.

Differential Hepatic Gene Expression Profile of Male Fathead Minnows Exposed to Daily Varying Dose of Environmental Contaminants Individually and in Mixture.

Environmental contaminants are known to impair reproduction, metabolism and development in wild life and humans. To investigate the mechanisms underlying adverse effects of contaminants, fathead minnows were exposed to a number of endocrine disruptive chemicals (EDCs) including Nonylphenol (NP), bisphenol-A (BPA), Di(2-ethylhexyl) phthalate (DEHP), and a mixture of the three chemicals for 21 days, followed by determination of the liver transcriptome by expression microarrays. Pathway analysis revealed a distinct mode of action for the individual chemicals and their mixture. The results showed expression changes in over 980 genes in response to exposure to these EDC contaminants individually and in mixture. Ingenuity Pathway core and toxicity analysis were used to identify the biological processes, pathways and the top regulators affected by these compounds. A number of canonical pathways were significantly altered, including cell cycle & proliferation, lipid metabolism, inflammatory, innate immune response, stress response, and drug metabolism. We identified 18 genes that were expressed in all individual and mixed treatments. Relevant candidate genes identified from expression microarray data were verified using quantitative PCR. We were also able to identify specific genes affected by NP, BPA, and DEHP individually, but were also affected by exposure to the mixture of the contaminants. Overall the results of this study provide novel information on the adverse health impact of contaminants tested based on pathway analysis of transcriptome data. Furthermore, the results identify a number of new biomarkers that can potentially be used for screening environmental contaminants.

E-cigarette Use and Subsequent Smoking Frequency Among Adolescents.

Data were pooled from 3 prospective cohort studies in California and Connecticut (baseline: 2013-2014; follow-up: 2014-2016; N = 6258). Polytomous regression models were used to evaluate the association of baseline e-cigarette use (never or ever) with cigarette use frequency at follow-up (experimental: initiation but no past-30-day use; infrequent: 1-2 of the past 30 days; frequent: 3-5 or more of the past 30 days). Polytomous regression models were also used to evaluate transitions between baseline ever or past-30-day single or dual product use and past-30-day single or dual product use at follow-up. Among baseline never smokers, e-cigarette users had greater odds of subsequent experimental (odds ratio [OR] = 4.58; 95% confidence interval [CI]: 3.56-5.88), infrequent (OR = 4.27; 95% CI: 2.75-6.62) or frequent (OR = 3.51; 95% CI: 1.97-6.24) cigarette use; the 3 OR estimates were not significantly different. Baseline past-30-day exclusive cigarette use was associated with higher odds at follow-up of exclusive cigarette or dual product use than of exclusive e-cigarette use. Tobacco control policy to reduce adolescent use of both e-cigarettes and cigarettes is needed to prevent progression to more frequent tobacco use patterns and reduce combustible cigarette use (with or without concurrent e-cigarette use) to lessen the adverse public health impact of e-cigarettes.

Respiratory Symptoms, Knowledge and Attitude among Male Smoker Students in Mutah University, Jordan

Smoking phenomenon has become one of the leading public health burdens. Smoking prevalence among university students in Jordan was unexpectedly elevated, with a lot of serious respiratory consequences like respiratory symptoms, diseases and lung function impairment. The chief purpose of this study was to assess the adverse respiratory health impact of smoking, also to evaluate student’s attitudes toward and knowledge about smoking habit among Mutah university male students. A cross sectional design was chosen. Using a randomly selected, cluster sampling technique at Mutah University students including all colleges and levels, the total participants were 204 male students (Jordanian). A per-designed questionnaire was used to collect information adopted from Global Adult Tobacco Survey (GATS), and anthropometrics measurements and lung function indices following the standard recommendations (ATS). Health indicators were calculated. Data were analyzed using SPSS (ver.22). A higher, shocking prevalence was identified (71%); adverse respiratory health effects were noticed, in addition to pulmonary function tests impairments, other important findings were poor knowledge of the study participants about smoking hazards, and positive attitude toward smoking. The smoking rate among male university students was very high; nevertheless most of them have short duration of smoking the respiratory health impact was noticed. Most of current smokers (male students) have the desire to quit smoking. Antismoking campaign was highly recommended among Jordanian university students In order to encourage a smoking free life style, additionally leisure time activities should be incorporated.

Chemical and mineral composition of fly ashes from home furnaces, and health and environmental risk related to their presence in the environment

The study presents the results of an analysis of fly ashes produced from burning of solid fuels mixed with municipal waste and assesses the environmental and health risk associated with infiltration of the selected metals to the environment. The phase composition suggests that the material is extremely mixed and diverse. Low-temperature components were mixed with substances formed in high temperatures. The variable composition of waste from different home furnaces with high content of the amorphous phase (which dissolves in water more easily than its crystalline equivalents) may be harmful to the environment and for the people. The dominant elements were silicates and aluminosilicates, such as: quartz, feldspar and plagioclase (albite). Clay minerals (kaolinite and mullite), carbonates (calcite), oxides/oxidehydroxides of iron and sulfate minerals (gypsum and anhydrite) were also abundant. The particles' major constituents were Si, Al, Ca and Fe oxides (85.5%), while S, Mg, Na, K and Ti oxides accounted for 12.6% of the total content. The risk assessment code suggested: Low Risk for As, Co, Cr, Ni, Medium Risk for Cd, Cu and Pb, and High Risk for Zn. Hazard Index (HI) calculated for non-cancerogenic substances for children was 2.35E+00. The total Risk index for children was 4.88E-05. As for adults, HI was 2.42E-01 for women, and 2.89E-01 for men, while the Risk index value was 6.85E-05 for women, and 8.48E-05 for men. The value HI > 1 points to the risk of adverse health impact on children exposed to fly ashes.

Mortality and morbidity due to ambient air pollution in Iran

IntroductionAir pollution is an emerging risk factor for human health like cancer and other health outcomes in developing countries, especially in Iran where air pollutants concentrations are high. However, the data on health effects of air pollution are limited. ObjectiveIn this study, we have estimated the mortality for all causes (TM) and for cardiovascular diseases (CM), as well as the number of hospital admissions due to cardiovascular (HA-CVD) and respiratory diseases (HA-RD), chronic obstructive pulmonary diseases (HA-COPD), and acute myocardial infarction (AMI) due to exposure to common air pollutants. Materials and MethodsIn our study, the World Health Organization (WHO) method was applied to assess the mortality and morbidity rates from published relative risk (RR) and baseline incidence (BI) values. ResultsThe results showed that 4.60% (95% CI: 3.50–5.31%) TM, 4.96% (95% CI: 3.16–10.50%) CM, 4.97% (95% CI: 3.04–6.81%) HA-RD, 5.55% (95% CI: 3.77–7.82%) HA-CVD, 2.50% (95% CI: 0–4.61%) HA-COPD and 4.73% (95% CI: 1.14–4.65%) AMI, respectively can be attributed to daily PM10 and SO2 concentrations exceeding 10μg/m3. ConclusionTo reduce the adverse health impact of air pollution, health advices and recommendations by local health authorities should be given to general population especially for vulnerable people i.e. children, elderly or people with chronic lung and cardiac pathologies during the dusty days.

Soil-transmitted helminth infections associated with wastewater and sludge reuse: a review of current evidence.

ObjectiveTo review current evidence on infections related to the concentration of soil‐transmitted helminth (STH) eggs in wastewater, sludge and vegetables irrigated with wastewater or grown on sludge‐amended soils.MethodSearch of Web of Science, Science Direct, PubMed and Google Scholar databases for publications reporting on STH egg concentration in wastewater, sludge and vegetables and for epidemiological studies on wastewater/sludge reuse and STH infections.Results STH egg concentrations were variable but high in wastewater and sludge especially in developing countries. They ranged from 6 to 16 000 eggs/L in wastewater and from 0 to 23 000 eggs/g in sludge and far exceed limits set in the WHO guideline for wastewater/sludge reuse. Numbers of STH eggs on vegetables ranged from 0 to 100 eggs/g. The concentration of STH eggs in wastewater, sludge and vegetables therefore relates to risks of infection through different exposure routes.ConclusionEpidemiological evidence reveals an increased prevalence of STH infections associated with direct exposure to wastewater or sludge (farmers) and consumption of vegetables grown on soil treated with it. This calls for increased efforts to reduce the adverse health impact of wastewater and sludge reuse in line with the WHO multi‐barrier approach.

The Burden of Disease Hospitalization due to Coal Burning in Beijing

Background/Aim: Coal plays an irreplaceable role in the energy use in China, however, it causes severe air pollution and adverse health impacts, i.e. outpatient /emergency visit, hospital admission, and death. Hospital admission of the exposed population costs large direct medical expenses, but its quantitative estimate is rarely studied in China. In this article we evaluated the direct economic burden caused by hospital admissions due to coal burning in Beijing. Methods: The data of daily air quality and hospital admissions with the related medical expenses for ischemic heart disease (IHD), lung cancer (LC), chronic obstructive pulmonary disease (COPD) and stroke in Jan 1st, 2013-Oct 22nd, 2014 were collected in Beijing. Time series study using a generalized additive model was used to evaluate the exposure-response relationship between PM2.5 concentration and hospital admission (for the four diseases as a whole and each). With the contribution rate of coal burning for PM2.5 and the insurance rate in Beijing, the extra hospital admissions caused by coal burning was estimated, and then the mean medical expenses were used to figure out the economic burden. Results: The daily average concentration of PM2.5 was 89.90 (6.28-397.30) μg/m3 during the study period. 162,009 patients were admitted for the four diseases, with a daily average of 247 inpatients. An increase of 10μg/m3 of PM2.5 could increase the risk of hospital admission for the four diseases by 0.66% (95%CI: 0.59%, 0.73%). Accordingly, at least 2287 extra inpatients occurred because of coal burning, with the total economic loss of 65.69 million RMB. The highest two extra inpatient numbers were from IHD (at least 898, 39.27%) and stroke (at least 868, 37.95%), which caused about 41.85% and 28.94% of the total medical expenses. Conclusions: Coal burning caused adverse health impact and huge economic burden on the exposed population in Beijing, especially on IHD and stroke patients.

Current Cigarette Smoking Among Adults - United States, 2016.

The U.S. Surgeon General has concluded that the burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products (1). Cigarettes are the most commonly used tobacco product among U.S. adults, and about 480,000 U.S. deaths per year are caused by cigarette smoking and secondhand smoke exposure (1). To assess progress toward the Healthy People 2020 target of reducing the proportion of U.S. adults aged ≥18 years who smoke cigarettes to ≤12.0% (objective TU-1.1),* CDC analyzed data from the 2016 National Health Interview Survey (NHIS). In 2016, the prevalence of current cigarette smoking among adults was 15.5%, which was a significant decline from 2005 (20.9%); however, no significant change has occurred since 2015 (15.1%). In 2016, the prevalence of cigarette smoking was higher among adults who were male, aged 25-64 years, American Indian/Alaska Native or multiracial, had a General Education Development (GED) certificate, lived below the federal poverty level, lived in the Midwest or South, were uninsured or insured through Medicaid, had a disability/limitation, were lesbian, gay, or bisexual (LGB), or had serious psychological distress. During 2005-2016, the percentage of ever smokers who quit smoking increased from 50.8% to 59.0%. Proven population-based interventions are critical to reducing the health and economic burden of smoking-related diseases among U.S. adults, particularly among subpopulations with the highest smoking prevalences (1,2).