Environmental Preventive Measures Research Articles

The effect of portable air-purifiers in improving indoor air quality in pediatric intensive care units at two tertiary hospitals in Riyadh, Saudi Arabia

Background: A set of environmental preventive measures involving ventilation control within healthcare facilities is well established. Portable air purifiers have been introduced in recent years as one of alternative technologies used to prevent infection and other respiratory complications in indoor environment. Objective: To asses indoor air quality in pediatric intensive care units at two tertiary hospitals in Riyadh, Saudi Arabia in the presence and absence of portable air purifiers.Method: Fine particles (PM 2.5) and coarse particles (PM10) were obtained using optical particle counter and microbial counts were obtained using Andersen air sampler from outdoor and two patient rooms in pediatric intensive care units. Pollutants levels reduction between outdoor and indoor were calculated and compared using Statistical Package for the Social Sciences software (SPSS Version 27.0. Armonk, NY: IBM Corp) were utilized for statistical analysis. Results: In hospital A and B, non-protective environment room (NPE) had a significantly higher number of fine particles and total bacterial count (TBC) respectively than semi-protective environment room (SPE). Meanwhile, there was significantly higher reductions of fine particles (hospital A) and coarse particles, fine particles and TBC (hospital B) in SPE rooms compared with NPE room. Hospital-A had significantly higher reduction efficacy compared with matched rooms in hospital-B for fine particles, coarse particles, and TBC. Conclusion: This study demonstrated that portable air purifiers have a great impact in the reduction of indoor air pollutants in PICUs including fine particulate matters and TBC in particular. Furthermore, ventilation systems equipped with HEPA filters along with portable air purifiers significantly reduce the levels indoor air pollutants of outdoor sources. Moreover, this study showed that newer and well-maintained HVAC systems play a significant role in controlling the levels of airborne pollutants.

Bioaccumulation Behavior and Human Health Risk of Polybrominated Diphenyl Ethers in a Freshwater Food Web of Typical Shallow Lake, Yangtze River Delta.

Polybrominated diphenyl ethers (PBDEs) have been commonly found in aquatic ecosystems. Many studies have elucidated the bioaccumulation and biomagnification of PBDEs in seas and lakes, yet few have comprehensively evaluated the bioaccumulation, biomagnification, and health risks of PBDEs in shallow lakes, and there is still limited knowledge of the overall effects of biomagnification and the health risks to aquatic organisms. In this study, a total of 154 samples of wild aquatic organism and environmental samples were collected from typical shallow lakes located in the Yangtze River Delta in January 2020. The concentrations of PBDEs were determined by an Agilent 7890 gas chromatograph coupled and an Agilent 5795 mass spectrometer (GC/MS) and the bioaccumulation behavior of PBDEs was evaluated in 23 aquatic organisms collected from typical shallow lakes of the Yangtze River Delta. Furthermore, their effects on human health were evaluated by the estimated daily intake (EDI), noncarcinogenic risk, and carcinogenic risk. The concentrations of ΣPBDE (defined as the sum of BDE-28, -47, -100, -99, -153, -154, -183, and -209) in biota samples ranged from 2.36 to 85.81 ng/g lipid weight. BDE-209, BDE-153 and BDE-47 were the major PBDE congeners. The factors affecting the concentration of PBDEs in aquatic organisms included dietary habits, species, and the metabolic debromination ability of the PBDE congeners. BDE-209 and BDE-47 were the strongest bioaccumulative PBDE congeners in aquatic organisms. Additionally, except for BDE-99, BDE-153 and BDE-154, the trophic magnification factor (TMF) values of PBDE congeners were significantly higher than 1. Moreover, the log Kow played a significant role in the biomagnification ability of PBDE congeners. The noncarcinogenic risk of PBDE congeners and carcinogenic risk of BDE-209 from aquatic products were lower than the thresholds. PBDE congeners were bioaccumulated and biomagnified to varying degrees in aquatic organisms from typical shallow lakes. Both the noncarcinogenic and carcinogenic risks assessment of edible aquatic products indicated that none of the PBDE congeners pose health risks to the localite. This study will provide a basis for a comprehensive assessment of PBDEs in aquatic ecosystems in shallow lakes and for environmental prevention measures for decision-makers.

Particulate Matter Exposure after a Cancer Diagnosis and All-Cause Mortality in a Regional Cancer Registry-Based Cohort in South Korea.

Although particulate matter (PM) is a Group 1 carcinogen, few studies have evaluated the effect of PM exposure after a cancer diagnosis on survival. Herein, we evaluated the effect of exposure to ambient PM10 after a cancer diagnosis on survival using data from the Regional Cancer Registry cohort in Chungbuk Province, Korea. A total of 44,432 patients with cancer who survived for >1 year after being diagnosed between 2005 and 2018 were followed until 31 December 2019; there were 32,734 survivors (73.7%) and 11,698 deceased (26.3%). The average follow-up period was 67.7 months, and the cumulative average concentration of PM10 exposure of patients with cancer after a diagnosis was 49.0 µg/m3. When PM10 concentration increased by 1 standard deviation (5.2 µg/m3), the all-cause mortality risk increased 2.06-fold (95% CI: 2.02–2.11). This trend was most pronounced in the younger patient group and in patients with local-stage cancer. This study demonstrates that exposure to PM10 after cancer diagnosis might influence the survival of patients with cancer, requiring environmental preventive measures such as lower pollutant exposure.

Mixed Outbreak of Falciparum and Vivax Malaria and Dengue Fever Among the Egyptian Five-a-Side Ball Team Returning From Nigeria After Participation in the African Cup of Nations (Egypt, July 2021)

Background On July 28, 2021, the Port Saeed health directorate was reported of a team member of the Egyptian five-a-side ball team who was admitted to the Port Saeed Fever Hospital on the same day with acute onset of high fever, headache, malaise, and delirium. The patient has recently returned from Nigeria with his teammates after participation in the African Cup of Nations. On asking the patient about other cases among his teammates, he informed of 1 who started to feel sick in Nigeria and was quarantined in the Abasia Fever Hospital in Cairo and another 2 who were currently at their homes in Port Saeed. Objective This study aims to confirm an outbreak, identify possible causes, and implement necessary control measures. Methods All 26 team members were contacted in their governorates. Active case finding among them and their contacts was performed using sensitive case definition. A case was defined as anyone from the Egyptian five-a-side ball team returning from Nigeria or their contacts who complained of sudden onset of fever, malaise, or respiratory or gastrointestinal symptoms. Symptomatic patients were swabbed for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR). Blood samples were collected for malaria film and immunoglobulin M (IgM) for dengue testing. Results Of 26 team members, 7 (27%) complained of symptoms, with an attack rate of 26.9%. Their mean age was 37.1 (8.6) years, and all of them were males. Of the 7 cases, 6 (86%) were from Port Saeed, their clinical symptoms ranged from fever (n=3, 43%) malaise (n=7, 100%), headache (n=4, 57%), nausea (n=3, 43%), and delirium (n=1, 14%). Laboratory testing confirmed 4 (57%) cases with malaria falciparum, including 1 (14%) positive for COVID-19. In addition, the blood film of 2 (28%) patients showed malaria falciparam and vivax, and 1 (14%) patient was positive for SARS-CoV-2 and dengue. All patients recovered and were discharged from the hospitals. Patients did not receive malaria prophylaxis before traveling, and they were sleeping in tents near a forest, where they exposed to mosquito bites. A vector survey was performed, and mosquito spraying and larvae destruction near the residential areas of all team members were implemented. Conclusions An outbreak of malaria and dengue occurred among the Egyptian five-a-side ball team that recently returned from Nigeria. The outbreak was caused by defective malaria-preventive measures with no prophylaxis. Outbreak was controlled through early patient detection, isolation, and treatment. In addition to entomological and environmental preventive measures, it is necessary to ensure that all sports teams traveling to malaria- and dengue-endemic areas receive prophylaxis and apply protective measures against mosquito bites.

Prevalence and characteristics of tobacco and cannabis co-use in 15-year-old students in Slovenia

Introduction: While the co-use of tobacco and cannabis is common among adolescents, no data on this topic is currently available for Slovenia. The purpose of this study was therefore to explore the prevalence and characteristics of tobacco and cannabis co-use in 15-year-old students in Slovenia.Methods: We analysed the data obtained from a representative sample of 15-year-old Slovene students (n = 1615) who took part in the 2014 Health Behaviour in School-Aged Children international cross-sectional survey, and performed a chi-square test and multivariate logistic regression analyses.Results: Lifetime tobacco and cannabis use was reported by 19.5 % of 15-year-old students with no gender difference (p = 0.108) and was associated with history of drunkenness (OR = 8.18, 95 % C.I. 5.74−11.64), friends' use of cannabis (OR = 3.93, 95 % C.I. 2.67−5.79) and tobacco (OR = 1.83, 95 % C. I. 1.25−2.69), and with lower perceived family support (OR = 0.88, 95 % C.I. 0.80−0.97). Current co-use was reported by 7.2 % with no gender difference (p = 0.136) and was associated with a history of drunkenness (OR = 8.06, 95 % C.I. 4.43−14.67), friends' use of cannabis (OR = 3.72, 95 % C.I. 2.23−6.19) and living in a reconstructed family (OR = 3.33, 95 % C. I. 1.74−6.40).Discussion and conclusion: Our study advocates for expanding preventive and cessation programmes from one to more psychoactive substances. Peers and family are the key factors which need to be addressed in theseprogrammes. They can be reached through the school and healthcare systems. Environmental prevention measures, including legislative measures, create environments promoting healthy choices and thus contribute to the reduction of such co-use.

Identification and Prioritization of Environmental Reproductive Hazards: A First Step in Establishing Environmental Perinatal Care.

In 2015, the International Federation of Gynecology and Obstetrics established the prevention of exposures to environmental reprotoxic substances as a priority for health professionals. However, available information about reproductive hazards is voluminous, dispersed, and complex, and this is a severe limitation for physicians to incorporate the prevention of environmental exposure into standard preventive care. One difficulty frequently cited by physicians is the lack of evidence-based information. The objective of our study was to identify a list of environmental chemical hazards to reproduction. We used lists present in relevant regulations or included in scientific reports or databases to identify reproductive hazards. The reproductive hazards were prioritized according to the strength of evidence concerning their impact on fertility or development of the offspring. We identified 1251 reproductive hazards. Our prioritization approach resulted in a high-priority classification for 462 risk factors belonging to the following eight classes: drugs (n = 206), metals (n = 116), pesticides (n = 38), organic solvents (n = 27), synthesizing and/or processing agents in industrial processes (n = 23), phthalates (n = 13), perfluorinated compounds (n = 13), and other compounds (n = 26). Despite the limitations of this work, the generated lists constitute a useful working basis to put in place innovative environmental preventive measures according to the principle of evidence-based medicine.

Workplace health promotion for employees working in offshore wind parks in the German exclusive economic zone: a mixed-methods study

ObjectivesTo investigate the awareness and use of health promotion offers among offshore wind workers and to study associations with demographic and workplace characteristics. To examine employees’ reasons for (non-)participation and...

Good practice models for public workplace health promotion projects in Austria: promoting mental health

Promoting mental health is a central public health issue since the Jakarta statement in 1997. In Austria, the nationwide organisation for health promotion is the 'Fonds Gesundes Österreich' (FGÖ), which has been established in 1998. The FGÖ funds and supports workplace health promotion projects; therefore, it co-operates with the Austrian Network on Workplace Health Promotion. In 2011, among others, two Austrian companies were honoured as best practice models for promoting mental health in the project 'Work. In tune with life. Move Europe'. One of their central key success factors are the provision of equal opportunities, engagement, their focus on overall health as well as the implementation of behavioural and environmental preventive measures. Since mental health problems in the population are still rising, public health promotion projects which orientate on the best practice models have to be established in Austria.

Seven-year surveillance of nosocomial invasive aspergillosis in a French University Hospital

This study aims at describing the evolution of the epidemiology of invasive aspergillosis (IA) in a French University Hospital focussing on nosocomial cases, in order to assess the efficiency of the environmental preventive measures which were implemented. From 2003 to 2009, IA cases were reviewed monthly and classified according to the EORTC/MSG criteria and the origin of contamination. Five proven and 65 probable IA cases were diagnosed. Most of the cases (74.3%) occurred in patients with haematological malignancies. Incidences of IA and nosocomial IA (NIA) were 0.106 and 0.032 cases per 1000 admissions, respectively. All the 21 NIA cases occurred in the absence of air treatment (laminar air flow facilities or Plasmair decontamination units) and/or during construction works. The 3-month and 1-year overall survival rates were 50.6% [38.2-61.7] and 31.1% [20-42.9] respectively, and did not differ according to the origin of contamination. Nosocomial IA still accounted for a third of all IA cases diagnosed from 2003 to 2009 and mainly occurred in the absence of environmental protective measures, which were confirmed to be effective when applied. Our results show that extension and/or reinforcement of these measures is needed, especially in the haematology unit and during construction works.

Knowledge, attitudes and practices (KAP) about malaria among people visiting referral hospitals of Eritrea in 2008

Background: Knowledge, attitudes, awareness, practices and beliefs of communities contribute immensely to sustainable control of endemic diseases such as malaria. Strategic malaria control involves primary prevention which focuses on vector elimination and personal behavior change specifically through the consistent use of insecticide-treated nets (ITNs) and prompt and effective case management. This health facility based study was conducted to investigate the knowledge, attitudes and practices toward malaria among people visiting referral Hospitals of Eritrea, so as to develop a cost effective behavioral change communication strategy for community based malaria control. Methods: The study was conducted in the Referral Hospitals of the four Zobas as well as Teseney Hospital where there was the highest malaria morbidity and mortality. A total of 250 people with 50 people from each hospital were randomly selected. A structured questionnaire covering information on respondent demographics, knowledge, attitudes and practices was administered upon receipt of an informed consent for participation. Results: All the study subjects knew at least one of the symptoms of malaria with nearly three quarters mentioning three or more of the classical symptoms including fever. More than 80% knew that mosquitoes were the vector for the disease with a similar proportion having participated in environmental preventive control measures. Nearly half (44.6%) of the respondents gave priority for usage of ITNs to children under 5 years, to both children and pregnant mother and 11.2% to pregnant mothers. Conclusion: The majority of the respondents in this study knew enough information about malaria, and had participated in environmental preventive measures. The primary prevention of malaria through uninterrupted use of ITNs and transformation of knowledge into practices requires emphasis on the development of a community based behavioral change communication strategy. Key words: KAP, malaria, Behavioral change communication strategy, Eritrea, ITNs

Suicide among Viennese minors, 1946–2002

The first documented conference on suicide among school pupils was held by the Viennese Psychoanalytical Society in 1910, yet since then research on youth suicide in Vienna and Austria has been sparse. We investigated cases of suicide among Viennese minors over a period of 57 years in terms of prevalence, gender differences, suicide methods and monthly distribution. We studied registered suicides among Viennese youths aged 19 or younger occurring between 1946 and 2002 (n = 683). The total suicide rate and the rates for male and female suicides among Viennese minors decreased over the period studied. The mean suicide rate was 6.2 per 100,000 (statistics on suicides per 100,000 were available only for the period 1953-2002), with a male-female ratio of 2.1:1. The predominant suicide method was domestic gas until its detoxification in Vienna. From 1976 jumping from a height became the most common suicide method of Viennese minors; it was also the predominant method among females, whereas hanging was the predominant method among males. Since 1996 the percentage of firearm suicides among males has doubled, and jumping suicides among females have tripled. A greater number of suicides among minors took place during the months of January, June, October and December. Suicide rates of Viennese minors are on the decline, corresponding to a reported decrease in the general suicide rate in Austria. In view of an observed recent increase in firearm suicides among males and jumping suicides among females aged 19 and younger, further monitoring as well as legal and environmental prevention measures are needed.

Knowledge of Malaria, Risk Perception, and Compliance with Prophylaxis and Personal and Environmental Preventive Measures in Travelers Exiting Zimbabwe from Harare and Victoria Falls International Airport

Travel associated malaria is a major health risk for visitors to malaria endemic destinations. To examine the knowledge of malaria prevention, risk perception, current prophylactic behavior, and compliance with chemoprophylaxis and personal and environmental protection measures we conducted a study in a cohort of travelers exiting Zimbabwe from two international airports during a peak malaria transmission period. Data were collected by pretested self-administered questionnaires from 595 adults in the departure lounges of Harare and Victoria Falls International airports. Excluded were children and travelers from the African continent. A multilingual research assistant supervised data collection. The majority of travelers obtained health advice prior to travel. Patterns of protective behavior and compliance with prophylaxis were inconsistent with a high perception of malaria threat and good knowledge. About 23% of travelers failed to use chemoprophylaxis during their visit. In the group of travelers who used chemoprophylaxis, 18% were noncompliant. Fifteen drug combinations were in use. Full compliance with medication plus use of personal preventive measures always was estimated as 13%. Forgetfulness was the main cause of noncompliance, followed by deliberate omission due to side effects. Of 57 travelers who reported side effects from current medication, over half used mefloquine. There is a need to examine how people process personal risk and communications about risk. We must recognize the competition between precautionary measures against malaria and other life demands that are imposed by travel, especially in young long stay travelers and persons visiting primarily for business purposes. Mediating a protective response will also depend on judgments about the effectiveness of the action, strengthening travelers intentions toward adherence, and increasing efficacy perception by individuals and their peers. Conflicts in prophylactic recommendations need to be resolved. As ecotourism develops in Zimbabwe and other malaria regions, stakeholders in this rapidly growing industry must be made aware of the important role they can play in protecting clients from malaria.

Sublingual immunotherapy in asthma and rhinoconjunctivitis; systematic review of paediatric literature

Aims: To evaluate the clinical efficacy of sublingual immunotherapy (SLIT) in respiratory allergy in children. Methods: A systematic literature review was conducted. The search was focused on all the double...

A high neonatal serum eosinophil cationic protein level is a risk factor for atopic symptoms

To show whether neonatal eosinophil counts (EC) and eosinophil cationic protein (ECP) can be used in assessing the risk of atopy, alone or in combination with family history of atopy (FHa). A group of 63 newborns was included: 38 with FHa, 25 without FHa. A blood sample was collected on the 4th day of life for EC and ECP evaluation. Clinical follow-up was conducted after 1, 3, 6, 12, 18, 24 and 36 mo. The chi2 test and the Student's t-test were used to compare dichotomic and continuous variables, respectively. Variables shown to be significant by univariate analysis were evaluated with a multivariate regression model and the relative risks (RR) were estimated. Twenty-six newborns (41%) displayed atopic manifestations during the follow-up. Twenty-one (55%) of 38 newborns with FHa displayed atopic symptoms versus 5/25 (20%) without FHa (p 0.012). Neither EC nor serum ECP levels were significantly different between newborns with FHa and newborns without. ECP levels did not differ between newborns with single heredity and newborns with dual heredity. EC did not differ significantly between newborns who developed atopy and those who did not. Instead, serum ECP levels were significantly higher in newborns who developed atopy (mean 27.9 microU/l vs 16.8 microU/l). Atopic manifestations appeared in 16 (62%) of 26 newborns with ECP > or = 18 microU/l compared with 10 (27%) of 37 with ECP < 18 microU/l (p = 0.006). In the multivariate regression model, with ECP < 18 microU/l and no FHa as reference class, the class 1 (no FHa and ECP > or = 18 microU/l) has a low RR (1.4), class 2 (FHa and ECP < 18 microU/l) an intermediate RR (2.7) and class 3 (FHa and ECP > or = 18 microU/l) a very high RR (16.3). Neonatal serum ECP levels, in contrast with EC, were significantly higher in newborns who developed atopic manifestations during follow-up. The risk of atopy was about twice as great when ECP was > or = 18 microU/l (and four times as great in multivariate analysis). When serum ECP was combined with FHa, the RR for newborns with FHa and ECP > or = 18 microU/l was 16 times greater than for those without FHa and ECP < 18 microU/l. The identification of newborns at "extremely high atopic risk" (FHa and ECP > or = 18 microU/l) may be expecially useful--in clinical practice--in newborns with only one atopic parent or sibling, for whom it is not universally agreed that dietary and environmental prevention measures should be applied.

Parents as Advocates for Child Pedestrian Injury Prevention: What Do They Believe about the Efficacy of Prevention Strategies and about How to Create Change?

This study describes the support of parents and other community members for child pedestrian safety measures, their willingness to pay in terms of volunteer time and money for efforts to make child pedestrian safety improvements in their neighborhood, and their views on how to affect child pedestrian safety improvements in their communities. In partnership with four city public elementary schools, data were collected through focus groups of parents and other caregivers and through a written survey distributed to parents and caregivers. The findings reveal that parents and caregivers are aware of a full range of prevention measures for the child pedestrian injury problem but are especially supportive of speed bumps, safety education for parents, and better traffic enforcement. Parents and caregivers are uncertain about what kind of strategies would work well to get changes made in their communities to protect child pedestrians. They also reveal that they are willing to get involved in trying to get changes made. Parents and other community members can be willing and effective partners in injury prevention, but they can benefit from receiving more information about the value of environmental prevention measures and from skill-building in injury prevention advocacy.

Avoidance of allergens and air pollutants in respiratory allergy

Avoidance of allergens and air pollutants in respiratory allergy

Two experiences on education and training in dry-cleaners

The aim of the study was to evaluate which training method was more useful for employers of small enterprises concerning occupational health and safety. Therefore, we decided to involve the dry-cleaner employers' associations of our town in a project of educational meetings with the employers, before making repressive inspections. In 1989, 43 dry-cleaners were then inspected and the data obtained about occupational risks were discussed in these meetings, in order to explain to the employers meaning and necessity of adopting the correct preventive measures provided for by the law. A second inspection was carried out some months later, in 1990, to check the effectiveness of the meetings. In 19 out of 43 dry-cleaners (44%) the lack in risk prevention, discovered in 1989, was not, or only in part, eliminated. Therefore, we thought to act towards the remaining dry-cleaner employers in a different way: (a) on the basis of the previous inspections, we produced a handbook easy to understand and rich in information about occupational risks in dry-cleaning and how to avoid them; (b) in 1992 our educational staff executed training inspections in 67 other dry-cleaners, together with employers and workers. They distributed the handbooks and, at the same time, gave some practical example of solution for safety problems. In 1993, in 25 (randomly selected) out of the 67 dry-cleaners, a inspection was carried out to check on: adoption of correct environmental prevention measures, correct utilization of personal protective equipment, execution of correct medical surveillance. Law violations were proportionally much lower (e.g., omitted or inadequate forced air drawing = 36%) than those found in the first inspection of 1989 (e.g., omitted or inadequate forced air drawing = 86%). Although other causes could interfere, it is possible that this result is connected to the last training method, that is more time-consuming but awakens the employers of small enterprises to the risks for health and safety and to act accordingly.