Public Health Risk Factors Research Articles

Air pollution: the emergence of a major global health risk factor.

Air pollution is now recognized by governments, international institutions and civil society as a major global public health risk factor. This is the result of the remarkable growth of scientific knowledge enabled by advances in epidemiology and exposure assessment. There is now a broad scientific consensus that exposure to air pollution increases mortality and morbidity from cardiovascular and respiratory disease and lung cancer and shortens life expectancy. Although air pollution has markedly declined in high-income countries, it was still responsible for some 4.9 million deaths in 2017, largely in low- and middle-income countries, where air pollution has increased over the past 25y. As governments act to reduce air pollution there is a continuing need for research to strengthen the evidence on disease risk at very low and very high levels of air pollution, identify the air pollution sources most responsible for disease burden and assess the public health effectiveness of actions taken to improve air quality.

Mitigation pathways towards national ambient air quality standards in India

Exposure to ambient particulate matter is a leading risk factor for environmental public health in India. While Indian authorities implemented several measures to reduce emissions from the power, industry and transportation sectors over the last years, such strategies appear to be insufficient to reduce the ambient fine particulate matter (PM2.5) concentration below the Indian National Ambient Air Quality Standard (NAAQS) of 40 μg/m3 across the country. This study explores pathways towards achieving the NAAQS in India in the context of the dynamics of social and economic development. In addition, to inform action at the subnational levels in India, we estimate the exposure to ambient air pollution in the current legislations and alternative policy scenarios based on simulations with the GAINS integrated assessment model. The analysis reveals that in many of the Indian States emission sources that are outside of their immediate jurisdictions make the dominating contributions to (population-weighted) ambient pollution levels of PM2.5. Consequently, most of the States cannot achieve significant improvements in their air quality and population exposure on their own without emission reductions in the surrounding regions, and any cost-effective strategy requires regionally coordinated approaches. Advanced technical emission control measures could provide NAAQS-compliant air quality for 60% of the Indian population. However, if combined with national sustainable development strategies, an additional 25% population will be provided with clean air, which appears to be a significant co-benefit on air quality (totaling 85%).

Clinical Spectrum of West Nile Virus Neuroinvasive Disease.

West Nile virus (WNV) is the most common arbovirus infection in the United States. The diagnosis requires consideration of not only a broad spectrum of presenting symptoms, ranging from a mild febrile illness to severe encephalitis and acute flaccid paralysis, but also public health risk factors and seasonality. There is no approved targeted therapy for WNV, so treatment relies on supportive care, management of neurologic sequelae and airway, treatment of other systems including the eye, and aggressive rehabilitation. Here, we describe a series of 3 cases of WNV encountered in September 2018 at one institution. First, we describe a case of WNV encephalitis with worsened dyskinesias and a relatively good recovery. Second, we describe a severe WNV encephalitis with overlying motor neuron involvement with a poor outcome. Finally, we describe a case of a WNV meningitis with significant bilateral chorioretinitis, an underappreciated complication of WNV infections. Through these cases, we review the epidemiology of WNV, risk factors for infection, the neurologic sequalae and long-term outcomes, and the importance of recognizing ocular involvement to prevent ophthalmologic complications.

Contaminación atmosférica y aerobiología del casco urbano de Calceta-Manabí

air pollution and noise generation represent environmental risk factors for public health in Calceta. Due to the lack of information on air pollutants, the objective of this work was to estimate the concentration of carbon monoxide (CO), sedimentary particulate matter (SPM), sound pressure level (SPL) and aerobic bacteria in the urban area of ​​the Calceta. 18 data collection points were established covering an area of ​​6.9 km2; the concentration of CO was measured with a portable detector; the MPS collection was carried out during 30 days continuously by passive method; for the NPS measurements, the 15-second method (Leq-15s) was applied; Aerobiology was performed in Petri dishes with nutrient medium. The concentration of CO in a sector of the urban area of ​​Calceta has an arithmetic mean of 5804,26 μg/m3 and according to the EPA this level is capable of affecting the population in general. The levels of SPM and SPL reflect the breach of the limits established in the national regulations for both pollutants. Bacterial concentrations were lower than 500 CFU/m3. The present study is a baseline in air quality that will allow in perspective the implementation of measures for the benefit of public health.
 Index Terms— Environmental monitoring, lung diseases, air

Methodology for developing and evaluating food-based dietary guidelines and a Healthy Eating Index for Ethiopia: a study protocol

IntroductionFood-based dietary guidelines (FBDGs) are used to promote and maintain healthy eating in a population, by providing country-specific guidance. However, many African countries like Ethiopia do not have FBDGs. This...

Abstract 2418: Are we underestimating cancer mortality? A mediation model shows a larger impact from smoking

Abstract Purpose: Cancer mortality is estimated using underlying cause of death. For instance, to estimate the risk of head and neck cancer (HNC) mortality attributed to smoking, ‘death by HNC’ is the outcome (ie, smoking → HNC death). This conventional approach has notable flaws. It relies on accurate reporting on cause of death, a potential source of misclassification, and it excludes any mortality effects in cancer patients who die from other causes, a potential source of selection bias. Regarding HNC, 80% of all patients are excluded using this approach. These potential biases may result in underestimating cancer mortality from important public health factors such as smoking, obesity and physical activity. To overcome these biases, we are proposing a new approach to estimate cancer mortality. The method uses a causal mediation model and we demonstrate it in a smoking and HNC example. Methods: The model estimates cancer mortality through a mediated pathway. In our example, smoking is the exposure, incident HNC is the mediator, and all-cause mortality is the outcome (smoking → HNC incidence → all deaths). The mediated effect is the risk of mortality attributed to HNC, which in turn, is attributed to smoking. We compare the results in the mediation model to the conventional approach using Aalen’s additive hazards, which estimates the absolute increase in deaths in smokers compared to non-smokers; the mediation model also uses logistic regression for the HNC mediator. Both models are adjusted for age, sex, race, body mass index, diet, alcohol use, physical activity, marital status, education, and reported health. We used the NIH-AARP Diet and Health cohort, which has smoking information at baseline, and cancer incidence and mortality during follow-up on 518,100 U.S. subjects. Results: In the study, 2,279 subjects developed HNC during follow-up, among whom, 508 (22%) died from HNC; 125,442 subjects died from any cause. Under the conventional method, 11.0 more deaths (per 100,000 person-years) are attributed to HNC from current smokers relative to never smokers (95% CI: 8.0, 13.9); 1.8 deaths in former smokers (95% CI: 0.4, 3.2). Under the mediation method, 13.4 more deaths are attributed to HNC from current smokers relative to never smokers (95% CI: 9.3, 16.8); 2.2 deaths in former smokers (95% CI: 1.2, 3.4). Comparing the two estimates, the conventional approach underestimates HNC mortality attributed to smoking by 18%. Noteworthy, the underestimate for current smokers manifests primarily in men, while the underestimate for former smokers manifests primarily in women. Conclusions: The mediation method overcomes limitations in prior approaches of cancer mortality. In our example, the method estimated a stronger effect on HNC mortality by smoking. Further study is warranted as published estimates of cancer mortality by notable public health risk factors (eg, smoking, obesity, physical activity) may be underestimating their impact. Citation Format: Ronald C. Eldridge, W. Dana Flanders, Colin Adler, Deborah W. Bruner, Canhua Xiao. Are we underestimating cancer mortality? A mediation model shows a larger impact from smoking [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2418.

THE PREVALENCE OF UNDERWEIGHT, OVERWEIGHT AND OBESITY IN A ROMANIAN POPULATION IN THE FIRST TRIMESTER OF PREGNANCY - CLINICAL IMPLICATIONS.

Underweight, overweight and obesity are important global public health issues and risk factors for adverse perinatal outcomes. To assess the distribution of the body mass index (BMI) in the Romanian obstetric population in the first trimester of pregnancy and its correlation with pregnancy outcomes. We also report the distribution of blood pressure (BP) parameters and their correlation with BMI. This retrospective study includes 9,064 women attending routine first trimester visit and ultrasound scan at 12.8(±0.6) gestational weeks. Characteristics, parity, method of conception, blood pressure (from 3,650 women), maternal weight and height, BMI and foetal ultrasound were recorded. Pregnancy outcomes were available for 1,607 deliveries. The Pearson correlation coefficient was assessed for each BMI group vs. blood pressure parameters, gestational age and birth weight. ANOVA analysis and post hoc tests were used to determine group differences. Linear regression was applied to estimate the contribution of BMI and gestational age to birth weight variance. In our population, 66.37% pregnant women had a normal BMI, 19.29% were overweight, and 7.56% were obese. There was a weak-to-medium positive correlation between BMI and blood pressure parameters, for all weight categories. The correlation between maternal BMI and birth weight was positive for normal and overweight. Our findings highlight the need for more effective health strategies targeting reduction of weight-related problems in women of childbearing age.

Assessment of Three Antimicrobial Residue Concentrations in Broiler Chicken Droppings as a Potential Risk Factor for Public Health and Environment

Tetracyclines, sulfonamides and amphenicols are broad spectrum antimicrobial drugs that are widely used in poultry farming. However, a high proportion of these drugs can be excreted at high concentrations in droppings, even after the end of a therapy course. This work intended to assess and compare concentrations of florfenicol (FF), florfenicol amine (FFa), chlortetracycline (CTC), 4-epi-chlortetracycline (4-epi-CTC), and sulfachloropyridazine (SCP) in broiler chicken droppings. To this end, 70 chickens were housed under controlled environmental conditions, and assigned to experimental groups that were treated with therapeutic doses of either 10% FF, 20% CTC, or 10% SCP. Consequently, we implemented and designed an in-house validation for three analytical methodologies, which allowed us to quantify the concentrations of these three antimicrobial drugs using liquid chromatography coupled to mass spectrometry (LC-MS/MS). Our results showed that FF and FFa concentrations were detected in chicken droppings up to day 10 after ceasing treatment, while CTC and 4-epi-CTC were detected up to day 25. As for SCP residues, these were detected up to day 21. Noticeably, CTC showed the longest excretion period, as well as the highest concentrations detected after the end of its administration using therapeutic doses.

Frequency of metabolic syndrome and its associated factors in health care workers

BackgroundIn recent decades, metabolic syndrome is one of the most important public health risk factors. Having this in mind, the present study was conducted to evaluate the frequency of metabolic syndrome and its associated risk factors in healthcare workers. MethodThis study is a cross-sectional study conducted on 410 healthcare workers in a teaching hospital in Iran. Demographic, occupational, and psychosocial characteristics were assessed using questionnaire. Assessment of metabolic syndrome of hospital staff was performed at workplace during their medical examination. ResultsThe frequency of metabolic syndrome was found to be 22.4%. This relationship was found among blood pressure and occupational stress, despite the fact that there was no significant relationship between metabolic syndrome and occupational stress. Higher age, having shift work, and inactivity were associated with metabolic syndrome. ConclusionConsidering the high frequency of metabolic syndrome among Iranian healthcare workers, it is advised that effective management should be employed to correct the occupational and psychosocial factors associated with this syndrome.

Impaired participation of potassium channels and Na+ /K+ -ATPase in vasodilatation due to reduced nitric oxide bioavailability in rats exposed to mercury.

Mercury intoxication is a public health risk factor due to its hazardous effect to several organs, including the cardiovascular system. There is evidence of endothelial dysfunction after exposure to mercury, but the effects on endothelium-dependent vasodilatation are still unknown. In the present study, we aimed to evaluate the chronic effects of high HgCl2 doses on the mechanisms of vasodilatation. Wistar rats were injected with HgCl2 (1st dose 10.86μg/kg, and daily doses 0.014μg/kg for 30days i.m.), and saline was used as control. Mercury exposure reduced the acetylcholine-induced vasodilatation in aortic rings, which was restored by incubation with antioxidant tiron. Inhibition of the NO synthase, Na+ /K+ -ATPase and K+ channels indicates reduced participation of these factors. In the mercury group, there were an increased local anion superoxide and a reduced NO. The vasodilatation to exogenous NO was partially inhibited by co-incubation with TEA plus tiron, suggesting that reduced NO bioavailability is the responsible to that decreased the participation of K+ channels. Moreover, there was an increased participation of the Na+ /K+ -ATPase associated with an up-regulation of its alpha-1 subunit. In conclusion, reduced NO bioavailability plays a major role in the impaired participation of K+ channels and Na+ /K+ -ATPase in the acetylcholine-mediated relaxation, although sodium pump is up-regulated probably as a compensatory mechanism.

Subnational regional inequality in the public health development index in Indonesia

ABSTRACTBackground: Achieving the Sustainable Development Goal of ‘ensuring healthy lives and promoting well-being for all at all ages’ necessitates regular monitoring of inequality in the availability of health-related infrastructure and access to services, and in health risks and outcomes.Objectives: To quantify subnational regional inequality in Indonesia using a composite index of public health infrastructure, services, behavioural risk factors and health outcomes: the Public Health Development Index (PHDI).Methods: PHDI is a composite index of 30 public health indicators from across the life course and along the continuum of care. An overall index and seven topic-specific sub-indices were calculated using data from the 2013 Indonesian Basic Health Survey (RISKESDAS) and the 2011 – Village Potential Survey (PODES). These indices were analysed at the national, province and district levels. Within-province inequality was calculated using the Weighted Index of Disparity (IDISW).Results: National average PHDI overall index was 54.0 (out of a possible 100); scores differed between provinces, ranging from 43.9 in Papua to 65.0 in Bali. Provinces in western regions of Indonesia tended to have higher overall PHDI scores compared to eastern regions. Large variations in province averages were observed for the non-communicable diseases sub-index, environmental health sub-index and infectious diseases sub-index. Provinces with a similar number of districts and with similar overall scores on the PHDI index showed different levels of relative within-province inequality. Greater within-province relative inequalities were seen in the environmental health and health services provisions sub-indices as compared to other indices.Conclusions: Achieving the goal of ensuring healthy lives and promoting well-being for all at all ages in Indonesia necessitates having a more focused understanding of district-level inequalities across a wide range of public health infrastructure, service, risk factor and health outcomes indicators, which can enable geographical comparison while also revealing areas for intervention to address health inequalities.

Impacts of O3 on premature mortality and crop yield loss across China

Exposure to ambient ozone (O3) is a risk factor for public health and causes damage to vegetation, including agricultural crops. In this study, we performed a comprehensive estimate of the spatial distribution of premature deaths and main crop yield losses attributed to ambient O3, across China in 2014, by applying the Global Burden of Diseases approach and AOT40 metric (i.e., above a threshold of O3 concentration of 40 ppb). Our results show that China's total premature deaths in 2014 due to COPD attributed to O3 exposure were 89,391 (CI95: 32,225–141,649) with spatial variation across provinces. O3 induced production losses from all crops were 78.4 million metric tons, and the relative yield losses ranged from 8.5 to 14.0% for winter wheat, 3.9–15.0% for rice, and 2.2–5.5% for maize. The top four Chinese provinces (Sichuan, Shandong, Henan and Hunan) for premature deaths attributed to O3 pollution also suffered severe losses in yields of winter wheat and rice. Our results provide quantitative evidence of O3 induced impacts on both the public health and crop yields across Chinese provinces, which have important policy implications for the government to alleviate O3 pollution in addition to PM2.5 pollution that is currently being addressed.

Molecular detection of Enteropathogens from diarrheic stool of HIV positive patients in Gondar, Ethiopia

BackgroundInfectious diarrhea is a common problem in the developing world, especially among people living with HIV/AIDS. Traditional diagnostic methods such as stool culture and microscopic examination are limited by resources and poor sensitivity. The use of molecular diagnostics for enteropathogen detection in this region of sub-Saharan Africa has not been fully explored. We sought to identify risk factors and characterize enteropathogens from diarrheic stools of HIV-positive patients in Gondar, Ethiopia using multiplex molecular panels targeting key infectious agents.MethodsA cross-sectional study of 100 stool samples was performed. Samples were collected consecutively from HIV- positive patients presenting with diarrhea at University of Gondar Hospital clinic, a major center in NW Ethiopia. Genomic DNA was extracted from stool and processed using a multiplex molecular panel Allplex™ [Seegene, Canada]. Correlations between patient characteristics, symptoms, public health risk factors, and enteropathogen type (s) were studied. Eighty-six samples were successfully analyzed by molecular methods.ResultsThe mean age was 35 with 43% male. Eighty percent lived in an urban area, 18% had access to well water only, and 81% practiced proper hand hygiene. The majority of patients (72%) were receiving HAART with a median CD4 cell count of 362/μL. Multiple pathogens were detected in 94% of specimens, with an average of 5 enteropathogens per sample. Common bacteria, viruses, and parasites detected were Shigella spp./enteroinvasive E. coli (80%), enterotoxigenic E. coli (73%), Norovirus (16%) and B. hominis (62%). CD4 cell count < 500/ μL was associated with the presence of viruses (p = 0.004) and the absence of STEC (p = 0.010). The use of HAART or CD4 levels was not associated with the number of enteropathogens detected.ConclusionsDiarrheic stool from HIV-positive outpatients in Gondar, Ethiopia had on average 5 enteropathogens present in their stool. Shigellaspp./enteroinvasive E. coli and enterotoxigenic E. coli are the major pathogens, not dissimilar to immunocompetent individuals in low income countries.

Coxiella burnetii infection in sheep and goats: a public risk health, Colombia

Objective. The aim of this study was to provide molecular evidence of C. burnetii in sheep and goats from some herds of Valledupar, Cesar, Colombia.Materials and methods. Fifteen herds of sheep and goats were chosen by convenience to investigate the infection by C. burnetii, during March and April of 2013. 328 female goats and 66 sheep from 15 herds were included in this study. Milk from ewes and vaginal mucus samples from goats were analyzed by Polymerase Chain Reaction for DNA detection of transposase gene (IS1111) of C. burnetii.Results. DNA of C. burnetii in 6% (4/66) of sheep’s milk and 0.6% (2/328) vaginal mucus from goats was found. 13% (2/15) of the herds had at least one infected animal.Discussion. Our findings suggest the circulation of C. burnetii in sheep and goats from some herds of Valledupar, Colombia, and it highlights the possibility of occurrence of infections in humans and animals.Conclusions. The detection of C. burnetii in sheep milk could represent a public health risk factor for people who consuming raw milk, cheeses or people associated to agricultura and livestock handling. Further studies are necessary to evaluate other routes such as tick’s bite, feces, milk from goats and vaginal mucus from sheep of this region of Colombia.

Stringent Emission Control Policies Can Provide Large Improvements in Air Quality and Public Health in India.

Exposure to high concentrations of ambient fine particulate matter (PM2.5) is a leading risk factor for public health in India causing a large burden of disease. Business‐as‐usual economic and industrial growth in India is predicted to increase emissions, worsen air quality, and increase the associated disease burden in future decades. Here we use a high‐resolution online‐coupled model to estimate the impacts of different air pollution control pathways on ambient PM2.5 concentrations and human health in India. We find that with no change in emissions, the disease burden from exposure to ambient PM2.5 in 2050 will increase by 75% relative to 2015, due to population aging and growth increasing the number of people susceptible to air pollution. We estimate that the International Energy Agencies New Policy Scenario (NPS) and Clean Air Scenario (CAS) in 2050 can reduce ambient PM2.5 concentrations below 2015 levels by 9% and 68%, respectively, offsetting 61,000 and 610,000 premature mortalities a year, which is 9% and 91% of the projected increase in premature mortalities due to population growth and aging. Throughout India, the CAS stands out as the most effective scenario to reduce ambient PM2.5 concentrations and the associated disease burden, reducing the 2050 mortality rate per 100,000 below 2015 control levels by 15%. However, even under such stringent emission control policies, population growth and aging results in premature mortality estimates from exposure to particulate air pollution to increase by 7% compared to 2015, highlighting the challenge facing efforts to improve public health in India.

Prevalence of bovine and avian tuberculosis in camel herds and associated public health risk factors in Isiolo County, Kenya.

A cross-sectional study was conducted among 308 lactating camels selected from 15 herds from three different camel milk clusters in Isiolo County, Kenya, to determine prevalence of bovine and avian tuberculosis using Single Comparative Intradermal Tuberculin Skin test. Seventy-five (75) questionnaires were administered to pastoralists/herders, and focus group discussions were conducted among 3-5 pastoralists/herders selected from each camel herd to collect information on camel husbandry and health management practices and knowledge on tuberculosis in livestock and wildlife. An overall prevalence of bovine and avian reactors was 3.57 and 18.18%, respectively, with bovine and avian reactors for different clusters being 2.38, 3.82, and 4.48% and 25, 17.2, and 11.94%, respectively. There was significant difference (p < 0.05) in prevalence of bovine and avian reactors between different clusters. There was a negative correction (r = -0.1399) between herd size and bovine reactors, while there was a positive correlation (r = 0.0445) between herd size and avian reactors. The respondents indicated that camel herds are exposed to several risk factors like close contact with other herds or livestock or wildlife during grazing and at watering points. Pastoralists have poor knowledge on mode of infection and transmission of bovine or avian tuberculosis. The high prevalence of bovine and avian reactors and pastoralists' poor knowledge on mode of transmission signify potential risk to public health.

Perfil de susceptibilidade antimicrobiana e produção de hemolisina de enterobactérias de psitacídeos de cativeiro

The practice of getting pets is increasingly inserted in society; this fact is due to the welfare and quality of life that the living with these animals brings to humans. The search for exotic animals has become frequent, with parrots being one of the groups most appreciated for this purpose. However, these birds are likely to transmit pathogens both to man and to other animals, representing a relevant risk factor for public health. The aim of this work was to determine the profile of antimicrobial susceptibility and hemolysin production in enterobacteria isolated from psittacines of captive of bird park in Toledo city Brazil. Escherichia coli positive samples (20% of the analysed sample), previously identified and isolated, were analyzed and performed according to Kirby &amp; Bauer method. Subsequently, virulence factor evaluation was performed by hemolytic activity test (TAH) by sowing the samples in Blood agar, having as a positive control sample of E. coli EHEC and as negative controls a sample of E. coli K12. The interpretation of the values of halos obtained in the antibiogram verified the degree of sensitivity of E. coli samples to antibiotics, where the resistance of the samples to several antibiotics tested was noted. Gamma haemolysis was identified in the TAH test. The determination of the sensitivity profile of strains of E. coli makes even more relevant the concern with microorganism’s pathogenicity that these birds can carry, considering the degree of resistance of these bacteria to the tested antibiotics. This profile also made it possible to know which antimicrobials have a more effective action on the bacteria found, allowing a better understanding of the microbiota of these animals.

The relationships between obesity-increasing risk factors for public health, environmental impacts, and health expenditures worldwide

PurposeThe purpose of this paper is to investigate the associations between obesogenic severity, the public health situation, environmental impacts, and health care expenditures in populations worldwide.Design/methodology/approachThis ecological study is based on official data available for approximately 140 countries worldwide. This study defines four main variables: obesogenic severity, environmental impact, public health implications (PHI), and health expenditures, all measured through specific indicators. Data were obtained mainly from the WHO, World Bank, and IDF. The indicators were reduced to the main variables through factorial reduction and multiple regression analyses were used to test the main hypotheses.FindingsObesogenic severity strongly and positively affects environmental impacts (β=0.6578; p<0.001), PHI-1 (cardiovascular risk factor) (β=0.3137; p<0.001) and PHI-2 (blood glucose and diabetes diagnoses) (β=0.3170; p<0.001). Additionally, environmental impacts strongly and positively affect PHI-1 (β=0.4978; p<0.001) but not PHI-2. Thus, results suggest that environmental impact, PHI-1, and PHI-2 strongly affect health expenditures (β=0.3154; p<0.001, β=0.5745; p<0.001, and β=−0.4843; p<0.001, respectively), with PHI-2 negatively affecting the health expenditures.Practical implicationsThis study presents evidence that can aid in decision making regarding public and private efforts to better align budgets and resources as well as predict the needs and expenditures of public health care systems.Originality/valueThis investigation finds that the main variables addressed are strongly associated at the worldwide level. Thus, these analytical procedures can be used to predict public health and health care cost scenarios at the global level.

Platelet aggregability, prehypertension, and heart rate in male smokers: An unwelcome circumstance for prothrombotic activity

Background: Smoking makes the blood stickier and the blood cells clump together due to which there is reduced blood flow which further leads to blockages in the heart. Cigarette smoking globally known risk factor for public health and being responsible for many illnesses such as hypertension, lung cancer, coronary heart disease, and stroke. It has a negative impact on endothelial function which leads to thrombotic episodes by enhancing platelet aggregation and also important for developing hypertension. There are various mechanisms by which it affects the cardiovascular system. Nicotine, main ingredient, is said to increase cardiac output by increasing both heart rate (HR) and myocardial contractility. Aims and Objectives: Considering above known facts, the objectives were assessed in the form of platelet aggregability by method given by O’Brien and early prediction of hypertension in smokers and non-smokers by measuring blood pressure (BP) and resting HR. Materials and Methods: Platelet aggregability was measured by method given by O’Brien and BP was recorded using sphygmomanometer taking the average while radial pulse was taken for HR. Results: Our result shows that platelet aggregability and systolic BP with diastolic BP to be highly significantly P < 0.0000 in smokers along with statistically significant P < 0.05 resting HR. Conclusion: The study thus highlights the endothelial damage with increased sympathetic activity which leads to increased platelet activation and aggregation in smokers, prehypertension also worsens platelet activation, appropriate prevention measures needs to be implemented to reduce the risk of cardiovascular disease.

Exposure to individual and multiple carcinogenic metals during paediatric age: an experience from an Italian urban scenario.

Exposure to single and multiple carcinogenic metals and/or semimetals represents a major environmental risk factor for public health. In particular, children are more susceptible to environmental pollutants than adults, but specific studies are still limited. The aims of the present study were: 1) to trace the exposure and co-exposure profiles to eight known or suspected carcinogenic metals and semimetals (As, Be, Cd, Co, Cr, Ni, Pb, and Sb); and: 2) to evaluate the influence of some possible interfering/confounding factors on the exposure to these elements during childhood. Cross-sectional study. We recruited 159 healthy Italian children attending a primary school of the urban area of Rome, Italy. Selected metals were determined by inductively coupled plasma mass spectrometry on urinary samples collected at the end of a "typical" day (one sample for each child), while information about possible confounding/interfering factors were collected via questionnaires. The great part of the studied children resulted co-exposed to the monitored metals: 83.2%, 69.2%, 51.0% and 29.3% of the participants were concurrently exposed to at least two, three, four and five trace elements, respectively. Gender was the only one among the investigated variable that significantly influenced the co-exposure, with females resulting at lower risk (OR = 0.392; 95 IC = 0.156 - 0.989; p < 0.047). Given the importance of protecting child's health and the risks related to the exposure to carcinogenic metals, especially when they occur simultaneously, other researches in this field are strongly recommended.