Significant Environmental Risk Factors Research Articles

Ultraviolet Radiation and Basal Cell Carcinoma: An Environmental Perspective.

Ultraviolet radiation (UVR) is a known carcinogen participated for the development of skin cancers. Solar UVR exposure, particularly ultraviolet B (UVB), is the mostly significant environmental risk factor for the occurrence and progress of basal cell carcinoma(BCC). Both cumulative and intermittent high-grade UVR exposure could promote the uncontrolled replication of skin cells. There are also exsiting other contributing environmental factors that combine with the UVR exposure to promote the development of BCC. DNA damage in formation of skin cancers is considered to be a result of UVR toxicity. It is UVR that could activate a series of oncogenes simultaneously inactivating tumor suppressor genes and aberrant proliferation and survival of keratinocytes that repair these damages. Furthermore, mounting evidence demonstrates that inflammatory responses of immune cells in the tumor microenvironment plays crucial role in the skin tumorigenesis as well. In this chapter, we will follow the function of UVR in the onset and development of BCC. We describe the factors that influence BCC induced by UVR, and also review the recent advances of pathogenesis of BCC induced by UVR from the genetic and inflammatory aspects.

Acetylated tau: A missing link between head injury and dementia

Head injury is the most significant environmental risk factor for Alzheimer's disease and dementia. Yet, our understanding of its pathophysiology remains limited, and therapeutic targets remain elusive. In a recent issue of Cell, Shin etal. discovered a promising molecular pathway linking head injury to Alzheimer's disease.

Impact of road network structure on dementia-related missing incidents: a spatial buffer approach

Dementia-related missing incidents are a highly prevalent issue worldwide. Despite being associated with potentially life-threatening consequences, very little is still known about what environmental risk factors may potentially contribute to these missing incidents. The aim of this study was to conduct a retrospective, observational analysis using a large sample of police case records of missing individuals with dementia (n = 210). Due to the influence that road network structure has on our real world navigation, we aimed to explore the relationship between road intersection density, intersection complexity, and orientation entropy to the dementia-related missing incidents. For each missing incident location, the above three variables were computed at a 1 km radius buffer zone around these locations; these values were then compared to that of a set of random locations. The results showed that higher road intersection density, intersection complexity, and orientation entropy were all significantly associated with dementia-related missing incidents. Our results suggest that these properties of road network structure emerge as significant environmental risk factors for dementia-related missing incidents, informing future prospective studies as well as safeguarding guidelines.

The prenatal, postnatal, neonatal, and family environmental risk factors for Developmental Coordination Disorder: A study with a national representative sample

Knowledge of obstetric and environmental influences on Developmental Coordination Disorder (DCD) helps provide increased understanding of the mechanisms underlying the disorder. However, the literature to date has not adequately examined the obstetric and environmental risk factors for DCD in a population-based sample. The current study was therefore conducted to explore the prenatal, perinatal, neonatal, and family environmental risk factors for DCD. A total of 2185 children aged 3–10 years from a national representative sample in China were included; the Movement Assessment Battery for Children-2 was used to assess motor function, and a questionnaire was completed by parents. DCD was identified in 156 children according to the DSM-5 criteria. Multilevel logistic regression was used, and comparisons were made between the DCD and non-DCD group. The results confirmed that male sex, BMI score, preterm birth, and some prenatal conditions are significant risk factors for DCD. Parents' education level and one-child status as two significant environmental risk factors for DCD appear largely independent of other risk factors in the Chinese population. This study provides an opportunity to explore the etiology of DCD and suggest potential assessment, monitoring and intervention programs for DCD that could be examined in the future.

Childhood adverse traumatic experiences and schizophrenia

Εpidemiological research during last decades has demonstrated the association of certain environmental variables with psychosis. Ιn parallel with understanding environmental contributors to schizophrenia, identification of those at high risk of psychosis has become a priority. These risk factors include adverse traumatic experiences, such as discrimination, social environment adversities, bullying, emigration and childhood trauma. For many years the possibility of a relationship of adverse traumatic experiences with schizophrenia was minimized in favor of a biological paradigm. However, there is evidence supporting that childhood adversities is one of the most significant environmental risk factors for psychosis, if not the most significant. Studies have demonstrated the validity and the reliability of retrospective reports of adverse traumatic experiences in psychotic patients. The question on the causal relationship between adverse traumatic experiences and psychosis has been raised for many years, but it has not yet been answered. Researchers have focused on the study of dysfunctional cognitive schemes being formed due to childhood adversities and interpreting the world as unfriendly and threatening. According to social defeat hypothesis, the patients do not experience more stressful life events but they experience them as less controllable. Furthermore, researchers study the mediator psychopathology associated directly with adverse traumatic experiences, such as anxiety, mood, dissociative and adaptation disorders, which possibly predispose to psychosis. Cannabis use and childhood adversities may interact to increase the risk of psychotic symptoms in adolescence, according to research findings. Several publications have positively linked the number of traumatic adverse experiences with the severity of mental health and possibly with high risk of psychosis in a dose-response relationship model. Taking note that it is important to have a plausible hypothesis of the biological mechanisms involved with the relationship between adverse traumatic experiences and psychosis, the putative systems being explored are: (1) the hypothalamus-pituitary-adrenal (HPA) axis because it mediates the principal adaptive response to perceived psychological or physiological stress and (2) the dopamine system, which is considered to be important in the development of psychosis. The biological and environmental risk factors are both important in the etiology of psychosis but the effects of some forms of childhood adversity act largely independently of pre-existing genetic liability to increase the risk of psychosis. A supposed differentiation of psychosis associated with adverse traumatic experiences from the classic neurodegenerative model possibly should be considered seriously by the clinician in order to design the best therapeutic plan.

Fenvalerate triggers Parkinson-like symptom during zebrafish development through initiation of autophagy and p38 MAPK/mTOR signaling pathway.

Fenvalerate (FEN), one of the most used synthetic pyrethroids, has the potential to interfere with human neural function. However, far too little attention was paid to the mechanism of FEN-induced neurotoxicity. Thus we exposed zebrafish to FEN from 4 to 120 h post fertilization (hpf), and analyzed the morphology and behavior of zebrafish. Our results showed that FEN decreased the survival rate of zebrafish, with increased malformation rates and abnormal behaviors. Furthermore, we found typical parkinson-like symptoms in FEN-exposed zebrafish with increases in parkinson's disease (PD), ubiquitin, and Lewy bodies-relevant genes. We also observed the loss of dopaminergic neurons in both FEN-exposed zebrafish and PC12 cells, which were all associated with PD-like symptoms. Besides, FEN activated autophagy by the enhanced expressions of p-mTOR, and LC3-II but the reduction of p62. Further, FEN initially activated p-p38 MAPK followed by p-mTOR, which triggered the transcription of genes responsible for autophagy process and prompted the Lewy bodies neuron generation leading to the PD-like symptoms. This process was inhibited by both 3-methyladenine (3-MA, an autophagy inhibitor) and SB203580 (a p38 MAPK selective inhibitor) in zebrafish and PC12 cells. These results suggest that FEN might cause parkinson-like symptom during zebrafish development through induction of autophagy and activation of p38 MAPK/mTOR signaling pathway. The study revealed the potential mechanism of FEN-induced neurotoxicity and should give new insights into a significant environmental risk factor of developing parkinson's disease.

Smoking cessation intervention for reducing disease activity in chronic autoimmune inflammatory joint diseases.

Chronic inflammatory joint diseases (IJDs) affect 1% to 2% of the population in developed countries. IJDs include rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and other forms of spondyloarthritis (SpA). Tobacco smoking is considered a significant environmental risk factor for developing IJDs. There are indications that smoking exacerbates the symptoms and worsens disease outcomes. The objective of this review was to investigate the evidence for effects of smoking cessation interventions on smoking cessation and disease activity in smokers with IJD. We searched the Cochrane Tobacco Addiction Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library; PubMed/MEDLINE; Embase; PsycINFO; the Cumulative Index to Nursing and Allied Health Literature (CINAHL); and three trials registers to October 2018. We included randomised controlled trials testing any form of smoking cessation intervention for adult daily smokers with a diagnosis of IJD, and measuring smoking cessation at least six months after baseline. We used standard methodological procedures as expected by Cochrane. We included two studies with 57 smokers with a diagnosis of rheumatoid arthritis (RA). We identified no studies including other IJDs. One pilot study compared a smoking cessation intervention specifically for people with RA with a less intensive, generic smoking cessation intervention. People included in the study had a mean age of 56.5 years and a disease duration of 7.7 years (mean). The second study tested effects of an eight-week cognitive-behavioural patient education intervention on cardiovascular disease (CVD) risk for people with RA and compared this with information on CVD risk only. The intervention encouraged participants to address multiple behaviours impacting CVD risk, including smoking cessation, but did not target smoking cessation alone. People included in the study had a mean age of 62.2 years (intervention group) and 60.8 years (control group), and disease duration of 11.6 years (intervention group) and 14.1 years (control group). It was not appropriate to perform a meta-analysis of abstinence data from the two studies due to clinical heterogeneity between interventions. Neither of the studies individually provided evidence to show benefit of the interventions tested. Only one study reported on adverse effects. These effects were non-serious, and numbers were comparable between trial arms. Neither of the studies assessed or reported disease activity or any of the predefined secondary outcomes. We assessed the overall certainty of evidence as very low due to indirectness, imprecision, and high risk of detection bias based on GRADE. We found very little research investigating the efficacy of smoking cessation intervention specifically in people with IJD. Included studies are limited by imprecision, risk of bias, and indirectness. Neither of the included studies investigated whether smoking cessation intervention reduced disease activity among people with IJD. High-quality, adequately powered studies are warranted. In particular, researchers should ensure that they measure disease markers and quality of life, in addition to long-term smoking cessation.

Sun exposure and protection practices in children after allogeneic hematopoietic stem cell transplantation: A Survey-Based Cross-Sectional Cohort Study.

Pediatric hematopoietic stem cell transplantation (HSCT) patients are at an increased risk for skin cancers. Sun exposure is a significant modifiable environmental risk factor. While patient education on sun protection and avoidance behaviors with regular dermatology evaluations are crucial for pediatric HSCT patients, the real-life practice of these sun-protection recommendations in this patient population compared to their peers is unknown. A survey-based cross-sectional cohort study was performed in pediatric HSCT patients seen at the Dana-Farber Cancer Institute and Boston Children's Hospital over a 1.5-year period compared with age/sex/Fitzpatrick skin phototype-matched healthy controls. Study participants were surveyed using the validated Glanz survey for pediatric sun protection behavioral research. Eighty-five pediatric HSCT patients and 85 controls completed the study. Pediatric HSCT patients more frequently used sunscreen, hats, umbrellas, and sunglasses and obtained full-body skin exams compared to controls. No difference was observed in sun exposure during hours of peak sun intensity, frequency of purposeful tanning, tanning bed use, and the number of painful sunburns received between pediatric HSCT patients and controls. Although pediatric HSCT patients practice more sun protection behaviors, they experienced harmful sunburns and intentional tanning behaviors at the same rate as their peers. Patient-directed counseling and strategies to improve patient adherence to optimal sun protection behaviors could have a significant impact on the dermatology quality of life in pediatric HSCT patients.

FEATURES OF SEASONAL MANIFESTATION OF BRUCELLOSIS INFECTION AMONG THE POPULATION OF THE REPUBLIC OF TAJIKISTAN

The aim of this work was to study modern manifestations of seasonal brucellosis among the population of the Republic of Tajikistan. The materials and methods: of the study were the official statistics, as well as the results of previously performed studies on the risk assessment of the incidence in population. A retrospective epidemiological analysis of annual incidence rate for the period from 1997 to 2016 was conducted, depending on the most significant social and environmental risk factors. Results. The article shows the impact on the annual incidence rate of socio-economic transformations, including the privatization of collective livestock farms, accompanied by the massive movement of farm animals to private ownership, the loss of practice in animal breeding, and changes in environmental and climatic conditions. Against the background of the intensification of sheep breeding, there is a tendency in seasonality smoothing and shifting the maximum levels of population incidence of brucellosis to the spring season. Conclusion. The modern features of seasonal manifestation of brucellosis infection in the Republic of Tajikistan make it necessary to apply a differentiated approach to planning and conducting preventive measures in various areas of the country.

Study of clinical profile of acute lower respiratory tract infection in children aged 2 months to 5 years

Background: Acute respiratory infections are a leading cause of morbidity and mortality in under-five chil-dren in developing countries. Hence, the present study was undertaken to study the various risk factors, clinical profile and outcome of acute lower respiratory tract infections (ALRI) in children aged 2 months to 5 years. To study the risk factors associated with ALRI in these children. To ascertain the association of the various cultural practices prevalent in this area with ALRI.Methods: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 months to 5 years were evaluated for potential risk factors, clinical profile and outcome as per a predesigned proforma in a rural medical college.Results: Socio-demographic risk factors like parental illiteracy, overcrowding, partial immunization and low socioeconomic status were potential risk factors; similarly, nutritional risk factors like early and late weaning, anemia, and malnutrition were associated with ALRI. Significant environmental risk factors were the use of biomass fuels, inadequate ventilation at home, and lack of separate kitchen.Conclusions: The present study has identified various socio-demographic, nutritional and environmental risk factors for ALRI which can be tackled by effective health education of the community and effective training of peripheral health personnel.

Improving Asthma Outcomes in Children: From the Emergency Department and Into the Community

Asthma is responsible for significant disease burden and health care cost. A heterogeneous disease with significant environmental, genetic, and economic risk factors, asthma disproportionally affects the most vulnerable children. Effective strategies to improve individual asthma control rely on a multidisciplinary, cross-sector approach. The emergency department (ED) is a critical resource to identify children at risk for high morbidity and mortality from asthma. It is imperative to identify barriers to asthma control in the ED while being mindful of transitions and care coordination, especially as the United States moves to value-based reimbursement of health care. We review recent literature on ED-based interventions, present data on the importance of addressing housing and involving schools, and conceptualize an ideal medical home for asthma. We also provide examples of how our own institution has developed programs across sectors to improve asthma outcomes in children.

Effects of USB port access on advanced cookstove adoption

Three billion people cook using traditional fires, and exposure to smoke from cooking remains a persistent and significant environmental health risk factor: household air pollution is estimated to cause 3–4 million premature deaths per year. “Improved cookstoves” could reduce the health risks associated with cooking, but the performance of most improved cookstoves is insufficient to result in meaningful health benefits, and global adoption of low-emission cookstoves remains low. However, a new class of advanced cookstoves equipped with thermoelectric generators could improve both emissions performance and adoption leading to better health outcomes. These cookstoves use electrical power provided by a thermoelectric generator to power combustion-improving fans while powering outboard USB charging ports. In communities lacking electricity access, USB levels of power could provide much-needed off-grid charging for mobile phones, small lights, and other loads. However, there is a risk that instead of being used primarily as a cooking tool, these cookstoves could be used solely as fire-powered USB chargers. Without displacing traditional cookstoves, “charging-only” adoption would result in a net increase in emissions exposure. In this study, we used custom Advanced Stove Use Monitor (ASUM) sensors to measure adoption of TEG-equipped cookstoves in 72 rural homes without electricity access in Odisha, India. To measure the impacts of the USB charging port, we randomized whether recipients received a cookstove with USB ports enabled or disabled. We found that access to USB charging ports significant increased adoption of cookstoves in “cooking” use modes; USB-enabled cookstoves were used for cooking 3.5X more than identical cookstoves with disabled USB ports. This substantial increase in cooking came with a relatively small marginal use of the cookstove in a “charging-only” mode; just 11% of total cookstove use was in this mode. As with past work, data showed that surveys of user behavior do not correlate well with sensor-measured behavior. The trial cookstove was much smaller and more cumbersome than traditional cookstoves, but still, we found that users were willing to prepare fuel and found the cookstove useful for light cooking tasks. Access to USB charging served as a catalyst for adoption of advanced cookstoves as cooking tools and did not increase undesirable “charging only” adoption modes. This work suggests that these kinds of USB-enabled cookstoves could be an important tool to improve biomass combustion, increase adoption, and realize meaningful health benefits.

Activation of GPR15 and its involvement in the biological effects of smoking

Smoking is one of the most significant modifiable environmental risk factors for many diseases. Smoking causes excessive mortality worldwide. Despite decades of long research, there has not been a clear understanding regarding the molecular mechanism that makes smoking harmful to health. Some recent studies have found that smoking influences most significantly the expression and methylation of GPR15. GPR15 is an orphan receptor that is involved in the regulation of the innate immunity and the T-cell trafficking in the intestinal epithelium. Further studies have confirmed that GPR15 is very strongly involved in smoking and smoking-induced molecular changes. Therefore, the altered expression and epigenetic regulation of GPR15 could have a significant role in the health impact of smoking. Impact statement The review describes an orphan receptor GPR15 that has recently been found to be influenced by smoking. This makes GPR15 very sensitive and adequate biomarker for smoking and smoking studies. Also, activation of GPR15 by smoking could help to explain its effects on health.

A prenatal nicotine exposure mouse model of methylphenidate responsive ADHD-associated cognitive phenotypes

Prenatal exposure to nicotine via cigarette smoke or other forms of tobacco use is a significant environmental risk factor for attention deficit hyperactivity disorder (ADHD). The neurobiological mechanisms underlying the link between prenatal nicotine exposure (PNE) and ADHD are not well understood. Animal models, especially rodent models, are beginning to bridge this gap in knowledge. Although ADHD is characterized by hyperactivity, inattention, impulsivity and working memory deficits, the majority of the animal models are based on only one or two ADHD associated phenotypes, in particular, hyperactivity or inattention. We report a PNE mouse model that displays the full range of ADHD associated behavioral phenotypes including working memory deficit, attention deficit and impulsive-like behavior. All of the ADHD-associated phenotypes respond to a single administration of a therapeutic equivalent dose of methylphenidate. In an earlier study, we showed that PNE produces hyperactivity, frontal cortical hypodopaminergic state and thinning of the cingulate cortex. Collectively, these data suggest that the PNE mouse model recapitulates key features of ADHD and may be a suitable preclinical model for ADHD research.

Indoor Air Pollution as a Risk Factor of Acute Lower Respiratory Tract Infection in Children

Introduction: This study was conducted to find out if indoor air pollution has any risk in occurrence of acute lower respiratory tract infection (ALRI) in children.Materials and methods: It was a case control study conducted on total 214 children 107 cases and 107 controls fulfilling the inclusion criteria with age and sex matched. Detailed history and physical examination was done after taking informed consent. History of upper respiratory tract infection in the family members and siblings, history of smoking by various family members, details of cooking fuel and indoor pollution was also recorded.Results: Those families using wood as a cooking material were associated with higher risk of ALRI (p=0.0001). Exposure to domestic animal was significantly positively associated (p=0.0001) and seven times higher risk to develop ALRI as compared to control group. Those children of case group who did not have separate kitchen were having nine times higher risk of ALRI (p=0.001). Family history of smoking was associated with six times increased risk of ALRI (p=0.001). With the use of kerosene lamps risk of ALRI was increased by 1.44 times (p=0.012).Conclusions: The significant environmental risk factors for ALRI were wood as cooking material, presence of domestic animal, place for cooking, family history of smoking, absence of windows and kerosene lamp as a source of light.Journal of Nepalgunj Medical College Vol.13(1) 2015: 5-7

Maternal environmental risk factors for congenital hydrocephalus: a systematic review.

OBJECTIVE Congenital hydrocephalus (CH) is one of the most frequent CNS congenital malformations, representing an entity with serious pathological consequences. Although several studies have previously assessed child-related risk factors associated with CH development, there is a gap of knowledge on maternal environmental risk factors related to CH. The authors have systematically assessed extrinsic factors in the maternal environment that potentially confer an increased risk of CH development. METHODS The Cochrane Library, MEDLINE, and EMBASE were systematically searched for works published between 1966 and December 2015 to identify all relevant articles published in English. Only studies that investigated environmental risk factors concerning the mother-either during gestation or pregestationally-were included. RESULTS In total, 13 studies (5 cohorts, 3 case series, 3 case-control studies, 1 meta-analysis, and 1 case report) meeting the inclusion criteria were identified. Maternal medication or alcohol use during gestation; lifestyle modifiable maternal pathologies such as obesity, diabetes, or hypertension; lack of prenatal care; and a low socioeconomic status were identified as significant maternal environmental risk factors for CH development. Maternal infections and trauma to the mother during pregnancy have also been highlighted as potential mother-related risk factors for CH. CONCLUSIONS Congenital hydrocephalus is an important cause of serious infant health disability that can lead to health inequalities among adults. The present study identified several maternal environmental risk factors for CH, thus yielding important scientific information relevant to prevention of some CH cases. However, further research is warranted to confirm the impact of the identified factors and examine their underlying behavioral and/or biological basis, leading to the generation of suitable prevention strategies.

The dark side of the light: mechanisms of photocarcinogenesis

Ultraviolet radiation (UVR) can have a beneficial biologic impact on skin, but it is also the most significant environmental risk factor for skin cancer development. Photocarcinogenesis comprises a complex interplay between the carcinogenic UVR, skin, and the immune system. UVB is absorbed by the superficial skin layers and is mainly responsible for direct DNA damage, which, if unrepaired, can lead to mutations in key cancer genes. UVA is less carcinogenic, penetrates deeper in the dermis, and mainly causes indirect oxidative damage to cellular DNA, proteins, and lipids, via photosensitized reactions. UVR not only induces mutagenesis, altering proliferation and differentiation of skin cells, but also has several immunosuppressive effects that compromise tumor immunosurveillance by impairing antigen presentation, inducing suppressive cells, and modulating the cytokine environment. This review focuses upon molecular and cellular effects of UVR, regarding its role in skin cancer development.

Facilitating organisational decision making: a change risk assessment model case study

Purpose This paper aims to take the challenge to propose a novel modelling approach named Change Risk Assessment Model (CRAM), which will contribute significantly to the missing formality of business models especially in the change risk assessment area and decision-making. Organisational change risks are assessed with the aid of analytic hierarchy process (AHP) in an attempt to define the internal dynamics of organisational change management within project management eliciting also risk cause-and-effect relationships. Design/methodology/approach The study discusses interviews/survey/AHP. Findings The study presents the following findings. Change risk factors assessment (identification and prioritisation) recommendations (see Case Study) integration of change management; project management; risk management top four risk factors, namely, leadership, communication, project management team and culture. Research limitations/implications As projects can be different in a variety of factors (quality, scope), an exhaustive list of risk factors cannot be identified. There is a continuous risk identification process throughout the projects’ life cycle. For example, many risks can be classified initially as unknown and can be refined after the initiation phase of the project. AHP factors limitation (eight per level) possible bias (survey analysis). Practical implications With the aid of modelling and especially CRAM, business change risks can be assessed numerically and prioritised. Several risk factors and related attributes were identified and categorised. This empowers project managers or other stakeholders to make proper decisions about whether to take on or abandon respective organisational or project changes. Social implications One of the values of CRAM is that it can be regarded as a global change risk assessment method that can be applied regardless of project type, size or organisation. Moreover, it has the advantage that it can be used by any kind of project, as the method is designed to be tailored to specific needs, taking significant environmental change risk factors into account. AHP has numerous uses in operational research, in project management and in general in areas where decisions (evaluation and selection) have to be made. The analysis of the case study presented, indicated that it is vital to assess the degree (impact) that each risk attribute poses to address complex organisational decisions. Originality/value CRAM aims to bridge the gap between theoretical and applied work in the integrated research field of change management, project management and risk management. Furthermore, the approach attempts to develop a novel systematic methodology (model) for assigning probabilities in attributes (criteria) pair-wise comparison and more specifically, modelling and assessing change management risks, adding a different perspective and technique to the research area.

A study of modifiable risk factors for acute lower respiratory tract infections among under five children in a tertiary care hospital in Gulbarga, Karnataka

Background: Acute respiratory infection includes any infection of the upper or lower respiratory system, as defined by the International Classification of Diseases. Acute respiratory infection is a leading cause of morbidity and mortality in under-five children in developing countries. Objective: This study was undertaken to identify various modifiable risk factors for acute lower respiratory tract infections (ALRI) in children aged from2 months to 5 years. Methodology: This hospital-based case–control study was conducted at Basaveshwarand Sangameshwar general hospital, Gulbarga over 1½. year 200 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 months to 5 years were interrogated for potentially modifiable risk factors as per a predesigned preformed. 200 healthy control children in the same age group were also interrogated. Results: The significant socio-demographic risk factors were incomplete immunization for age, low parental education, low socioeconomic status, and overcrowding (p<0.05 in all). Significant nutritional risk factors includemalnutrition, anemia, and rickets (p<0.05 in all). Significant environmental risk factors were parental smoking, use of biomass fuel, and mud/cow dung flooring (p<0.05 in all). Using multiple logistic regression analysis, the factors which were found to be significantly associated were younger age (p=0.000), anemia (p=0.000), incomplete immunization for age (p=0.002), malnutrition (p=0.00), low literacy level of father (p=0.000), and overcrowding (p=0.000). Conclusion: This study has identified various socio-demographic, nutritional, and environmental modifiable risk factors for ALRI which can be tackled by effective education of the community and appropriate initiatives taken by the government.

Demographic profile of children with acute lower respiratory tract infections of age between 2months to 5 years

Background: Acute respiratory infections are a leading cause of morbidity and mortality in under-five children in developing countries. Hence, the present study was undertaken to study the various demographic risk factors which predispose to acute lower respiratory tract infections (ALRI) in children aged 2 month to 5 year. Objective; Demographic factors associated with acute lower respiratory tract infections in children aged 2 months to 5 years. Methods: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 month to 5 years were evaluated for demographic risk factors and clinical profile as per a predesigned proforma in a rural medical college. Results: Socio-demographic risk factors like parental illiteracy, overcrowding, partial immunisation and low socioeconomic status were potential risk factors; similarly nutritional risk factors like early and late weaning, anaemia and malnutrition were associated with ALRI. Significant environmental risk factors were use of biomass fuels, inadequate ventilation at home, and lack of separate kitchen. Conclusion: The present study has identified various socio-demographic, nutritional and environmental risk factors for ALRI which can be tackled by effective health education of the community and effective training of peripheral health personnel.