Exposure Of Women Research Articles

Trauma exposure and IPV experienced by Afghan women: Analysis of the baseline of a randomised controlled trial.

BackgroundFour decades of conflict has indelibly impacted the lives of Afghans, exposing many to different forms of trauma. The aim of this paper investigate a hypothesis that (mostly war related) trauma is a key driver of partner violence in Afghanistan.Methods1,463 women aged 18–48 were recruited into a randomised controlled trial (RCT) to evaluate a women empowerment intervention in 8 villages of Kabul and Nangarhar provinces. The women were interviewed at baseline. The analysis uses multivariable logistic regression and structural equation modelling (SEM) to describe relationships between measures.Results57.4% of women reported exposure to one of four types of trauma: 23.3% an armed attack, 39.4% had felt close to death, 10.6% witnessed a friend or family member being killed and 21.4% witnessed the death of a stranger or someone unknown. Trauma exposure was associated with being older, Pashtan, madrassa educated, and food insecure. Women who were trauma exposed were more likely to have ever experienced IPV, have hit their children in the last 4 weeks, and be hit by a sibling or relative of their husband or their mother-in-law in the last year. They held less patriarchal personal gender attitudes and perceived the community to be more patriarchal. The SEM showed that all pathways between trauma exposure and IPV were ultimately mediated by either (mostly mental) ill-health or quarrelling, but not both of these. There were multiple paths through which trauma exposure impacted women’s past year experience of physical IPV. One was mediated by childhood trauma exposure and a latent variable for ill health. Other paths were mediated by women’s education and personal gender attitudes and ill-health, or else by quarrelling. Trauma exposure was related to lower educational levels. Another path was mediated by less patriarchal personal gender attitudes and ill health. Community gender attitudes was a mediating variable on a path which was also mediated by ill health and another mediated by quarrelling. It was also a mediator on a path which included personal gender attitudes and ill-health. Food insecurity mediated another path with ill health. It was also connected to childhood trauma, community gender attitudes and educational level.ConclusionTrauma exposure due to conflict will persist until the conflict ends but the impact on women can be ameliorated. This analysis suggests interventions to reduce women’s exposure to IPV should focus on reducing poverty, changing social norms on gender, providing relationship skills to help reduce quarrelling and supporting women’s mental health.

Women at Work: How Exposed Are They?

Aim: To use workers' compensation claims for occupational disease and illness over a 25-year period as an indicator for women's exposures at work.Methods: Accepted compensation claims and labour fo...

Air Pollution Exposure and Risk of Spontaneous Abortion in the Nurses' Health Study II

STUDY QUESTION Is there an association between air pollution exposures and the risk of spontaneous abortion (SAB)? SUMMARY ANSWER Higher exposure to particulate matter (PM) air pollution above and beyond a woman's average exposure may be associated with greater risk of SAB, particularly among women experiencing at least one SAB during follow-up. WHAT IS KNOWN ALREADY There is sufficient biologic plausibility to suggest that air pollution adversely affects early pregnancy outcomes, particularly pregnancy loss; however, the evidence is limited. STUDY DESIGN, SIZE, DURATION Our prospective cohort study included 19 309 women in the Nurses' Health Study II who contributed a total of 35 025 pregnancies between 1990 and 2008. We also conducted a case-crossover analysis among 3585 women (11 212 pregnancies) with at least one SAB and one live birth during follow-up. PARTICIPANTS/MATERIALS, SETTING, METHODS Proximity to major roadways and exposure to PM <10 microns (PM10), 2.5-10 microns (PM2.5-10) and <2.5 microns (PM2.5) were determined for residential addresses between 1989 and 2007. Pregnancy outcomes were self-reported biannually throughout follow-up and comprehensively in 2009. Multivariable log-binomial regression models with generalized estimating equations were used to estimate the risk ratios and 95% CIs of SAB. Conditional logistic regression was used for the case-crossover analysis. MAIN RESULTS AND THE ROLE OF CHANCE During the 19 years of follow-up, 6599 SABs (18.8% of pregnancies) were reported. In the main analysis, living closer to a major roadway and average exposure to PM10, PM10-2.5 or PM2.5 in the 1 or 2 years prior to pregnancy were not associated with an increased risk of SAB. However, small positive associations between PM exposures and SAB were observed when restricting the analysis to women experiencing at least one SAB during follow-up. In the case-crossover analysis, an increase in PM10 (per 3.9 μg/m3), PM2.5-10 (per 2.3 μg/m3) and PM2.5 (per 2.0 μg/m3) in the year prior to pregnancy was associated with 1.12 (95% CI 1.06, 1.19), 1.09 (95% CI 1.03, 1.14) and 1.10 (95% CI 1.04, 1.17) higher odds of SAB, respectively. LIMITATIONS, REASONS FOR CAUTION We did not have information on the month or day of SAB, which precluded our ability to examine specific windows of susceptibility or acute exposures. We also used ambient air pollution exposures as a proxy for personal exposure, potentially leading to exposure misclassification. WIDER IMPLICATIONS OF THE FINDINGS In our case-crossover analysis (but not in the entire cohort) we observed positive associations between exposure to all size fractions of PM exposure and risk of SAB. This may suggest that changes in PM exposure confer greater risk of SAB or that women with a history of SAB are a particularly vulnerable subgroup. STUDY FUNDING/COMPETING INTEREST(S) The authors are supported by the following NIH grants UM1CA176726, R00ES026648 and P30E02. The authors have no actual or potential competing financial interests to disclose.

Mental health in girls and boys exposed to intimate partner violence.

Children of abused women have a greater risk of mental health problems. This study assesses the association between women's exposure to intimate partner violence (IPV) and the mental health of their children in the population of the Madrid Region. Cross-sectional. Data were drawn from the '2014 Survey on Intimate Partner Violence against Women in the Madrid Region'. Women meeting the definition of IPV answered the Strengths and Difficulties Questionnaire (SDQ) on the mental health of one of their children aged 4-16 years. The comparison group was made up of mother-child dyads that had not been exposed to IPV. We used multivariate analysis to assess whether the children of abused women had a greater probability of having higher SDQ subscale and total scores. A total of 209 mother-child dyads were analyzed, 64 exposed (50% boys) and 145 unexposed to IPV (51% boys). Exposure to IPV was associated with a high SDQ score (greater risk of mental health problems), with a prevalence ratio of 3.6 (95% CI 1.2-10.3) in girls and 2.4 (95% CI 1.1-5.1) in boys. Among girls, moreover, exposure to IPV was significantly associated with behavioral and inattention/hyperactivity problems. In conclusion, exposure to IPV was associated with an increased frequency of mental health problems among children in general, and girls in particular. This study reinforces the recommendations to conduct studies with data disaggregated by sex and to address the impact of IPV in mothers and children jointly.

Lifetime number of years of menstruation as a risk index for postmenopausal endometrial cancer in the Norwegian Women and Cancer Study.

IntroductionLifetime number of years of menstruation (LNYM) reflects a woman's cumulative exposure to endogenous estrogen and can be used as a measure of the combined effect of reproductive factors related to endometrial cancer (EC) risk.Material and methodsWe aimed to study the association between LNYM and EC risk among postmenopausal women and calculate the population attributable fraction of EC for different LNYM categories. Our study sample consisted of 117 589 women from the Norwegian Women and Cancer (NOWAC) Study. All women were aged 30‐70 years at enrollment and completed a baseline questionnaire between 1991 and 2006. Women were followed up for EC to December 2014 through linkages to national registries. We used Cox proportional hazards models to estimate hazard ratios with 95% confidence intervals (95% CIs), adjusted for potential confounders.ResultsIn all, 720 women developed EC. We found a statistically significant, positive dose‐response relationship between LNYM and EC, with a 9.1% higher risk for each additional year of LNYM (P for trend < .001). Using the LNYM category ≥40 as a reference, the hazard ratios for LNYM <25, 25‐29, 30‐34, 35‐39 were 0.17 (95% CI 0.22‐0.27), 0.25 (95% CI 0.17‐0.36), 0.43 (95% CI 0.32‐0.58), and 0.68 (95% CI 0.51‐0.92), respectively. The association between LNYM and EC was independent of incomplete pregnancies, menopausal hormone therapy, diabetes, and body mass index. When considering the population attributable fraction, 67% of EC was estimated to be attributable to LNYM ≥25 years.ConclusionsOur study supports that increasing LNYM is an important and independent predictor of EC risk.

Chemical-by-chemical and cumulative risk assessment of residential indoor exposure to semivolatile organic compounds in France

BackgroundThe toxic effects of environmental exposure to chemicals are increasingly being studied and confirmed, notably for semivolatile organic compounds (SVOCs). These are found in many products and housing materials, from which they are emitted to indoor air, settled dust and other surfaces. ObjectivesThe objective of this work is to assess the human health risk posed by residential indoor exposure to 32 SVOCs, assessed in previous nationwide studies. MethodsA chemical-by-chemical risk assessment, using a hazard quotient (HQ) or excess risk (ER) method, was supplemented by a cumulative risk assessment (CRA). For CRA, a hazard index (HI) method, as well as higher tier approaches using relative potency factors (RPFs) or toxic equivalency factors (TEFs) were used for the following endpoints: neurotoxicity, reproductive toxicity, genotoxicity and immunotoxicity. ResultsHQs were above 1 for 50% of French children from birth to 2 years for BDE 47, and for 5% of children for lindane and dibutyl phthalate (DBP). Corresponding hazards are reprotoxic for BDE 47 and DBP, and immunotoxic for lindane. The CRA approach provided additional information of reprotoxic risks (HI > 1) that may occur for 95% of children and for 5% of the offspring for pregnant women's exposure. The SVOCs contributing most to these risks were PCB 101 and 118, BDE 47, and DBP. The higher tier CRA approaches showed that exposure to dwellings' SVOC mixtures were of concern for 95% of children for neurotoxic compounds having effects linked with neuronal death. To a lesser extent, effects mediated by the aryl hydrocarbon receptor (AhR) or by a decrease in testosterone levels may concern 5% of children and adults. Lastly, unacceptable immunotoxic risk related to exposure to 8 indoor PCBs was also observed for 5% of children. ConclusionsIn view of uncertainties related to compounds' toxicity for humans, these results justify the implementation of preventive measures, as well as the production of more standardized and comprehensive toxicological data for some compounds.

Association between ambient air pollution and pregnancy rate in women who underwent IVF.

Are the concentrations of five criteria air pollutants associated with probabilities of biochemical pregnancy loss and intrauterine pregnancy in women? Increased concentrations of ambient particulate matter (PM10), nitrogen dioxide (NO2), carbon monoxide (CO) during controlled ovarian stimulation (COS) and after embryo transfer were associated with a decreased probability of intrauterine pregnancy. Exposure to high ambient air pollution was suggested to be associated with low fertility and high early pregnancy loss in women. Using a retrospective cohort study design, we analysed 6621 cycles of 4581 patients who underwent one or more fresh IVF cycles at a fertility centre from January 2006 to December 2014, and lived in Seoul at the time of IVF treatment. To estimate patients' individual exposure to air pollution, we computed averages of hourly concentrations of five air pollutants including PM10, NO2, CO, sulphur dioxide (SO2) and ozone (O3) measured at 40 regulatory monitoring sites in Seoul for each of the four exposure periods: period 1 (start of COS to oocyte retrieval), period 2 (oocyte retrieval to embryo transfer), period 3 (embryo transfer to hCG test), and period 4 (start of COS to hCG test). Hazard ratios (HRs) from the time-varying Cox-proportional hazards model were used to estimate probabilities of biochemical pregnancy loss and intrauterine pregnancy for an interquartile range (IQR) increase in each air pollutant concentration during each period, after adjusting for individual characteristics. We tested the robustness of the result using generalised linear mixed model, accounting for within-woman correlation. Mean age of the women was 35 years. Average BMI was 20.9 kg/m2 and the study population underwent 1.4 IVF cycles on average. Cumulative pregnancy rate in multiple IVF cycles was 51.3% per person. Survival analysis showed that air pollution during periods 1 and 3 was generally associated with IVF outcomes. Increased NO2 (adjusted HR = 0.93, 95% CI: 0.87, 0.99) and CO (0.94, 95% CI: 0.89, 1.00) during period 1 were associated with decreased probability of intrauterine pregnancy. PM10 (0.92, 95% CI: 0.85, 0.99), NO2 (0.93, 95% CI = 0.86, 1.00) and CO (0.93, 95% CI: 0.87, 1.00) levels during period 3 were also inversely associated with intrauterine pregnancy. Both PM10 (1.17, 95% CI: 1.04 1.33) and NO2 (1.18, 95% CI: 1.03, 1.34) during period 3 showed positive associations with biochemical pregnancy loss. The district-specific ambient air pollution treated as an individual exposure may not represent the actual level of each woman's exposure to air pollution. Smoking, working status, parity or gravidity of women, and semen analysis data were not included in the analysis. This study provided evidence of an association between increased ambient concentrations of PM10, NO2 and CO and reduced probabilities for achieving intrauterine pregnancy using multiple IVF cycle data. Specifically, our results indicated that lower intrauterine pregnancy rates in IVF cycles may be linked to ambient air pollution during COS and the post-transfer period. This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2013 R1A6A3A04059017, 2016 R1D1A1B03933410 and 2018 R1A2B6004608) and the National Cancer Center of Korea (NCC-1810220-01). The authors report no conflicts of interest. N/A.

The relationship between domestic violence against women and suicide risk

The purpose of this study is to examine the relationship between domestic violence against women and suicide risk. The population of the study consisted of married women aged 18 years and over in 10 Family Health Centers located within the boundaries of Yeşilyurt Municipality of Malatya Province. The study was completed with 1025 women. In the data collection, a 6-question questionnaire prepared by the researcher upon the literature review, Domestic Violence Scale, and Suicide Probability Scale were used. Percentage distribution, arithmetic mean, independent samples t test, and correlation were used to assess the data. In the study, it was found that domestic violence levels of the women were high and their suicide risks were moderate. A statistically positive correlation was determined between DVS subscale and total mean scores of the women and their suicide risk subscale and total mean scores (p < 0.05). In the study, it was determined that as the women's exposure to domestic violence increased, their suicide risks also increased. It can be recommended to establish centers for women and organize trainings in order to prevent domestic violence and suicide risk in women.

Endocrine disrupting chemicals in seminal plasma and couple fecundity

Growing evidence supports the importance of men's exposure to non-persistent endocrine disruptors (EDCs) and couple fecundability, as measured by time-to-pregnancy (TTP). This evolving literature contrasts with the largely equivocal findings reported for women's exposures and fecundity. While most evidence relies upon urinary concentrations, quantification of EDCs in seminal plasma may be more informative about potential toxicity arising within the testes. We analyzed 5 chemical classes of non-persistent EDCs in seminal plasma for 339 male partners of couples who were recruited prior to conception and who were followed daily until pregnant or after one year of trying. Benzophenones, bisphenols, parabens, and phthalate metabolites and phthalate diesters were measured using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) except for phthalate diesters, which were analyzed using gas chromatography-mass spectrometry. Cox regression with discrete-time was used to estimate fecundability odds ratios (FORs) and 95% confidence intervals (CIs) for each chemical to estimate the probability of pregnancy. While most EDCs were detected in seminal plasma, concentrations were lower than urinary concentrations previously analyzed for the cohort. None of the EDCs were significantly associated with fecundability even after covariate adjustment, though benzophenones consistently yielded FORs <1.0 (ranging from 0.72 to 0.91) in couple-adjusted models suggestive of diminished fecundity (longer TTP). The findings underscore that a range of EDCs can be quantified in seminal plasma, but the lower concentrations may require a large cohort for assessing couple fecundability, as well as the need to consider other fecundity outcomes such as semen quality.

Preliminary assessment of vibration impacts generated by the public transport systems on pregnant women based on subjective reactions.

Research efforts summarised in this study were a part of preliminary investigation to evaluate the impact of pregnant women's exposure to vibrations generated by public transport system when using. The assessment of the problem and discomfort for pregnant women, caused by the public transportation is based on a questionnaire including questions relating to the women's subjective feelings on well-being or discomfort when exposed to vibration during the ride in passenger cars or when using means of public transport. In the second stage of investigation, vibrations transmitted onto a sitting person during the tram or car ride were measured. The survey shows that when travelling on a tram the women complained mostly of digestive or neurological disorders, during the car ride they suffered most acutely from digestive disorders, sensed enhanced foetus movements and reported problems with the osteoarticular system. Amplitude-frequency characteristics of the investigated vehicle types reveal that vibration amplitudes registered during the ride in a motor vehicle are higher than on tram (in the analysed frequency range). Furthermore, vibration accelerations in the z-axis direction registered during the tram ride exceed the vibration discomfort threshold, particularly for the 1/3 octave bands 5 and 6.3 Hz. These are frequency ranges corresponding to resonance frequencies of vital organs in the abdominal cavity (4.5-10 Hz). Correlating these results with frequencies reported in literature associated with subjective human responses to vibration, shows that pregnant women using public transport are likely to suffer from a variety of ailments caused by vibrations generated during the ride.

Severe intimate partner physical violence as a risk factor for inadequate cervical cancer screening.

With the aim of assessing the occurrence of severe intimate partner physical violence as a risk factor for inadequate screening of uterine cervical cancer, a case-control study was performed with a multidimensional questionnaire in a sample of 640 users of the Family Health Strategy in the Municipality of Nova Iguaçu, Rio de Janeiro State, Brazil. Cases were defined as women who had not had a cervical cytology test in the previous three years. The results showed that severe physical violence against the woman (adjustedOR = 2.2; 95%CI: 1.1-4.4) and co-occurrence of the event in the couple (adjustedOR = 3.8; 95%CI: 1.4-9.8) were risk factors for inadequate screening. Alcohol abuse by the woman was an effect modifier for not having the test among victims of violence (adjustedOR = 10.2; 95%CI: 1.8-56.4) and in cases of co-occurrence of violence (adjustedOR = 8.5; 95%CI: 1.4-50.7). In addition to known causal factors for intimate partner violence, the results point to a risk association between women's exposure to abuse and inadequate screening. The findings call for an expanded view of women's absenteeism from screening, since this indicator can represent unmet demands not readily detected by health teams.

Police violence among women in four U.S. cities

Police violence has been identified as a public health concern in the U.S., yet few studies have assessed the prevalence and nature of police violence among women. Furthermore, increasing evidence suggests that women reporting intimate partner violence (IPV) and sexual violence (SV) to police are often met with harmful or neglectful police responses and thus, women's exposures to police violence may be associated with experiences of IPV and SV; however, this has not yet been empirically tested. This study assesses lifetime prevalence and sociodemographic correlates of police violence among women and investigates potential associations between IPV, SV, and police violence. A cross-sectional survey was administered in four Eastern U.S. cities in March and April 2016 (N=932). Physical, sexual, and psychological police victimization and neglect by police were assessed. Logistic regression was used to examine the relationship between IPV, SV, and police violence, adjusting for sociodemographics. Lifetime prevalence of physical (4%), sexual (3.3%), and psychological (14.4%) police violence and neglect (17.2%), show that a notable proportion of women experience police victimization, with significantly higher rates among racial and ethnic minority women. Women with IPV and SV histories had increased odds of experiencing most forms of police violence compared to women without IPV and SV histories. Findings suggest the need for gender-inclusive community-centered policing initiatives and other preventive efforts aimed at eliminating police violence. Police violence and victimization among women should also be considered in IPV and SV intervention and treatment responses.

Qualitative Research Methods to Advance Research on Health Inequities Among Previously Incarcerated Women Living With HIV in Alabama.

Justice-involved HIV-positive women have poor health outcomes that constitute health inequities. Researchers have yet to embrace the range of qualitative methods to elucidate how psychosocial histories are connected to pathways of vulnerability to HIV and incarceration for this key population. We used life course narratives and intersubjectivity-predicated on interview dialogue-to investigate how familial and social settings established their social patterning of HIV, incarceration risk, and poor health. Working with two Alabama community-based organizations, we recruited and interviewed 24 HIV-positive cisgender women with cyclical incarceration. We analyzed the data by charting women's life histories and conducting iterative content analyses. Participants described chaotic home environments, marked by exposure to trauma in childhood. The majority experienced repeated sexual and physical abuse that went undiagnosed and untreated until adulthood. Adolescence and young adulthood were characterized by onset of substance use, violent intimate partnerships, and subsequent behavioral and mental health problems. In adulthood, risk behaviors persisted for decades and women lacked mental health treatment and social support. Life course narratives and intersubjectivity contributed to knowledge by affording agency to marginalized participants to reflect on and narrate their life stories; instilling needed trust for researchers to investigate the complex risk pathways and psychosocial histories with this population; illuminating the nature, timing, sequence, and frequency of events underlying women's vulnerability and exposure to HIV and incarceration; and clarifying that early shaping events in childhood are connected to later risk environments and behaviors in adolescence and adulthood, suggesting the need for earlier interventions than are typically proposed.

The effect of a husband's history of political imprisonment on intimate partner violence: evidence from the occupied Palestinian territory using propensity score matching

BackgroundLittle is known about the direct effect of political imprisonment on men's subsequent violent behaviour within the family. Availability of these recent survey data about intimate partner violence and measures of men's detention in prison and their associated physical and emotional torture provides a unique opportunity to assess the causal association between these two factors. We aimed to examine the effect of political imprisonment on intimate partner violence, using data from the 2011 Palestinian domestic violence survey, which included the West Bank and Gaza Strip. MethodsThe study was based on data from a 2011 cross-sectional survey of a representative sample of 4413 married Palestinian women. A total of 3988 women were included in the matching analysis, of which 640 women had husbands who had been detained. The outcome variable was the women's exposure to partner physical violence during the past year. The treatment effect was whether a husband had been detained before 2010. We used propensity score matching and propensity-based weighted regression models to assess the effect of a whether a husband had a history of detention on intimate partner violence. Score matching was undertaken with the variables of age, education, region, type of residence, refugee status, residential crowding, labour force participation, poverty, financial stress, decision making index, and husband control index. FindingsSevere physical intimate partner violence during the past year was reported by 455 (11%) women and sexual violence by 439 (11%) women. 640 (16%) women reported that their husbands were detained before 2010. Analysis of model-based estimates and average treatment effect showed a positive effect of a husbands who had been detained on their physical violence (mean treatment effect 0·036, 95% CI 0·008 to 0·62), but not with sexual violence (mean treatment effect −0·014, 95% CI −0·040 to 0·11) towards their partner. InterpretationThe results are important for the design of specific interventions that might mitigate the negative effect of a husband's detention on their wives's lives. A potential confounder is that Palestinian men who are more likely to be imprisoned (eg, active in demonstrations) might also be more likely to commit intimate partner violence. An important implication is the need to consider rehabilitation services or counselling for previous detainees in this context. FundingNone.

Rapid spread of an ongoing outbreak of Zika virus disease in pregnant women in a Mexican hospital

In the first nine weeks of implementation of a Zika Virus Preparedness Plan in a Mexican Public Hospital, we cared for 221 pregnant women with any signal or symptom suggesting Zika virus infection and 99 (44.8%) patients were found to be positive for Zika virus.The median age of patients was 25.3 years (range 13–49). Symptoms in PCR-positive patients were rash (91.4%) followed by headache (53.1%), myalgia (46.9%), arthralgia (45.7%), pruritus (35.8%), retroocular pain (29.6%), conjunctivitis (21%), and fever (21%). The women's epidemiologic exposure history indicates local transmission and a community outbreak.

Changes in Use of Family Planning among the Urban Poor: Evidence from Nairobi Slums

As urbanization continues unabated in Kenya, the wellbeing of the urban poor ‐ whose majority live in slum settlements ‐ will increasingly drive national development indicators including Vision 2030, SDGs and FP2020 goals. It is therefore central to understand and identify ways to address the poor reproductive health outcomes among poor urban slum populations in the country. Taking advantage of APHRC's NCSS surveys conducted in 2000 and 2012 among a representative sample of slum households across Nairobi, we show that there has been a considerable increase in use of modern contraception among women in Nairobi slums, from 34% in 2000 to 53% in 2012, and a reduction in inequity in access through much higher increases among previously disadvantaged groups. Using decomposition analysis techniques, we show that much of the observed increase is due to behavioral changes in the effect of fertility preferences on contraceptive use; and to compositional changes in woman's education, child survival and exposure to FP information. This may be the result of efforts by the government of Kenya and its development partners to reduce the disparities in uptake and use of FP services through various programs and policies targeting the poor segments of the Kenyan population.

A Critique of Risk Disclosure as the Solution for Minimizing Toxic Exposures in Pregnancy.

The issue of pregnant women's exposures to everyday chemicals and the implications for the health of future children are receiving increased attention in popular media and in the academic press. In response, health profession organizations are developing clinical practice guidelines for warning pregnant women about the risks associated with exposures to certain toxics. We evaluate different sides of a risk-avoidance approach for pregnant women in the context of a hypothetical case study involving phthalates and women who work in nail salons. We consider the ubiquitous nature of low-dose exposures and both the positive aspects and limitations of promoting avoidance measures with respect to phthalate exposures. We conclude that a risk-disclosure approach has both practical limitations and equity dimensions which must be factored in to public health guidelines and messaging and the development of clinical practice guidelines. Upstream solutions including regulatory action on chemicals and heightened attention to environmental justice would result in optimal management of this issue.

Impact of military trauma exposures on posttraumatic stress and depression in female veterans

Previous research has demonstrated the deleterious effects of traumatic military experiences on symptoms of posttraumatic stress disorder (PTSD) and depression in female veterans. However, more research is needed to identify the unique predictors of distressing psychological symptoms when both combat-related and sexual trauma are considered, particularly as women's combat exposure in the military increases. Female veterans who had attended at least one appointment at a large Veterans Health Administration medical center were invited to complete questionnaires about traumatic military exposures and psychiatric symptoms. A total of 403 veterans responded, with 383 respondents’ data used in analyses. Multiple regression analyses were conducted with trauma exposure items entered simultaneously to determine their association with symptoms of (1) PTSD and (2) depression. Sexual assault had the strongest relationship with both posttraumatic and depressive symptoms. Sexual assault, sexual harassment, feeling in danger of being killed, and seeing others killed/injured were associated with symptoms of PTSD, but only sexual assault and sexual harassment were associated with symptoms of depression, even when accounting for several aspects of combat exposure. Improving assessment for trauma exposure and developing treatments personalized to type of trauma experienced are important clinical research priorities as female service members’ roles in the military expand.

Methylmercury Exposure in Women of Childbearing Age and Children.

Methylmercury Exposure in Women of Childbearing Age and Children.

Effect of Environmental Factors on Low Weight in Non-Premature Births: A Time Series Analysis.

ObjectiveExposure to pollutants during pregnancy has been related to adverse birth outcomes. LBW can give rise to lifelong impairments. Prematurity is the leading cause of LBW, yet few studies have attempted to analyse how environmental factors can influence LBW in infants who are not premature. This study therefore sought to analyse the influence of air pollution, noise levels and temperature on LBW in non-premature births in Madrid during the period 2001–2009.MethodsEcological time-series study to assess the impact of PM2.5, NO2 and O3 concentrations, noise levels, and temperatures on LBW among non-premature infants across the period 2001–2009. Our analysis extended to infants having birth weights of 1,500 g to 2,500 g (VLBW) and less than 1,500 g (ELBW). Environmental variables were lagged until 37 weeks with respect to the date of birth, and cross-correlation functions were used to identify explaining lags. Results were quantified using Poisson regression models.ResultsAcross the study period 298,705 births were registered in Madrid, 3,290 of which had LBW; of this latter total, 1,492 were non-premature. PM2.5 was the only pollutant to show an association with the three variables of LBW in non-premature births. This association occurred at around the third month of gestation for LBW and VLBW (LBW: lag 23 and VLBW: lag 25), and at around the eighth month of gestation for ELBW (lag 6). Leqd was linked to LBW at lag zero. The RR of PM2.5 on LBW was 1.01 (1.00 1.03). The RR of Leqd on LBW was 1.09 (0.99 1.19)(p<0.1).ConclusionsThe results obtained indicate that PM2.5 had influence on LBW. The adoption of measures aimed at reducing the number of vehicles would serve to lower pregnant women's exposure. In the case of noise should be limited the exposure to high levels during the final weeks of pregnancy.