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Role of neuroticism and perceived stress on quality of life among patients with dry eye disease. Sci Rep 2022; 12:7079. [PMID: 35490178 PMCID: PMC9056508 DOI: 10.1038/s41598-022-11271-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
This hospital-based, cross-sectional observational study aimed to examine whether neuroticism has an impact on stress that is related to dry eye disease (DED) and quality of life (QOL). One hundred participants who had DED completed the Dry Eye-Related Quality-of-Life Score (DEQS) questionnaire, a 5-level EQ-5D (EQ-5D-5L), Neuroticism Inventory (NI), and 10-Item Perceived Stress Scale (PSS). Hierarchical linear regression was applied to determine the predictive effect of the independent variables. Participants' mean age was 50.91 ± 14.3 years, and females totalled 89.0%. Hierarchical linear regression analysis showed that DESQ-Ocular symptoms were the strongest predictor for QOL either assessed by DEQS or EQ-5D, and its effect was lessened when perceived stress and neuroticism were added to the model. The final model explained up to 30-39% variance of the QOL, compared with 13-32% by DESQ-Ocular symptoms alone. QOL of the patients with DED, is not only related to eye symptoms but perceived stress. Moreover, neuroticism was a strong predictor contributing to the QOL among patients with DED. The study showed a significant association between perceived stress, neuroticism and the QOL of patients with DED. Personality has some impact on both subjective dry eye symptoms and impact on daily life, along with the general health-related QOL.
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Zijlema WL, de Kluizenaar Y, van Kamp I, Hartman CA. Associations between road traffic noise exposure at home and school and ADHD in school-aged children: the TRAILS study. Eur Child Adolesc Psychiatry 2021; 30:155-167. [PMID: 32246274 PMCID: PMC7864841 DOI: 10.1007/s00787-020-01521-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/23/2020] [Indexed: 11/27/2022]
Abstract
Environmental noise may play a role in the manifestation and severity of attention deficit/hyperactivity disorder (ADHD) symptoms, but evidence is limited. We investigated the cross-sectional associations between residential and school road traffic noise exposure and ADHD symptoms and diagnosis. The sample included n = 1710, 10-12-year-old children from the TRAILS study in The Netherlands. ADHD symptoms were measured using a DSM-IV based subscale from the Child Behavior Checklist. Children with diagnosed ADHD originated from the clinic-referred cohort. Road traffic noise (Lden) was estimated at the residence and school level, by model calculation. Risk ratios for ADHD symptoms and ADHD diagnoses, and regression coefficients for symptom severity were estimated separately and simultaneously for residential and school road traffic noise. Adjusted multinomial models with residential road traffic noise showed that residential noise was not associated with ADHD symptoms, but was associated with lower risks for ADHD diagnosis (RR = 0.93; 95% CI 0.89, 0.97). Similar associations were observed for models including school road traffic noise and models including both exposures. No clear exposure response relationship was observed for associations between residential or school noise and ADHD symptom severity. We found no evidence for a harmful association between road traffic noise and ADHD. Associations between noise and lower risks for ADHD were observed only in referred cases with a confirmed ADHD diagnosis and may be due to residual confounding or selection bias. Future studies should focus on residential and school noise exposure, and study associations with ADHD symptoms and diagnosis over time.
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Affiliation(s)
- W. L. Zijlema
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), C/Doctor Aiguader 88, 08003 Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | | | - I. van Kamp
- RIVM, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - C. A. Hartman
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Prevalence of non-specific health symptoms in livestock dense areas: Looking beyond respiratory conditions. Int J Hyg Environ Health 2020; 230:113603. [PMID: 32882646 DOI: 10.1016/j.ijheh.2020.113603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 06/01/2020] [Accepted: 08/05/2020] [Indexed: 11/22/2022]
Abstract
The aim of this study was to gain more insight in the association between prevalence of diverse acute non-specific symptoms (NSS) and livestock density as a possible risk factor among residents of livestock-dense and non-dense regions, taking into account socio-demographic factors and psychological morbidity. Prevalence of NSS and psychological morbidity were assessed for the year 2017, based on electronic health records from 39 general practices in the Netherlands. The study group consisted of people who lived in rural areas with high numbers of livestock (n = 74093), while the control group included people in rural areas with low numbers of livestock (n = 50139). For a large portion of the study group, exposure estimates (to livestock) were calculated. Multiple logistic multilevel regression analyses were performed. Two methods were used: 1) area comparisons between study and control areas in relation to health problems, and 2) estimates of livestock exposure (to goats, poultry, pigs, and cattle) within the study area. It was found that prevalence of diarrhea, headache, sleep disturbance, respiratory symptoms, and skin problems were higher in the study group. The data suggest that there may be a protective effect of livestock exposure: in general, there was a lower risk of NSS closer to livestock (within the exposure analyses). The study suggests that the previously identified higher risk of respiratory health problems in livestock dense areas might also apply to the prevalence of various other NSS. Longitudinal research taking into account different or more individual and contextual characteristics could possibly elucidate why prevalence of NSS in closer proximity to livestock is lower compared to people who live further away, whilst a more overarching analysis indicated that living in livestock dense areas was associated with more NSS.
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Clark C, Crumpler C, Notley H. Evidence for Environmental Noise Effects on Health for the United Kingdom Policy Context: A Systematic Review of the Effects of Environmental Noise on Mental Health, Wellbeing, Quality of Life, Cancer, Dementia, Birth, Reproductive Outcomes, and Cognition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E393. [PMID: 31936110 PMCID: PMC7013411 DOI: 10.3390/ijerph17020393] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/23/2019] [Accepted: 12/24/2019] [Indexed: 12/12/2022]
Abstract
This systematic review commissioned by the UK Department for the Environment, Food and Rural Affairs (Defra), considers how the evidence base for noise effects on health has changed following the recent reviews undertaken for the WHO Environmental Noise Guidelines. This systematic review assesses the quality of the evidence for environmental noise effects on mental health, wellbeing, and quality of life; birth and reproductive outcomes; and cognition for papers published since the WHO reviews (mid-2015 to March 2019), as well as for cancer and dementia (January 2014 to March 2019). Using the GRADE methodology (Grading of Recommendations Assessment, Development and Evaluation) most evidence was rated as low quality as opposed to very low quality in the previous reviews. There is now low-quality evidence for a harmful effect of road traffic noise on medication use and interview measures of depression and anxiety and low quality evidence for a harmful effect of road traffic noise, aircraft noise, and railway noise on some cancer outcomes. Many other conclusions from the WHO evidence reviews remain unchanged. The conclusions remain limited by the low number of studies for many outcomes. The quantification of health effects for other noise sources including wind turbine, neighbour, industrial, and combined noise remains a research priority.
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Affiliation(s)
- Charlotte Clark
- Acoustics, Ove Arup & Partners, 13 Fitzroy Street, London W1T 4BQ, UK
| | - Clare Crumpler
- Acoustics, Ove Arup & Partners, 13 Fitzroy Street, London W1T 4BQ, UK
| | - Hilary Notley
- UK Department for the Environment, Food and Rural Affairs (Defra), Ground Floor, Seacole Building, 2 Marsham Street, London SW1P 4DF, UK;
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Abbasi M, Yazdanirad S, Habibi P, Arabi S, Fallah Madvari R, Mehri A, Poursadeghiyan M, Ebrahimi MH, Ghaljahi M. Relationship among noise exposure, sensitivity, and noise annoyance with job satisfaction and job stress in a textile industry. ACTA ACUST UNITED AC 2019. [DOI: 10.1177/0957456519853812] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate the relationship among noise exposure, sensitivity, and noise annoyance with job satisfaction and job stress among the workers of a textile industry. In this study, Weinstein’s Noise Sensitivity Scale, Noise Annoyance Questionnaire (recommended based on ISO 15666-2003), Health and Safety Executive (HSE) Job Stress Questionnaire, and Job Satisfaction Scale were used to determine the degree of noise sensitivity, noise annoyance, occupational stress, and job satisfaction, respectively. The results showed that there was a significant difference in the mean of job satisfaction, job stress, noise sensitivity, and noise annoyance between case and control groups. The results of multivariate analysis of covariance showed that noise exposure, noise sensitivity, and noise annoyance can justify 0.09, 0.19, and 0.06 of the variance of job stress, respectively. These variables also could justify 0.09, 0.12, and 0.05 of the variance of job satisfaction, respectively. Noise sensitivity had the greatest effect on increasing the occupational stress and job satisfaction.
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Affiliation(s)
- Milad Abbasi
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Yazdanirad
- School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Peymaneh Habibi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Arabi
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Rohollah Fallah Madvari
- Student Research Committee, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Mehri
- Department of Occupational Health Engineering, School of Public Health, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Mohsen Poursadeghiyan
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Hossein Ebrahimi
- Environmental and Occupational Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Maryam Ghaljahi
- Department of Occupational Health Engineering, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
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Gimenez SRML, Madazio G, Zambon F, Behlau M. Análise da timidez na desvantagem vocal percebida em professores. Codas 2019; 31:e20180149. [DOI: 10.1590/2317-1782/20182018149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/30/2018] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Verificar a relação entre a timidez autorreferida e a desvantagem vocal percebida em professores da Educação Infantil e Fundamental I e II. Método 200 professores (média de 41,8 anos), sem queixa vocal atual, preencheram 3 protocolos: uma ficha de identificação pessoal e caracterização do trabalho, composta por 11 questões, elaborada pelo Programa de Saúde Vocal do SinproSP; o Índice de Desvantagem Vocal, instrumento de autoavaliação que investiga a autopercepção do impacto de um problema vocal; e a Escala de Timidez, com 14 itens sobre sentimentos e comportamentos comunicativos relacionados ao cotidiano organizacional. Resultados Do total da amostra, 142 (71%) professores não apresentaram desvantagem vocal, sendo 42% (n=59) professores tímidos e 58% (n=83) não tímidos. Para os 58 (29%) professores que apresentaram desvantagem vocal, houve um maior número de tímidos (64%) do que não tímidos (26%). Entre o total de professores tímidos, houve uma proporção maior destes entre os professores que atuam exclusivamente na Educação Infantil, com faixa etária entre 20-30 anos, formados em até 10 anos e com queixa da presença de ruído na sala de aula. A presença de afecções de vias aéreas superiores foi o único aspecto que diferenciou tímidos com e sem desvantagem vocal, sendo mais frequente nos professores tímidos sem desvantagem vocal. Conclusão Professores tímidos percebem mais desvantagem vocal quando comparados aos não tímidos. Os docentes com faixa etária entre 20 e 30 anos, com até 10 anos de formados e que lecionam para Educação Infantil relatam timidez, porém sem associação com a desvantagem vocal.
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Affiliation(s)
| | | | - Fabiana Zambon
- Centro de Estudos da Voz, Brasil; Sindicato dos Professores de São Paulo, Brasil
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Cheng Q, Xu Y, Xie L, Hu Y, Lv Y. Prevalence and environmental impact factors of somatization tendencies in eastern Chinese adolescents: a multicenter observational study. CAD SAUDE PUBLICA 2019; 35:e00008418. [DOI: 10.1590/0102-311x00008418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 08/17/2018] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is at examining the prevalence and impact factors of adolescent somatization tendencies (ST) across three eastern Chinese provinces. A multicenter school-based cross-sectional study was conducted in these provinces from 2015 to 2016. The sample included 11,153 middle-school students aged 13-18 years, who were randomly selected using a multi-phase stratified cluster sampling technique. We also designed a multicenter school-based case-control study to evaluate the potential environmental impact of ST factors on this population. The overall positive rate of ST among the eastern Chinese adolescents was 12.1%. Somatic symptoms score (SSS) and positive ST rate were higher in females than males. Additionally, the SSS and positive ST rate for the 18-year-old group were significantly higher than in other age groups. In comparison to those in urban areas, adolescents in rural areas had significantly higher SSS and positive ST rate. Multiple conditional regression analyses revealed that family medical history, anxiety and depression scores; superstitious beliefs; left-behind adolescents; teacher-student support; family conflict; and family independence and achievement orientation were significantly linked to ST in adolescents. The models also indicated family medical history was the strongest impact factor to adolescent ST, even though ST were prevalent in the three studied eastern Chinese provinces. Gender, age, and dwelling differences were very significant in the SSS and positive ST rate in adolescents. This study concludes that adolescent ST are influenced by multiple environments.
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Affiliation(s)
- Qinglin Cheng
- Hangzhou Center for Disease Control and Prevention, China
| | - Yong Xu
- Medical College of Soochow University, China
| | - Li Xie
- Hangzhou Center for Disease Control and Prevention, China
| | - Yunkai Hu
- Fuyang Center for Disease Control and Prevention, China
| | - Yongxiang Lv
- Jin’an District Center for Disease Control and Prevention, China
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Martens AL, Slottje P, Timmermans DRM, Kromhout H, Reedijk M, Vermeulen RCH, Smid T. Modeled and Perceived Exposure to Radiofrequency Electromagnetic Fields From Mobile-Phone Base Stations and the Development of Symptoms Over Time in a General Population Cohort. Am J Epidemiol 2017; 186:210-219. [PMID: 28398549 DOI: 10.1093/aje/kwx041] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/29/2016] [Indexed: 12/18/2022] Open
Abstract
We assessed associations between modeled and perceived exposure to radiofrequency electromagnetic fields (RF-EMF) from mobile-phone base stations and the development of nonspecific symptoms and sleep disturbances over time. A population-based Dutch cohort study, the Occupational and Environmental Health Cohort Study (AMIGO) (n = 14,829; ages 31-65 years), was established in 2011/2012 (T0), with follow-up of a subgroup (n = 3,992 invited) in 2013 (T1; n = 2,228) and 2014 (T2; n = 1,740). We modeled far-field RF-EMF exposure from mobile-phone base stations at the home addresses of the participants using a 3-dimensional geospatial model (NISMap). Perceived exposure (0 = not at all; 6 = very much), nonspecific symptoms, and sleep disturbances were assessed by questionnaire. We performed cross-sectional and longitudinal analyses, including fixed-effects regression. We found small correlations between modeled and perceived exposure in AMIGO participants at baseline (n = 14,309; rSpearman = 0.10). For 222 follow-up participants, modeled exposure increased substantially (>0.030 mW/m2) between T0 and T1. This increase in modeled exposure was associated with an increase in perceived exposure during the same time period. In contrast to modeled RF-EMF exposure from mobile-phone base stations, perceived exposure was associated with higher symptom reporting scores in both cross-sectional and longitudinal analyses, as well as with sleep disturbances in cross-sectional analyses.
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Morley DW, Gulliver J. Methods to improve traffic flow and noise exposure estimation on minor roads. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 216:746-754. [PMID: 27350039 DOI: 10.1016/j.envpol.2016.06.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/03/2016] [Accepted: 06/19/2016] [Indexed: 06/06/2023]
Abstract
Address-level estimates of exposure to road traffic noise for epidemiological studies are dependent on obtaining data on annual average daily traffic (AADT) flows that is both accurate and with good geographical coverage. National agencies often have reliable traffic count data for major roads, but for residential areas served by minor roads, especially at national scale, such information is often not available or incomplete. Here we present a method to predict AADT at the national scale for minor roads, using a routing algorithm within a geographical information system (GIS) to rank roads by importance based on simulated journeys through the road network. From a training set of known minor road AADT, routing importance is used to predict AADT on all UK minor roads in a regression model along with the road class, urban or rural location and AADT on the nearest major road. Validation with both independent traffic counts and noise measurements show that this method gives a considerable improvement in noise prediction capability when compared to models that do not give adequate consideration to minor road variability (Spearman's rho. increases from 0.46 to 0.72). This has significance for epidemiological cohort studies attempting to link noise exposure to adverse health outcomes.
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Affiliation(s)
- David W Morley
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, Faculty of Medicine, Imperial College London, W2 1PG, London, UK.
| | - John Gulliver
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, Faculty of Medicine, Imperial College London, W2 1PG, London, UK
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Zijlema WL, Smidt N, Klijs B, Morley DW, Gulliver J, de Hoogh K, Scholtens S, Rosmalen JGM, Stolk RP. The LifeLines Cohort Study: a resource providing new opportunities for environmental epidemiology. ACTA ACUST UNITED AC 2016; 74:32. [PMID: 27482379 PMCID: PMC4968004 DOI: 10.1186/s13690-016-0144-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/23/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Lifelines is a prospective population-based cohort study investigating the biological, behavioral and environmental determinants of healthy ageing among 167,729 participants from the North East region of the Netherlands. The collection and geocoding of (history of) home and work addresses allows linkage of individual-level health data to detailed exposure data. We describe the reasons for choosing particular assessments of environmental exposures in LifeLines and consider the implications for future investigations. METHODS Exposure to ambient air pollution and road traffic noise was estimated using harmonized models. Data on noise annoyance, perceived exposure to electromagnetic fields, perceived living environment, and neighborhood characteristics were collected with questionnaires. A comprehensive medical assessment and questionnaires were completed in order to assess determinants of health and well-being. Blood and urine samples were collected from all participants and genome wide association data are available for a subsample of 15,638 participants. RESULTS Mean age was 45 years (standard deviation (SD) 13 years), and 59 % were female. Median levels of NO2 and PM10 were 15.7 (interquartile range (IQR) 4.9) μg/m(3) and 24.0 (IQR 0.6) μg/m(3) respectively. Median levels of daytime road traffic noise were 54.0 (IQR 4.2) dB(A). CONCLUSIONS The combination of harmonized environmental exposures and extensive assessment of health outcomes in LifeLines offers great opportunities for environmental epidemiology. LifeLines aims to be a resource for the international scientific community.
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Affiliation(s)
- Wilma L Zijlema
- Department of Epidemiology, University Medical Center Groningen, HPC CC72, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University Medical Center Groningen, HPC CC72, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - Bart Klijs
- Department of Epidemiology, University Medical Center Groningen, HPC CC72, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - David W Morley
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - John Gulliver
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Kees de Hoogh
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK ; Swiss Tropical and Public Health Institute, Basel, Switzerland ; University of Basel, Basel, Switzerland
| | | | - Judith G M Rosmalen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ronald P Stolk
- Department of Epidemiology, University Medical Center Groningen, HPC CC72, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands ; LifeLines Cohort Study, Groningen, The Netherlands
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Yzermans J, Baliatsas C, van Dulmen S, Van Kamp I. Assessing non-specific symptoms in epidemiological studies: Development and validation of the Symptoms and Perceptions (SaP) questionnaire. Int J Hyg Environ Health 2016; 219:53-65. [DOI: 10.1016/j.ijheh.2015.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 08/27/2015] [Accepted: 08/27/2015] [Indexed: 01/24/2023]
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Zijlema WL, Klijs B, Stolk RP, Rosmalen JGM. (Un)Healthy in the City: Respiratory, Cardiometabolic and Mental Health Associated with Urbanity. PLoS One 2015; 10:e0143910. [PMID: 26630577 PMCID: PMC4667966 DOI: 10.1371/journal.pone.0143910] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/11/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Research has shown that health differences exist between urban and rural areas. Most studies conducted, however, have focused on single health outcomes and have not assessed to what extent the association of urbanity with health is explained by population composition or socioeconomic status of the area. Our aim is to investigate associations of urbanity with four different health outcomes (i.e. lung function, metabolic syndrome, depression and anxiety) and to assess whether these associations are independent of residents' characteristics and area socioeconomic status. METHODS Our study population consisted of 74,733 individuals (42% males, mean age 43.8) who were part of the baseline sample of the LifeLines Cohort Study. Health outcomes were objectively measured with spirometry, a physical examination, laboratory blood analyses, and a psychiatric interview. Using multilevel linear and logistic regression models, associations of urbanity with lung function, and prevalence of metabolic syndrome, major depressive disorder and generalized anxiety disorder were assessed. All models were sequentially adjusted for age, sex, highest education, household equivalent income, smoking, physical activity, and mean neighborhood income. RESULTS As compared with individuals living in rural areas, those in semi-urban or urban areas had a poorer lung function (β -1.62, 95% CI -2.07;-1.16), and higher prevalence of major depressive disorder (OR 1.65, 95% CI 1.35;2.00), and generalized anxiety disorder (OR 1.58, 95% CI 1.35;1.84). Prevalence of metabolic syndrome, however, was lower in urban areas (OR 0.51, 95% CI 0.44;0.59). These associations were only partly explained by differences in residents' demographic, socioeconomic and lifestyle characteristics and socioeconomic status of the areas. CONCLUSIONS Our results suggest a differential health impact of urbanity according to type of disease. Living in an urban environment appears to be beneficial for cardiometabolic health but to have a detrimental impact on respiratory function and mental health. Future research should investigate which underlying mechanisms explain the differential health impact of urbanity.
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Affiliation(s)
- Wilma L. Zijlema
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
- * E-mail:
| | - Bart Klijs
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Ronald P. Stolk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Judith G. M. Rosmalen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
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