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Malmqvist E, Oudin A. Bridging disciplines-key to success when implementing planetary health in medical training curricula. Front Public Health 2024; 12:1454729. [PMID: 39165783 PMCID: PMC11333318 DOI: 10.3389/fpubh.2024.1454729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 07/29/2024] [Indexed: 08/22/2024] Open
Abstract
Planetary health is being or should be added to medical training curricula in accordance with association consensus. Several articles published in recent years have addressed concern on the implementation, and the challenges that can occur if not addressed properly. This scoping narrative literature review focuses on planetary health as a concept, as well as challenges and suggested solutions to address these challenges. Planetary health is an important concept and needs to be addressed in all medical training. We found that one main challenge is implementation without ensuring the right competences and resources. Medically trained teachers set out to understand and teach complex natural and social systems. At some institutions the time allocated to teach planetary health is limited or non-existent. Case studies and student led teaching are solutions suggested, while other argue that true interdisciplinarity by inviting experts are more in line with what we expect from other subjects. In conclusion, the roots of planetary health, the enormous health risks at stake and nature of the subject requires medical training to adopt a true inter/trans-disciplinary approach to succeed. It might not be expected for all students to become planetary health experts, but all need a general understanding of the most important aspects and values.
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Affiliation(s)
- Ebba Malmqvist
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Anna Oudin
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Division of Sustainable Health, Umeå University, Umeå, Sweden
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Mao XY, Zheng M, Wang JP, Kou S, Wang WH, Lin JJ, Chen RC, Sun QH, Zheng WJ. Effects of cooking with solid fuel on hearing loss in Chinese adults-Based on two cohort studies. Sci Rep 2024; 14:10763. [PMID: 38730264 PMCID: PMC11087465 DOI: 10.1038/s41598-024-61498-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/07/2024] [Indexed: 05/12/2024] Open
Abstract
The association between cooking fuel and hearing loss still needs more research to clarify, and two longitudinal cohort studies were explored to find if solid fuel use for cooking affected hearing in Chinese adults. The data from Chinese Health and Retirement Longitudinal Survey (CHARLS) and Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed. Participants (older than 18) without hearing loss at baseline and follow-up visits were included, which were divided into clean fuel and solid fuel groups. Hearing loss rate was from follow-up visits (both in year 2011) until the recent one (year 2018 in CHARLS and 2019 in CLHLS). Cox regressions were applied to examine the associations with adjustment for potential confounders. Fixed-effect meta-analysis was used to pool the results. A total of 9049 participants (average age 8.34 ± 9.12 [mean ± SD] years; 4247 [46.93%] males) were included in CHARLS cohort study and 2265 participants (average age, 78.75 ± 9.23 [mean ± SD] years; 1148 [49.32%] males) in CLHLS cohort study. There were 1518 (16.78%) participants in CHARLS cohort and 451 (19.91%) participants in CLHLS cohort who developed hearing loss. The group of using solid fuel for cooking had a higher risk of hearing loss (CHARLS: HR, 1.16; 95% CI 1.03-1.30; CLHLS: HR, 1.43; 95% CI 1.11-1.84) compared with the one of using clean fuel. Pooled hazard ratio showed the incidence of hearing loss in the solid fuel users was 1.17 (1.03, 1.29) times higher than that of clean fuel users. Hearing loss was associated with solid fuel use and older people were at higher risk. It is advised to replace solid fuel by clean fuel that may promote health equity.
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Affiliation(s)
- Xue-Yun Mao
- Zhejiang Chinese Medicine University, Hangzhou, China
| | - Miao Zheng
- Zhejiang Chinese Medicine University, Hangzhou, China
| | - Jun-Ping Wang
- Zhejiang Chinese Medicine University, Hangzhou, China
| | - Shou Kou
- Zhejiang Chinese Medicine University, Hangzhou, China
| | - Wei-Hao Wang
- Zhejiang Chinese Medicine University, Hangzhou, China
| | - Jun-Jie Lin
- Zhejiang Chinese Medicine University, Hangzhou, China
| | - Ru-Cheng Chen
- Zhejiang Chinese Medicine University, Hangzhou, China
| | - Qing-Hua Sun
- Zhejiang Chinese Medicine University, Hangzhou, China
| | - Wei-Jun Zheng
- Zhejiang Chinese Medicine University, Hangzhou, China.
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Vallée A, Ceccaldi PF, Carbonnel M, Feki A, Ayoubi JM. Pollution and endometriosis: A deep dive into the environmental impacts on women's health. BJOG 2024; 131:401-414. [PMID: 37814514 DOI: 10.1111/1471-0528.17687] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND The interaction between pollution and endometriosis is a pressing issue that demands immediate attention. The impact of pollution, particularly air and water pollution, or occupational hazards, on hormonal disruption and the initiation of endometriosis remains a major issue. OBJECTIVES This narrative review aims to delve into the intricate connection between pollution and endometriosis, shedding light on how environmental factors contribute to the onset and severity of this disease and, thus, the possible public health policy implications. DISCUSSION Endocrine-disrupting chemicals (EDCs) in pollutants dysregulate the hormonal balance, contributing to the progression of this major gynaecological disorder. Air pollution, specifically PM2.5 and PAHs, has been associated with an increased risk of endometriosis by enhancing chronic inflammation, oxidative stress, and hormonal imbalances. Chemical contaminants in water and work exposures, including heavy metals, dioxins, and PCBs, disrupt the hormonal regulation and potentially contribute to endometriosis. Mitigating the environmental impact of pollution is required to safeguard women's reproductive health. This requires a comprehensive approach involving stringent environmental regulations, sustainable practices, responsible waste management, research and innovation, public awareness, and collaboration among stakeholders. CONCLUSION Public health policies have a major role in addressing the interaction between pollution and endometriosis in a long-term commitment.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France
| | - Pierre-François Ceccaldi
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Foch Hospital, Suresnes, France
- Medical School, University of Versailles, Saint-Quentin-en-Yvelines (UVSQ), Versailles, France
| | - Marie Carbonnel
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Foch Hospital, Suresnes, France
- Medical School, University of Versailles, Saint-Quentin-en-Yvelines (UVSQ), Versailles, France
| | - Anis Feki
- Department of Gynaecology and Obstetrics, University Hospital of Fribourg, Fribourg, Switzerland
| | - Jean-Marc Ayoubi
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Foch Hospital, Suresnes, France
- Medical School, University of Versailles, Saint-Quentin-en-Yvelines (UVSQ), Versailles, France
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Adélaïde L, Hough I, Seyve E, Kloog I, Fifre G, Launoy G, Launay L, Pascal M, Lepeule J. Environmental and social inequities in continental France: an analysis of exposure to heat, air pollution, and lack of vegetation. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00641-6. [PMID: 38279031 DOI: 10.1038/s41370-024-00641-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Cumulative environmental exposures and social deprivation increase health vulnerability and limit the capacity of populations to adapt to climate change. OBJECTIVE Our study aimed at providing a fine-scale characterization of exposure to heat, air pollution, and lack of vegetation in continental France between 2000 and 2018, describing spatiotemporal trends and environmental hotspots (i.e., areas that cumulate the highest levels of overexposure), and exploring any associations with social deprivation. METHODS The European (EDI) and French (FDep) social deprivation indices, the normalized difference vegetation index, daily ambient temperatures, particulate matter (PM2.5 and PM10), nitrogen dioxide, and ozone (O3) concentrations were estimated for 48,185 French census districts. Reference values were chosen to characterize (over-)exposure. Hotspots were defined as the areas cumulating the highest overexposure to temperature, air pollution, and lack of vegetation. Associations between heat overexposure or hotspots and social deprivation were assessed using logistic regressions. RESULTS Overexposure to heat was higher in 2015-2018 compared with 2000-2014. Exposure to all air pollutants except for O3 decreased during the study period. In 2018, more than 79% of the urban census districts exceeded the 2021 WHO air quality guidelines. The evolution of vegetation density between 2000 and 2018 was heterogeneous across continental France. In urban areas, the most deprived census districts were at a higher risk of being hotspots (odds ratio (OR): 10.86, 95% CI: 9.87-11.98 using EDI and OR: 1.07, 95% CI: 1.04-1.11 using FDep). IMPACT STATEMENT We studied cumulative environmental exposures and social deprivation in French census districts. The 2015-2018 period showed the highest overexposure to heat between 2000 and 2018. In 2018, the air quality did not meet the 2021 WHO guidelines in most census districts and 8.6 million people lived in environmental hotspots. Highly socially deprived urban areas had a higher risk of being in a hotspot. This study proposes for the first time, a methodology to identify hotspots of exposure to heat, air pollution, and lack of vegetation and their associations with social deprivation at a national level.
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Affiliation(s)
- Lucie Adélaïde
- Santé publique France, 12 rue du Val d'Osne, 94415, Saint-Maurice Cedex, France.
- Université Grenoble Alpes, Inserm, CNRS, IAB, Site Santé, Allée des Alpes, 38700, La Tronche, France.
| | - Ian Hough
- Université Grenoble Alpes, Inserm, CNRS, IAB, Site Santé, Allée des Alpes, 38700, La Tronche, France
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Emie Seyve
- Université Grenoble Alpes, Inserm, CNRS, IAB, Site Santé, Allée des Alpes, 38700, La Tronche, France
- Université de Paris Cité, Inserm, INRAE, Centre of Research in Epidemiology and StatisticS (CRESS), 75000, Paris, France
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Grégory Fifre
- Météo-France, 73 avenue de Paris, 94165, Saint-Mandé Cedex, France
| | - Guy Launoy
- U1086 Inserm Anticipe, Avenue Général Harris, 14076, Caen Cedex, France
- University Hospital of Caen, 14076, Caen Cedex, France
| | - Ludivine Launay
- U1086 Inserm Anticipe, Avenue Général Harris, 14076, Caen Cedex, France
- Plateforme MapInMed, US PLATON, Avenue Général Harris, 14076, Caen Cedex, France
- Centre François Baclesse, Avenue Général Harris, 14076, Caen Cedex, France
| | - Mathilde Pascal
- Santé publique France, 12 rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
| | - Johanna Lepeule
- Université Grenoble Alpes, Inserm, CNRS, IAB, Site Santé, Allée des Alpes, 38700, La Tronche, France.
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Pereira Barboza E, Montana F, Cirach M, Iungman T, Khomenko S, Gallagher J, Thondoo M, Mueller N, Keune H, MacIntyre T, Nieuwenhuijsen M. Environmental health impacts and inequalities in green space and air pollution in six medium-sized European cities. ENVIRONMENTAL RESEARCH 2023; 237:116891. [PMID: 37595831 DOI: 10.1016/j.envres.2023.116891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND The GoGreenRoutes project aims to introduce co-created nature-based solutions (NBS) to enhance environmental quality in six medium-sized cities (Burgas, Lahti, Limerick, Tallinn, Umeå, and Versailles). We estimated the mortality and economic impacts attributed to suboptimal exposure to green space and air pollution, economic impacts, and the distribution thereof the adult population by socioeconomic status. METHODS We retrieved data from publicly accessible databases on green space (NDVI and % Green Area), air pollution (NO2 and PM2.5) and population (≥20 years, n = 804,975) at a 250m × 250m grid-cell level, and mortality for each city for 2015. We compared baseline exposures at the grid-cell to World Health Organization's recommendations and guidelines. We applied a comparative risk assessment to estimate the mortality burden attributable to not achieving the recommendations and guidelines. We estimated attributable mortality distributions and the association with income levels. RESULTS We found high variability in air pollution and green spaces levels. Around 60% of the population lacked green space and 90% were exposed to harmful air pollution. Overall, we estimated age-standardized mortality rates varying from 10 (Umeå) to 92 (Burgas) deaths per 100,000 persons attributable to low NDVI levels; 3 (Lahti) to 38 (Burgas) per 100,000 persons to lack of % Green Area; 1 (Umeå) to 88 (Tallinn) per 100,000 persons to exceedances of NO2 guidelines; and 1 (Umeå) to 206 (Burgas) per 100,000 persons to exceedances of PM2.5 guidelines. Lower income associated with higher or lower mortality impacts depending on whether deprived populations lived in the densely constructed, highly-trafficked city centre or greener, less polluted outskirts. CONCLUSIONS We attributed a considerable mortality burden to lack of green spaces and higher air pollution, which was unevenly distributed across different social groups. NBS and health-promoting initiatives should consider socioeconomic aspects to regenerate urban areas while providing equally good environments.
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Affiliation(s)
- Evelise Pereira Barboza
- Barcelona Institute for Global Health (ISGlobal), Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain; CIBER Epidemiología y Salud Pública, Spain
| | | | - Marta Cirach
- Barcelona Institute for Global Health (ISGlobal), Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Tamara Iungman
- Barcelona Institute for Global Health (ISGlobal), Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Sasha Khomenko
- Barcelona Institute for Global Health (ISGlobal), Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain; CIBER Epidemiología y Salud Pública, Spain
| | | | - Meelan Thondoo
- Barcelona Institute for Global Health (ISGlobal), Spain; University of Cambridge, United Kingdom
| | - Natalie Mueller
- Barcelona Institute for Global Health (ISGlobal), Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain; CIBER Epidemiología y Salud Pública, Spain
| | | | | | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain; CIBER Epidemiología y Salud Pública, Spain.
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Sarroeira R, Henriques J, Sousa AM, Ferreira da Silva C, Nunes N, Moro S, Botelho MDC. Monitoring Sensors for Urban Air Quality: The Case of the Municipality of Lisbon. SENSORS (BASEL, SWITZERLAND) 2023; 23:7702. [PMID: 37765759 PMCID: PMC10537901 DOI: 10.3390/s23187702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023]
Abstract
Air pollution is a global issue that impacts environmental inequalities, and air quality sensors can have a decisive role in city policymaking for future cities. Science and society are already aware that during the most challenging times of COVID-19, the levels of air pollution in cities decreased, especially during lockdowns, when road traffic was reduced. Several pollution parameters can be used to analyse cities' environmental challenges, and it is more pressing than ever to have city climate decisions supported by sensor data. We have applied a data science approach to understand the evolution of the levels of carbon monoxide, nitrogen dioxide, particulate matter 2.5, and particulate matter 10 between August 2021 and July 2022. The analysis of the air quality levels, captured for the first time via 80 monitoring stations distributed throughout the municipality of Lisbon, has allowed us to realize that nitrogen dioxide and particulate matter 10 exceed the levels that are recommended by the World Health Organization, thereby increasing the health risk for those who live and work in Lisbon. Supported by these findings, we propose a central role for air quality sensors for policymaking in future cities, taking as a case study the municipality of Lisbon, Portugal, which is among the European cities that recently proposed be climate-neutral and smart city by 2030.
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Affiliation(s)
- Rodrigo Sarroeira
- ISTAR, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisboa, Portugal; (R.S.); (S.M.)
| | - João Henriques
- CIES, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisboa, Portugal; (J.H.); (M.d.C.B.)
| | - Ana M. Sousa
- CERENA, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal;
| | | | - Nuno Nunes
- CIES, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisboa, Portugal; (J.H.); (M.d.C.B.)
| | - Sérgio Moro
- ISTAR, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisboa, Portugal; (R.S.); (S.M.)
| | - Maria do Carmo Botelho
- CIES, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisboa, Portugal; (J.H.); (M.d.C.B.)
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Badaloni C, De Sario M, Caranci N, De' Donato F, Bolignano A, Davoli M, Leccese L, Michelozzi P, Leone M. A spatial indicator of environmental and climatic vulnerability in Rome. ENVIRONMENT INTERNATIONAL 2023; 176:107970. [PMID: 37224679 DOI: 10.1016/j.envint.2023.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/14/2023] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Urban areas are disproportionately affected by multiple pressures from overbuilding, traffic, air pollution, and heat waves that often interact and are interconnected in producing health effects. A new synthetic tool to summarize environmental and climatic vulnerability has been introduced for the city of Rome, Italy, to provide the basis for environmental and health policies. METHODS From a literature overview and based on the availability of data, several macro-dimensions were identified on 1,461 grid cells with a width of 1 km2 in Rome: land use, roads and traffic-related exposure, green space data, soil sealing, air pollution (PM2.5, PM10, NO2, C6H6, SO2), urban heat island intensity. The Geographically Weighted Principal Component Analysis (GWPCA) method was performed to produce a composite spatial indicator to describe and interpret each spatial feature by integrating all environmental dimensions. The method of natural breaks was used to define the risk classes. A bivariate map of environmental and social vulnerability was described. RESULTS The first three components explained most of the variation in the data structure with an average of 78.2% of the total percentage of variance (PTV) explained by the GWPCA, with air pollution and soil sealing contributing most in the first component; green space in the second component; road and traffic density and SO2 in the third component. 56% of the population lives in areas with high or very high levels of environmental and climatic vulnerability, showing a periphery-centre trend, inverse to the deprivation index. CONCLUSIONS A new environmental and climatic vulnerability indicator for the city of Rome was able to identify the areas and population at risk in the city, and can be integrated with other vulnerability dimensions, such as social deprivation, providing the basis for risk stratification of the population and for the design of policies to address environmental, climatic and social injustice.
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Affiliation(s)
- Chiara Badaloni
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy.
| | - Manuela De Sario
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Nicola Caranci
- Regional Health and Social Care Agency, Emilia-Romagna Region, Bologna, Italy
| | - Francesca De' Donato
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | | | - Marina Davoli
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Letizia Leccese
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Paola Michelozzi
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
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Phung VLH, Oka K, Hijioka Y, Ueda K, Sahani M, Wan Mahiyuddin WR. Environmental variable importance for under-five mortality in Malaysia: A random forest approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 845:157312. [PMID: 35839873 DOI: 10.1016/j.scitotenv.2022.157312] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 06/29/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Environmental factors have been associated with adverse health effects in epidemiological studies. The main exposure variable is usually determined via prior knowledge or statistical methods. It may be challenging when evidence is scarce to support prior knowledge, or to address collinearity issues using statistical methods. This study aimed to investigate the importance level of environmental variables for the under-five mortality in Malaysia via random forest approach. METHOD We applied a conditional permutation importance via a random forest (CPI-RF) approach to evaluate the relative importance of the weather- and air pollution-related environmental factors on daily under-five mortality in Malaysia. This study spanned from January 1, 2014 to December 31, 2016. In data preparation, deviation mortality counts were derived through a generalized additive model, adjusting for long-term trend and seasonality. Analyses were conducted considering mortality causes (all-cause, natural-cause, or external-cause) and data structures (continuous, categorical, or all types [i.e., include all variables of continuous type and all variables of categorical type]). The main analysis comprised of two stages. In Stage 1, Boruta selection was applied for preliminary screening to remove highly unimportant variables. In Stage 2, the retained variables from Boruta were used in the CPI-RF analysis. The final importance value was obtained as an average value from a 10-fold cross-validation. RESULT Some heat-related variables (maximum temperature, heat wave), temperature variability, and haze-related variables (PM10, PM10-derived haze index, PM10- and fire-derived haze index, fire hotspot) were among the prominent variables associated with under-five mortality in Malaysia. The important variables were consistent for all- and natural-cause mortality and sensitivity analyses. However, different most important variables were observed between natural- and external-cause under-five mortality. CONCLUSION Heat-related variables, temperature variability, and haze-related variables were consistently prominent for all- and natural-cause under-five mortalities, but not for external-cause.
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Affiliation(s)
- Vera Ling Hui Phung
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan.
| | - Kazutaka Oka
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Yasuaki Hijioka
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Kyoto, Japan; Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Kyoto, Japan
| | - Mazrura Sahani
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Wan Rozita Wan Mahiyuddin
- Environmental Health Research Center, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health, Shah Alam, Selangor, Malaysia
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Horton A, Jones SJ, Brunt H. Air pollution and public health vulnerabilities, susceptibilities and inequalities in Wales, UK. J Public Health (Oxf) 2022:6672910. [PMID: 35993370 DOI: 10.1093/pubmed/fdac083] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Outdoor air pollution is the largest environmental risk to health. Air pollution, deprivation and poor health status are inextricably linked; highlighting issues of environmental injustice, social and health inequalities. METHODS Air pollution (nitrogen dioxide, NO2 and fine particulate matter, PM2.5), population and deprivation data were identified at Lower Super Output Area level in Wales, UK, for 2012-18. Air pollution data were categorized according to different air pollution concentrations. Population and deprivation data were considered simultaneously to describe population vulnerabilities, susceptibilities and inequalities. Simple statistical analyses were performed using a difference in proportions method with 95% confidence intervals. RESULTS Over time, the majority of Welsh people transitioned to living in areas of lower NO2 and PM2.5 pollution. Areas of worse air pollution comprised more young people than people aged 65+; both populations are known to be susceptible to air pollution exposure. By 2018, significant socioeconomic inequality gaps were found where 'most deprived' population groups for both pollutants experienced greater disadvantage. CONCLUSION Air quality in Wales is improving. However, local-level variations in exposure risk still exist. System-wide action must ensure that air quality improvement-related benefits are equitable and acknowledge current evidence about the harms that even low levels of air pollution can have on health.
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Affiliation(s)
- Amber Horton
- Environmental Public Health, Health Protection, Public Health Wales, Tyndall Street, Cardiff CF10 4BZ, UK
| | - Sarah J Jones
- Environmental Public Health, Health Protection, Public Health Wales, Tyndall Street, Cardiff CF10 4BZ, UK
| | - Huw Brunt
- Environmental Public Health, Health Protection, Public Health Wales, Tyndall Street, Cardiff CF10 4BZ, UK
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Pereira Barboza E, Nieuwenhuijsen M, Ambròs A, Sá THD, Mueller N. The impact of urban environmental exposures on health: An assessment of the attributable mortality burden in Sao Paulo city, Brazil. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 831:154836. [PMID: 35351512 DOI: 10.1016/j.scitotenv.2022.154836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Currently, more than half of the global population lives in cities. Contemporary urban planning practices result in environmental risk factors (e.g. air pollution, noise, lack of green space, excess heat) that put health and well-being of city dwellers at risk and contribute to chronic diseases and premature death. Despite a growing body of evidence on adverse health impacts related to current urban and transport planning practices, especially for cities in the Global North, not much is known about associated health impacts in South American cities. Therefore, we estimated the mortality burden attributable to breaching internationally-recommended or locally-preferable exposure levels of urban planning related environmental exposures in Sao Paulo, Brazil. METHODS We carried out a health impact assessment study, following the comparative risk assessment framework, to assess preventable mortality impacts of breaching exposure recommendations for air pollution, green spaces and temperature at the census tract (CT) level (n = 18,363). We also assessed the distribution thereof by socioeconomic vulnerability. RESULTS We estimated that annually 11,372 (95% CI: 7921; 15,910) attributable deaths could be prevented by complying with recommended exposure levels. The largest proportion of preventable mortality was due to breaching air pollution limits (i.e. 8409 attributable deaths), followed by insufficient green space (i.e. 2593), and excess heat (i.e. 370). Adverse health impacts were larger in CTs of lower socioeconomic vulnerability, due to demographic profile, traffic density and residential area configurations. DISCUSSION Not complying with the health limits for air pollution, green space and temperature exposures resulted in a considerable preventable mortality burden (i.e. 17% of total expected deaths) in Sao Paulo. This burden can be reduced by improving current urban and transport planning practices.
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Affiliation(s)
- Evelise Pereira Barboza
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; École de Hautes Etudes en Santé Publique (EHESP), France
| | - Mark Nieuwenhuijsen
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Albert Ambròs
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Thiago Herick de Sá
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Natalie Mueller
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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11
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Chen J, Hao S, Wu Y. Housing and health in vulnerable social groups: an overview and bibliometric analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:267-279. [PMID: 34049423 DOI: 10.1515/reveh-2020-0167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/08/2021] [Indexed: 06/12/2023]
Abstract
Previous studies have confirmed that poor living conditions can lead to a wide range of health problems. However, in the context of the COVID-19 pandemic, vulnerable groups in unstable housing are more susceptible to disease. This study aims to systematically examine the housing and health problems of vulnerable groups using a bibliometric approach to explore how housing causes health problems, types of health illnesses, and coping strategies. It is found that the poor housing mechanism, persistent inequalities, and poor housing environments have a significant impact on the health of vulnerable groups. Therefore, the government must make concerted efforts across all sectors to ensure that the housing and health care needs of vulnerable groups are improved, and that housing security standards and related policies are improved; targeted safety plans are formulated with community as the carrier, taking into account the characteristics of vulnerable groups; and new information technology is widely used to provide medical convenience for vulnerable groups. It is hoped that the research in this paper can arouse social attention to the health of vulnerable groups and improve their health from the perspective of housing, so as to point out the direction for solving the housing health problems of vulnerable groups in the future.
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Affiliation(s)
- Junhua Chen
- Department of Urban and Real Estate Management, Central University of Finance and Economics, Beijing, Beijing, China
| | - Shuya Hao
- Department of Urban and Real Estate Management, Central University of Finance and Economics, Beijing, Beijing, China
| | - Ying Wu
- National Institute of Social Development, Central University of Finance and Economics, No. 5 Jiangguomennei Street, 100732, Beijing, Beijing, China
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12
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Abstract
PURPOSE OF REVIEW This paper presents an analytical review of recent research on social inequality caused or compounded by ambient air pollution in the European Union. RECENT FINDINGS While empirical studies have developed significantly both in the academic and institutional arena, they have largely focused on only one aspect: the exposure and sensitivity of individuals and groups to air pollution according to various criteria, documenting substantial and overlapping inequality. While EU policy should better address this proven impact inequality, research is also needed on new fronts of air (ine)quality (namely mental health impact and indoor air quality) as well as other types of ambient air inequality (such as inequality in responsibility and impact of air pollution mitigation policy).
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Affiliation(s)
- Éloi Laurent
- OFCE/Sciences Po, Sciences Po/PSIA, Ponts Paris Tech, Stanford University, 10 Place de Catalogne, 75014, Paris, France.
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13
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Chen C, Chan A, Dominici F, Peng RD, Sabath B, Di Q, Schwartz J, Bell ML. Do temporal trends of associations between short-term exposure to fine particulate matter (PM 2.5) and risk of hospitalizations differ by sub-populations and urbanicity-a study of 968 U.S. counties and the Medicare population. ENVIRONMENTAL RESEARCH 2022; 206:112271. [PMID: 34710436 PMCID: PMC8810624 DOI: 10.1016/j.envres.2021.112271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 05/29/2023]
Abstract
While associations between short-term exposure to fine particulate matter (PM2.5) and risk of hospitalization are well documented and evidence suggests that such associations change over time, it is unclear whether these temporal changes exist in understudied less-urban areas or differ by sub-population. We analyzed daily time-series data of 968 continental U.S. counties for 2000-2016, with cause-specific hospitalization from Medicare claims and population-weighted PM2.5 concentrations originally estimated at 1km × 1 km from a hybrid model. Circulatory and respiratory hospitalizations were categorized based on primary diagnosis codes at discharge. Using modified Bayesian hierarchical modelling, we evaluated the temporal trend in association between PM2.5 and hospitalizations and whether disparities in this trend exist across individual-level characteristics (e.g., sex, age, race, and Medicaid eligibility as a proxy for socio-economic status) and urbanicity. Urbanicity was categorized into three levels by county-specific percentage of urban population based on urban rural delineation from the U.S. Census. In this cohort with understudied less-urban areas without regulatory monitors, we still found positive association between circulatory and respiratory hospitalization and short-term exposure to PM2.5, with higher effect estimates towards the end of study period. Consistent with current literature, we identified significant disparity in associations by race, socioeconomic status and urbanicity. We found that the percentage change in circulatory hospitalization rate per 10 μg/m3 increase in PM2.5 was higher in the 2008-2016 time period compared to the 2000-2007 period by 0.33% (95% posterior credible interval 0.22, 0.44%), 0.52% (0.33, 0.69%), and 0.67% (0.53, 0.83%) for low, medium and high tertiles of urban areas, respectively. We also observed significant differences in temporal trends of associations across socioeconomic status, sex, and age, indicating a possible widening in disparity of PM2.5-related health burden. This study raises the importance of considering environmental justice issues in PM2.5-related health impacts with respect to how associations may change over time.
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Affiliation(s)
- Chen Chen
- School of the Environment, Yale University, New Haven, USA.
| | - Alisha Chan
- School of Engineering and Applied Science, Yale University, New Haven, USA
| | | | - Roger D Peng
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Ben Sabath
- Harvard T.H. Chan School of Public Health, Boston, USA
| | - Qian Di
- School of Medicine, Tsinghua University, Beijing, China
| | - Joel Schwartz
- Harvard T.H. Chan School of Public Health, Boston, USA
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14
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Perafita X, Saez M. Clustering of Small Territories Based on Axes of Inequality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063359. [PMID: 35329047 PMCID: PMC8955561 DOI: 10.3390/ijerph19063359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022]
Abstract
Background: In the present paper, we conduct a study before creating an e-cohort for the design of the sample. This e-cohort had to enable the effective representation of the province of Girona to facilitate its study according to the axes of inequality. Methods: The territory under study is divided by municipalities, considering these different axes. The study consists of a comparison of 14 clustering algorithms, together with 3 data sets of municipal information to detect the grouping that was the most consistent. Prior to carrying out the clustering, a variable selection process was performed to discard those that were not useful. The comparison was carried out following two axes: results and graphical representation. Results: The intra-cluster results were also analyzed to observe the coherence of the grouping. Finally, we study the probability of belonging to a cluster, such as the one containing the county capital. Conclusions: This clustering can be the basis for working with a sample that is significant and representative of the territory.
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Affiliation(s)
- Xavier Perafita
- Observatori—Organisme Autònom de Salut Pública de la Diputació de Girona (Dipsalut), 17003 Girona, Spain;
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003 Girona, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003 Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-972-418338; Fax: +34-972-418032
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15
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Gouveia N, Slovic AD, Kanai CM, Soriano L. Air Pollution and Environmental Justice in Latin America: Where Are We and How Can We Move Forward? Curr Environ Health Rep 2022; 9:152-164. [PMID: 35146705 DOI: 10.1007/s40572-022-00341-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Air pollution in Latin America is a major environmental threat, yet few studies have focused on aspects of environmental justice with regard to air pollution in the region. We examined the scientific literature and described whether and how this issue has been addressed, identify possible gaps in knowledge, and offer suggestions for future research to contribute to policies that seek greater equity concerning air pollution impacts in Latin America. RECENT FINDINGS There is a limited literature that has addressed issues of environmental justice or environmental health inequalities about air pollution in Latin America, with studies concentrated in Brazil, Mexico, and Chile. Studies that examined disparities in exposure to air pollution found a clear pattern of higher exposure in socially deprived areas. Studies that examined disparities in health impacts associated with air pollution have mixed results, but many found a clear modification of effect with those in the lower socioeconomic groups presenting greater effects. Despite Latin America's colonial and slavery history, no studies have considered ethnicity or minority populations. The literature shows that health risks (exposure and susceptibility) associated with air pollution are unevenly distributed among Latin American populations. Methodological approaches varied and can be improved in future studies, especially for exposure assessment to air pollution, as well as for assigning socioeconomic position to individuals. Using smaller geographic units and spatial regression techniques will allow a reduction in measurement error. Attempts should be made to include both individual and contextual socioeconomic indicators in the analysis. Better quality information will help understand these differential exposures and effects and provide inputs to policies to tackle these inequalities.
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Affiliation(s)
- Nelson Gouveia
- Department of Preventive Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455, Sao Paulo, SP, 01246-903, Brazil.
| | - Anne Dorothée Slovic
- Department of Environmental Health, University of Sao Paulo School of Public Health, Av. Dr. Arnaldo, Sao Paulo, SP, 715, Brazil
| | - Claudio Makoto Kanai
- Department of Preventive Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455, Sao Paulo, SP, 01246-903, Brazil
| | - Lucas Soriano
- Department of Preventive Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455, Sao Paulo, SP, 01246-903, Brazil
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16
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Jonidi Jafari A, Charkhloo E, Pasalari H. Urban air pollution control policies and strategies: a systematic review. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:1911-1940. [PMID: 34900316 PMCID: PMC8617239 DOI: 10.1007/s40201-021-00744-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/20/2021] [Indexed: 06/01/2023]
Abstract
A wide range of policies, strategies, and interventions have been implemented to improve air quality all over the world. This systematic review comprehensively appraises the policies and strategies on air pollutants controls enacted in different countries, worldwide. Three databases, Web of Science, PubMed and Scopus, were used for the search. After screening, a total of 114 eligible manuscripts were selected from 2219 documents for further analysis. Selected articles were divided into two categories: (1) articles focusing on introducing the policies and strategies enacted for controlling air pollution in different countries, and (2) articles which focused on different policies and strategies to control one or more specific pollutants. In the former one, urban air pollution control strategies and policies were divided into four categories, namely, general strategies and policies, transportation, energy, and industry. In case of latter category, policies and strategies focused on controlling six pollutants (PM, SO2, NO2, VOCS, O3 and photochemical smog). The results indicated that, the most common policies and strategies enacted in most countries are pertinent to the transportation sector. Changing energy sources, in particular elimination or limited use of solid fuels, was reported as an effective action by governments to reduce air pollution. Overall, most policies enacted by governments can be divided into three general categories: (a) incentive policies such as implementing a free public transportation program to use fewer private cars, (b) supportive policies such as paying subsidies to change household fuels, and (c) punitive policies such as collecting tolls for cars to enter the congestion charging areas. Depending on the circumstances, these policies are implemented alone or jointly. In addition to the acceptance of international agreements to reduce air pollution by governments, greater use of renewable energy, clean fuels, and low-pollution or no-pollution vehicles such as electric vehicles play an important role in reducing air pollution.
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Affiliation(s)
- Ahmad Jonidi Jafari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Esmail Charkhloo
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Pasalari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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17
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Exploring the contribution of housing adaptations in supporting everyday life for people with dementia: a scoping review. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abstract
The primary aim of this scoping review was to explore the contribution of housing adaptations to supporting everyday life for people with dementia living at home in the community. The study adopted a scoping review methodology which was guided by the Joanna Briggs Institute Reviewers Manual. Four review questions were developed which subsequently informed the inclusion criteria and search terms. Eight databases were searched resulting in 2,339 records, with 13 papers being included in the review. Evidence from the review found that the most common adaptations were recommended and/or implemented to compensate for a person's physical limitations and for safety reasons, rather than adaptations to support activities of daily living for a person with dementia. Support to implement adaptations was provided by a range of professionals coupled with ‘trial and error’ approaches adopted by the person themselves, and these were seen as key enablers. Barriers to implementing and using adaptations were fourfold: (a) access to information, (b) knowing when to make changes, (c) carer resistance, and (d) the unsuitability of the home. It would appear that housing adaptations have a positive impact on both the person with dementia and the carer (where one is present), with some adaptations having a relatively sustained impact and being particularly effective if implemented early in the lived trajectory of dementia.
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18
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Li R, Hou J, Tu R, Liu X, Zuo T, Dong X, Pan M, Yin S, Hu K, Mao Z, Huo W, Li S, Guo Y, Chen G, Wang C. Associations of mixture of air pollutants with estimated 10-year atherosclerotic cardiovascular disease risk modified by socio-economic status: The Henan Rural Cohort Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 793:148542. [PMID: 34174609 DOI: 10.1016/j.scitotenv.2021.148542] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/05/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Low socio-economic status (SES) and exposure to single-air pollutant relate to increased prevalent atherosclerotic cardiovascular diseases (ASCVD), however, interactive effect between SES and exposure to single- or multiple-air pollutants on high 10-year ASCVD risk remains unclear. METHODS A total of 31,162 individuals were derived from the Henan Rural Cohort Study. Concentrations of air pollutants (particulate matter with an aerodynamic diameter ≤ 1.0 μm (PM1), ≤2.5 μm (PM2.5) or ≤10 μm (PM10), nitrogen dioxide (NO2)) were assessed using a spatiotemporal model based on satellites data. Independent and joint associations of SES, single- and multiple- air pollutants with high 10-year ASCVD risk were evaluated using logistic regression models, quantile g-computation and structural equation models. The interactive effects of SES and exposure to single- or multiple air pollutants on high 10-year ASCVD risk were visualized by using Interaction plots. RESULTS Exposure to single air pollutant (PM1, PM2.5, PM10 or NO2) related to increased high 10-year ASCVD risk among individuals with low education level or personal average monthly income, compared to the ones with high education level or personal average monthly income. Furthermore, similar results of exposure to mixture of air pollutants with high 10-year ASCVD risk were observed. Positive interactive effects between low SES and exposure to high single air pollutant or the mixture of air pollutants on high 10-year ASCVD risk were observed. CONCLUSION Positive association of low SES with high 10-year ASCVD risk was amplified by exposure to high levels of single air pollutant or a mixture of air pollutants, implying that individuals with low SES may more susceptible to air pollution-related adverse health effect.
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Affiliation(s)
- Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Tantan Zuo
- Department of Orthopedics, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, PR China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Mingming Pan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Shanshan Yin
- Department of health policy research, Henan Academy of Medical Sciences, Zhengzhou, PR China
| | - Kai Hu
- Department of health policy research, Henan Academy of Medical Sciences, Zhengzhou, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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19
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Wu Y, Zhang L, Wang J, Mou Y. Communicating Air Quality Index Information: Effects of Different Styles on Individuals' Risk Perception and Precaution Intention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910542. [PMID: 34639842 PMCID: PMC8507816 DOI: 10.3390/ijerph181910542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 01/16/2023]
Abstract
Air Quality Index (AQI) is information about atmospheric pollutants, which is essential for governments to inform the public about the current air quality and potential health risks. By analyzing the AQIs from 11 countries (regions), we discovered considerable variations in the design of AQI information, which may open up room for unintended interpretation from the public. Therefore, as an attempt to address the inefficiency of some common styles of AQI information in promoting the public's precaution against bad air and better design such information, an online experiment with a 2 (descriptor: neutral vs. negatively valenced) × 2 (target groups in AQI warning messages: vague vs. specific) factorial design was conducted to test the effects of such information on individuals' risk perception and precaution intention. The results indicated that AQI information with a neutral descriptor was associated with lower self-risk perception and precaution intention levels than with a negatively valenced one. Among the individuals not included in the at-risk groups, those who read the warning messages with vague target groups had a higher third-person perception toward smog risk than those targeting specific population groups. Practical and theoretical implications are discussed.
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Affiliation(s)
| | | | | | - Yi Mou
- Correspondence: ; Tel.: +86-186-1696-2207
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20
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Ross-Driscoll K, Patzer RE, Axelrod DA. Ecological factors and posttransplant outcomes: Causation or correlation? Am J Transplant 2021; 21:3219-3220. [PMID: 34117719 PMCID: PMC9051979 DOI: 10.1111/ajt.16716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 01/25/2023]
Affiliation(s)
- Katherine Ross-Driscoll
- Division of Transplant, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia,Health Services Research Center, Emory University School of Medicine, Atlanta, Georgia
| | - Rachel E. Patzer
- Division of Transplant, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia,Health Services Research Center, Emory University School of Medicine, Atlanta, Georgia
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21
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Mak HWL, Ng DCY. Spatial and Socio-Classification of Traffic Pollutant Emissions and Associated Mortality Rates in High-Density Hong Kong via Improved Data Analytic Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6532. [PMID: 34204413 PMCID: PMC8296480 DOI: 10.3390/ijerph18126532] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 12/04/2022]
Abstract
Excessive traffic pollutant emissions in high-density cities result in thermal discomfort and are associated with devastating health impacts. In this study, an improved data analytic framework that combines geo-processing techniques, social habits of local citizens like traffic patterns and working schedule and district-wise building morphologies was established to retrieve street-level traffic NOx and PM2.5 emissions in all 18 districts of Hong Kong. The identification of possible human activity regions further visualizes the intersection between emission sources and human mobility. The updated spatial distribution of traffic emission could serve as good indicators for better air quality management, as well as the planning of social infrastructures in the neighborhood environment. Further, geo-processed traffic emission figures can systematically be distributed to respective districts via mathematical means, while the correlations of NOx and mortality within different case studies range from 0.371 to 0.783, while varying from 0.509 to 0.754 for PM2.5, with some assumptions imposed in our study. Outlying districts and good practices of maintaining an environmentally friendly transportation network were also identified and analyzed via statistical means. This newly developed data-driven framework of allocating and quantifying traffic emission could possibly be extended to other dense and heavily polluted cities, with the aim of enhancing health monitoring campaigns and relevant policy implementations.
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Affiliation(s)
- Hugo Wai Leung Mak
- Department of Mathematics, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
- Department of Geography, The University of Hong Kong, Hong Kong
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong
| | - Daisy Chiu Yi Ng
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong;
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22
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Ferguson L, Taylor J, Zhou K, Shrubsole C, Symonds P, Davies M, Dimitroulopoulou S. Systemic inequalities in indoor air pollution exposure in London, UK. BUILDINGS & CITIES 2021; 2:425-448. [PMID: 34124667 PMCID: PMC7610964 DOI: 10.5334/bc.100] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Deprived communities in many cities are exposed to higher levels of outdoor air pollution, and there is increasing evidence of similar disparities for indoor air pollution exposure. There is a need to understand the drivers for this exposure disparity in order to develop effective interventions aimed at improving population health and reducing health inequities. With a focus on London, UK, this paper assembles evidence to examine why indoor exposure to PM2.5, NOx and CO may disproportionately impact low-income groups. In particular, five factors are explored, namely: housing location and ambient outdoor levels of pollution; housing characteristics, including ventilation properties and internal sources of pollution; occupant behaviours; time spent indoors; and underlying health conditions. Evidence is drawn from various sources, including building physics models, modelled outdoor air pollution levels, time-activity surveys, housing stock surveys, geographical data, and peer-reviewed research. A systems framework is then proposed to integrate these factors, highlighting how exposure to high levels of indoor air pollution in low-income homes is in large part due to factors beyond the control of occupants, and is therefore an area of systemic inequality. POLICY RELEVANCE There is increasing public and political awareness of the impact of air pollution on public health. Strong scientific evidence links exposure to air pollution with morbidity and mortality. Deprived communities may be more affected, however, with limited evidence on how deprivation may influence their personal exposure to air pollution, both outdoors and indoors. This paper describes different factors that may lead to low-income households being exposed to higher levels of indoor air pollution than the general population, using available data and models for London (i.e. living in areas of higher outdoor air pollution, in poor-quality housing, undertaking more pollution-generating activities indoors and spending more time indoors). A systems approach is used to show how these factors lead to systemic exposure inequalities, with low-income households having limited opportunities to improve their indoor air quality. This paper can inform actions and public policies to reduce environmental health inequalities, considering both indoor and outdoor air.
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Affiliation(s)
- Lauren Ferguson
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, London, UK
| | - Jonathon Taylor
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, London, UK; Department of Civil Engineering, Tampere University, Tampere, Finland
| | - Ke Zhou
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, London, UK
| | - Clive Shrubsole
- Environmental Hazards and Emergencies Department, Public Health England, UK. UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, London, UK
| | - Phil Symonds
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, London, UK
| | - Mike Davies
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, London, UK
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Bretagne G, Blanc-Février J, Lang T. Tackling social inequalities in health: acceptability and feasibility of a systematic approach toward health impact assessment of urban projects. Glob Health Promot 2021; 29:5-13. [PMID: 33740874 DOI: 10.1177/1757975921995468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The general objective of this research project was to explore the feasibility and acceptability of an original method intended to systematically identify urban planning projects whose potential impacts on health and social inequalities in health (SIH) would be most damaging. An approach based on a short meeting and a tool would help to discuss whether or not to engage in a more comprehensive health impact assessment. METHODS A tool was developed by the research team based on various tools reported in the literature and modified with urban planners. Meetings were organized for each development project with the volunteer planners, who were working on the projects selected. Reviews of six projects at different stages of design made it possible to assess the acceptability and feasibility of this approach to identify public health and social equity issues in health. RESULTS The process and the use of the tool were found to be feasible. The tool was easily understandable, adapted to the practices of planners and usable without real training other than a quick introduction to tool usage. It was also found to be acceptable. Despite an interest in the inclusion of SIH, the integration of the relationship between SIH and urban development was not easy for most of the urban planners. CONCLUSION This exploratory work suggests that a systematic approach to assessing the impact of urban projects on health and SIH is feasible and acceptable. Dealing with SIH was not found to be easy by the urban planners.
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Affiliation(s)
- Geneviève Bretagne
- Agence d'Urbanisme et d'Aménagement de Toulouse Aire métropolitaine (AUAT) and Laboratoire Interdisciplinaire Solidarités Sociétés Territoires (LISST), France
| | | | - Thierry Lang
- Institut Fédératif d'Etudes et de Recherche Santé Société (IFERISS), France
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Rocha D, Suemoto CK, Souza Santos I, Lotufo PA, Benseñor I, Gouveia N. Vehicular traffic density and cognitive performance in the ELSA-Brasil study. ENVIRONMENTAL RESEARCH 2020; 191:110208. [PMID: 32941838 DOI: 10.1016/j.envres.2020.110208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND Despite the knowledge about the deleterious effects of air pollutants and their influence on mortality and morbidity due to respiratory and cardiovascular diseases, little is known about the relationship between atmospheric pollutants and neurological diseases. Recently, studies from high-income countries have suggested an association between exposures to air pollutants with cognitive impairment. Thus, we investigated the association of air pollution with cognitive performance in the participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS Cognitive function was evaluated using the word list, the verbal fluency, and the trail making tests (TMT). Pollutant exposure was evaluated indirectly using the distance-weighted traffic density (DWTD) of participants' residence and workplace. We investigated the cross-sectional association between DWTD and cognitive test scores using adjusted linear regression models for sociodemographic and clinical variables. RESULTS 3050 were included (mean age = 52.1 ± 9.2 years old, 56.5% women, and 63.6% white). In the simple linear regression models, participants in the higher tertile of combined DWTD (residence and workplace) presented better cognitive performance in all tests when compared to participants in the lower tertile. The DWTD was not associated with cognitive performance in adjusted linear models especially when adjusted for socioeconomic variables (age, sex, education, and race). We found similar results when we investigated the association of cognitive performance with DTWD near participants' workplace and residence separately. CONCLUSION Air pollutants were not associated with worse cognitive performance in a large sample of middle-aged and older adults.
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Affiliation(s)
- Douglas Rocha
- Department of Preventive Medicine, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Claudia K Suemoto
- Center for Clinical and Epidemiological Research, University of São Paulo, São Paulo, SP, Brazil; Division of Geriatrics, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Itamar Souza Santos
- Center for Clinical and Epidemiological Research, University of São Paulo, São Paulo, SP, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University of São Paulo, São Paulo, SP, Brazil
| | - Isabela Benseñor
- Center for Clinical and Epidemiological Research, University of São Paulo, São Paulo, SP, Brazil
| | - Nelson Gouveia
- Department of Preventive Medicine, University of São Paulo Medical School, São Paulo, SP, Brazil.
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Ferguson L, Taylor J, Davies M, Shrubsole C, Symonds P, Dimitroulopoulou S. Exposure to indoor air pollution across socio-economic groups in high-income countries: A scoping review of the literature and a modelling methodology. ENVIRONMENT INTERNATIONAL 2020; 143:105748. [PMID: 32629198 PMCID: PMC7903144 DOI: 10.1016/j.envint.2020.105748] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 05/20/2023]
Abstract
Disparities in outdoor air pollution exposure between individuals of differing socio-economic status is a growing area of research, widely explored in the environmental health literature. However, in developed countries, around 80% of time is spent indoors, meaning indoor air pollution may be a better proxy for personal exposure. Building characteristics - such as build quality, volume and ventilation - and occupant behaviour, mean indoor air pollution may also vary across socio-economic groups, leading to health inequalities. Much of the existing literature has focused on inequalities in exposure to outdoor air pollution, and there is thus a lack of an evidence base reviewing data for indoor environments. In this study, a scoping review of the literature on indoor air pollution exposures across different socio-economic groups is performed, examining evidence from both monitoring and modelling studies in the developed world. The literature was reviewed, identifying different indoor pollutants, definitions for socio-economic status and pre- and post- housing interventions. Based on the review, the study proposes a modelling methodology for evaluating the effects of environmental policies on different socio-economic populations. Using a sample size calculation, obstacles in obtaining sufficiently large samples of monitored data are demonstrated. A modelling framework for the rapid quantification of daily home exposure is then outlined as a proof of concept. While significant additional research is required to examine inequalities in indoor exposures, modelling approaches may provide opportunities to quantify exposure disparities due to housing and behaviours across populations of different socio-economic status.
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Affiliation(s)
- Lauren Ferguson
- UCL Energy Institute, Bartlett School of Environment, Energy and Resources, University College London, UK; Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, UK; Air Quality & Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Science and Innovation Campus, Chilton, UK.
| | - Jonathon Taylor
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, UK
| | - Clive Shrubsole
- Air Quality & Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Science and Innovation Campus, Chilton, UK
| | - Phil Symonds
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, UK
| | - Sani Dimitroulopoulou
- Air Quality & Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Science and Innovation Campus, Chilton, UK
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Griffin S, Walker S, Sculpher M. Distributional cost effectiveness analysis of West Yorkshire low emission zone policies. HEALTH ECONOMICS 2020; 29:567-579. [PMID: 32003147 DOI: 10.1002/hec.4003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 12/20/2019] [Accepted: 12/29/2019] [Indexed: 05/13/2023]
Abstract
Alternative strategies can reduce road vehicle emissions, with differential effects on exposure across population groups. We compare alternative strategies in West Yorkshire using a framework for economic evaluation that considers multiple perspectives and that takes account of the distribution of health outcomes. Exposure to pollutants by area is converted, via dose response relationships, into disease averted. Health benefits and National Health Service costs from diseases are estimated conditional on population demographics and index of multiple deprivation. The net health benefits from alternative strategies are expressed as distributions of quality-adjusted life expectancy (QALE), which are compared using dominance criteria and societal aversion to health inequality. Net production is estimated from intervention costs and the effects of health improvement on production and consumption. Social care outcomes are estimated from health improvement among care recipients and changes in care expenditure. A switch to less polluting private vehicles is dominant in terms of the distribution of QALE and social care outcomes but not consumption. Inclusion of health inequality aversion alters the rank order compared with prioritisation on health maximisation. The results were sensitive to the magnitude of health opportunity costs, the level of inequality aversion, and the proportion of intervention cost that generates health opportunity cost.
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Affiliation(s)
- Susan Griffin
- Centre for Health Economics, University of York, York, UK
| | - Simon Walker
- Centre for Health Economics, University of York, York, UK
| | - Mark Sculpher
- Centre for Health Economics, University of York, York, UK
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Khomenko S, Nieuwenhuijsen M, Ambròs A, Wegener S, Mueller N. Is a liveable city a healthy city? Health impacts of urban and transport planning in Vienna, Austria. ENVIRONMENTAL RESEARCH 2020; 183:109238. [PMID: 32062485 DOI: 10.1016/j.envres.2020.109238] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/13/2020] [Accepted: 02/05/2020] [Indexed: 05/20/2023]
Abstract
Each year, The Economist Intelligence Unit (EIU) computes the Global Liveability Index and determines the most liveable cities around the world. Vienna, Austria, was ranked by the EIU as the most liveable city worldwide in 2018 and 2019. However, the relationship between a liveable as well as healthy and environmentally-just city has not been previously explored. To explore whether the most liveable city is also a healthy and environmentally-just one, we estimated the premature mortality burden related to non-compliance with international exposure level recommendations for physical activity (PA), air pollution (PM2.5 and NO2), road traffic noise, green space and heat for Vienna, as well as its distribution by socioeconomic status (SES). We applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) methodology and estimated the annual mortality, life expectancy (LE) and economic impact of non-compliance with exposure guidelines for the Viennese adult population ≥ 20 years. We compared current with recommended exposure levels, quantified the association between exposures and mortality and calculated attributable health impact fractions. Eight percent of premature mortality (i.e. 1239 deaths, 95% CI: 679-1784) was estimated to be attributable to non-compliance with the recommended exposure levels. Seventy-six percent of the attributable premature mortality was due to PM2.5 exposure and insufficient PA. Non-compliance also resulted in an average of 199 days of LE lost for the adult population (95% CI: 111-280) and an economic impact of 4.6 (95% CI: 2.5-6.7) billion 2015€ annually. Overall, residents of lower SES neighbourhoods faced higher risk of premature mortality due to higher exposure to NO2, road traffic noise, heat and less green space. Despite high liveability standards according to EIU definition, a considerable premature mortality burden was attributable to non-compliance with exposure recommendations, and socioeconomic inequalities were estimated. Although the exposure attributable mortality burden was lower than in other European cities and local Viennese policies favour the reduction of motorized traffic, alongside the promotion of active and public transport and urban greening, there is room for further alignment of liveability, environmental health and justice objectives.
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Affiliation(s)
- Sasha Khomenko
- Institute for Global Health (ISGlobal), Barcelona, Spain; Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, Netherlands
| | - Mark Nieuwenhuijsen
- Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Albert Ambròs
- Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sandra Wegener
- Institute for Transport Studies, University of Natural Resources and Life Sciences (BOKU), Vienna, Austria
| | - Natalie Mueller
- Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Health disparities attributable to air pollutant exposure in North Carolina: Influence of residential environmental and social factors. Health Place 2020; 62:102287. [PMID: 32479364 DOI: 10.1016/j.healthplace.2020.102287] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/23/2022]
Abstract
Understanding the environmental justice implications of the mortality impacts of air pollution exposure is a public health priority, as some subpopulations may face a disproportionate health burden. We examined which residential environmental and social factors may affect disparities in the air pollution-mortality relationship in North Carolina, US, using a time-stratified case-crossover design. Results indicate that air pollution poses a higher mortality risk for some persons (e.g., elderly) than others. Our findings have implications for environmental justice regarding protection of those who suffer the most from exposure to air pollution and policies to protect their health.
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Assessing the Effects on Health Inequalities of Differential Exposure and Differential Susceptibility of Air Pollution and Environmental Noise in Barcelona, 2007-2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183470. [PMID: 31540448 PMCID: PMC6766056 DOI: 10.3390/ijerph16183470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 11/26/2022]
Abstract
The hypotheses we intended to contrast were, first, that the most deprived neighborhoods in Barcelona, Spain, present high exposure to environmental hazards (differential exposure) and, secondly, that the health effects of this greater exposure were higher in the most deprived neighborhoods (differential susceptibility). The population studied corresponded to the individuals residing in the neighborhoods of Barcelona in the period 2007–2014. We specified the association between the relative risk of death and environmental hazards and socioeconomic indicators by means of spatio-temporal ecological regressions, formulated as a generalized linear mixed model with Poisson responses. There was a differential exposure (higher in more deprived neighborhoods) in almost all the air pollutants considered, when taken individually. The exposure was higher in the most affluent in the cases of environmental noise. Nevertheless, for both men and women, the risk of dying due to environmental hazards in a very affluent neighborhood is about 30% lower than in a very depressed neighborhood. The effect of environmental hazards was more harmful to the residents of Barcelona’s most deprived neighborhoods. This increased susceptibility cannot be attributed to a single problem but rather to a set of environmental hazards that, overall, a neighborhood may present.
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Fairburn J, Schüle SA, Dreger S, Karla Hilz L, Bolte G. Social Inequalities in Exposure to Ambient Air Pollution: A Systematic Review in the WHO European Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173127. [PMID: 31466272 PMCID: PMC6747075 DOI: 10.3390/ijerph16173127] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/21/2019] [Accepted: 08/24/2019] [Indexed: 01/22/2023]
Abstract
Ambient air pollution is a long-standing and significant public health issue. The aim of this review is to systematically examine the peer-reviewed evidence on social inequalities and ambient air pollution in the World Health Organization European Region. Articles published between 2010 and 2017 were analyzed in the review. In total 31 articles were included in the review. There is good evidence from ecological studies that higher deprivation indices and low economic position are usually linked with higher levels of pollutants such as particulate matter (particulate matter under 2.5 and 10 microns in diameter, PM2.5, PM10) and oxides of nitrogen (e.g., NO2, and NOx). There is also evidence that ethnic minorities experience a mixed exposure in comparison to the majority population being sometimes higher and sometimes lower depending on the ethnic minority under consideration. The studies using data at the individual level in this review are mainly focused on pregnant women or new mothers, in these studies deprivation and ethnicity are more likely to be linked to higher exposures of poor air quality. Therefore, there is evidence in this review that the burden of higher pollutants falls disproportionally on different social groups.
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Affiliation(s)
- Jonathan Fairburn
- Staffordshire Business School, Staffordshire University, Stoke on Trent ST4 2DF, UK.
| | - Steffen Andreas Schüle
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
| | - Stefanie Dreger
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
| | - Lisa Karla Hilz
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
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Bolte G, Bunge C, Hornberg C, Köckler H. [Environmental justice as an approach to tackle environmental health inequalities]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:674-683. [PMID: 29725725 DOI: 10.1007/s00103-018-2739-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Current international studies show that environment-related diseases disproportionately affect vulnerable people. This is a case of environmental injustice. Environmental justice goes beyond the mere description of environment- and health-related social inequalities by comprising two dimensions of justice as a normative approach: distributional and procedural justice. Attempts to explain the link between social circumstances, the environment and health deal with both the socially unequal distribution of environmental hazards and environmental resources (exposure variation) and social differences in vulnerability to the health effects of environmental exposures (effect modification). Integrated monitoring approaches provide the basis for deriving interventions under various aspects of environmental justice. Parting from public health research and embedded in the Health in All Policies (HiAP) concept, environmental justice has now been taken up in a number of fields, including politics, administration and practice. There are strategic considerations and attempts to anchor it in politics at the federal, state and the communal level, both by government and non-government groups. Health-promoting urban development is a core field for intervention. The Soziale Stadt (Social City) programme for promoting urban planning and construction as well as place oriented sectoral planning make an important contribution by helping to focus on urban spaces with multiple health hazards and to implement target group-oriented participation processes. There continues to be a need to develop methods and systematically implemented evaluations of political strategies and corresponding interventions regarding their effects on inequalities in health and environmental justice.
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Affiliation(s)
- Gabriele Bolte
- Institut für Public Health und Pflegeforschung, Abteilung Sozialepidemiologie, Universität Bremen, Grazer Str. 4, 28359, Bremen, Deutschland.
| | - Christiane Bunge
- Fachgebiet II 1.1 "Übergreifende Angelegenheiten Umwelt und Gesundheit", Umweltbundesamt, Berlin, Deutschland
| | - Claudia Hornberg
- Fakultät für Gesundheitswissenschaften, AG 7 - Umwelt und Gesundheit, Universität Bielefeld, Bielefeld, Deutschland
| | - Heike Köckler
- Department of Community Health, Hochschule für Gesundheit, Bochum, Deutschland
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Dadzie EK, Ephraim RK, Afrifa J, Quaicoe R, Bediako BS, Duku BI, Adjetey T, Dadzie I. Persistent exposure to wood smoke is associated with variations in biochemical and hematological indices among regular wood burners in the Cape Coast metropolis, Ghana. SCIENTIFIC AFRICAN 2019. [DOI: 10.1016/j.sciaf.2019.e00100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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The Role of Socioeconomic Status in the Association of Lung Function and Air Pollution-A Pooled Analysis of Three Adult ESCAPE Cohorts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111901. [PMID: 31146441 PMCID: PMC6603717 DOI: 10.3390/ijerph16111901] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/21/2019] [Accepted: 05/24/2019] [Indexed: 12/20/2022]
Abstract
Ambient air pollution is a leading environmental risk factor and its broad spectrum of adverse health effects includes a decrease in lung function. Socioeconomic status (SES) is known to be associated with both air pollution exposure and respiratory function. This study assesses the role of SES either as confounder or effect modifier of the association between ambient air pollution and lung function. Cross-sectional data from three European multicenter adult cohorts were pooled to assess factors associated with lung function, including annual means of home outdoor NO2. Pre-bronchodilator lung function was measured according to the ATS-criteria. Multiple mixed linear models with random intercepts for study areas were used. Three different factors (education, occupation and neighborhood unemployment rate) were considered to represent SES. NO2 exposure was negatively associated with lung function. Occupation and neighborhood unemployment rates were not associated with lung function. However, the inclusion of the SES-variable education improved the models and the air pollution-lung function associations got slightly stronger. NO2 associations with lung function were not substantially modified by SES-variables. In this multicenter European study we could show that SES plays a role as a confounder in the association of ambient NO2 exposure with lung function.
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Arroyo V, Díaz J, Salvador P, Linares C. Impact of air pollution on low birth weight in Spain: An approach to a National Level Study. ENVIRONMENTAL RESEARCH 2019; 171:69-79. [PMID: 30660920 DOI: 10.1016/j.envres.2019.01.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/11/2019] [Accepted: 01/12/2019] [Indexed: 05/23/2023]
Abstract
BACKGROUND According to the WHO, low birth weight (<2500 gr) is a primary maternal health indicator as the cause of multiple morbi-mortality in the short and long-term. It is known that air pollution from road traffic (PM10, NO2) and O3 have an important impact on low birth weight (LBW), but there are few studies of this topic in Spain. The objective of this study is to determine the possible exposure windows in the gestational period in which there is greater susceptibility to urban air pollution and to quantify the relative risks (RR) and population attributable risks (PAR) of low birth weight associated with pollutant concentrations in Spain. METHODS We calculated the weekly average births with low birth weight (ICD-10: P07.0-P07.1) for each Spanish province for the period 2001-2009, using the average weekly concentrations of PM10, NO2 and O3, measured in the capital cities of the provinces. The estimation of RR and PAR were carried out using generalized linear models with link Poisson, controlling for the trend, seasonality and auto-regressive character of the series and for the influence of temperature during periods of heat waves and/or cold. Finally, a meta-analysis was used to estimate the global RR and PAR based on the RR obtained for each of the provinces. RESULTS The RR for the whole of Spain is 1.104 (CI95%: 1.072, 1.138) for the association between LBW and PM10, and 1.091 (CI95%: 1.059, 1.124) for the association between NO2 and LBW. Our results suggest that 5% of low birth weight births in the case of PM10 and 8% in the case of NO2 could have been avoided with a reduction of 10 μg/m3 in the concentrations of these pollutants. CONCLUSIONS The impact of the results obtained- with 6105 cases attributable to PM10 and up to 9385 cases attributable to NO2 in a period of 9 study years- suggest the need to design structural and awareness public health measures to reduce air pollution in Spain.
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Affiliation(s)
- Virginia Arroyo
- National School of Public Health, Carlos III Institute of Health. Madrid, Spain; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
| | - Julio Díaz
- National School of Public Health, Carlos III Institute of Health. Madrid, Spain.
| | - P Salvador
- Environmental Department of research, Centre for energy, Environment and Technology (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas/CIEMAT), Madrid, Spain
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health. Madrid, Spain
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Rodrigues PCDO, Ignotti E, Hacon SDS. Socioeconomic factors increase the adverse effects of air pollution and temperature on mortality. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190011. [PMID: 30892474 DOI: 10.1590/1980-549720190011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/01/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To verify the effects of PM2.5 and temperature on mortality due to cardiovascular diseases according to socioeconomic status and traffic proximity. METHOD Time series were used, using the generalized additive models with the Poisson regression option, at 5% significance level. Interactionbetween proximity of traffic and socioeconomic status was analyzed through stratification. The proximity to the traffic was divided into distances up to 150m or over 150m. Socioeconomic status in the residential environment was categorized as high and low based on the median (3.9%). The relative risk percentage (%RR) of cardiovascular disease deaths was calculated for each linear increase of 10 µg/m3 at PM2.5 and 1ºC at the maximum temperature. RESULTS Mortality due to cardiovascular diseases presented %RR 1.64 (95%CI -0.03; 3.33), related to the maximum temperature and %RR 4.60 (95%CI 0.78; 8.56) related to PM2.5, in areas with high traffic exposure. In areas with poor living conditions, %RR 1.34 (95%CI -0.31; 3.01) was observed, related to maximum temperature and RR% 3.95 (95%CI -0.27; 8.34) associated with PM2.5. CONCLUSION Areas with poor living conditions and high-exposure to vehicular traffic had an increased risk of cardiovascular disease mortality related to high temperature and PM2.5.
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Affiliation(s)
| | - Eliane Ignotti
- Universidade do Estado de Mato Grosso - Cáceres (MT), Brasil
| | - Sandra de Souza Hacon
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
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Ribeiro AG, Downward GS, Freitas CUD, Chiaravalloti Neto F, Cardoso MRA, Latorre MDRDDO, Hystad P, Vermeulen R, Nardocci AC. Incidence and mortality for respiratory cancer and traffic-related air pollution in São Paulo, Brazil. ENVIRONMENTAL RESEARCH 2019; 170:243-251. [PMID: 30594696 DOI: 10.1016/j.envres.2018.12.034] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/29/2018] [Accepted: 12/15/2018] [Indexed: 05/15/2023]
Abstract
BACKGROUND Multiple lines of evidence have associated exposure to ambient air pollution with an increased risk of respiratory malignancies. However, there is a dearth of evidence from low-middle income countries, including those within South America, where the social inequalities are more marked. OBJECTIVES To quantify the association between exposures to traffic related air pollution and respiratory cancer incidence and mortality within São Paulo, Brazil. Further, we aim to investigate the role of socioeconomic status (SES) upon these outcomes. METHODS Cancer incidence between 2002 and 2011 was derived from the population-based cancer registry. Mortality data (between 2002 and 2013) was derived from the Municipal Health Department. A traffic density database and an annual nitrogen dioxide (NO2) land use regression model were used as markers of exposure. Age-adjusted Binomial Negative Regression models were developed, stratifying by SES and gender. RESULTS We observed an increased rate of respiratory cancer incidence and mortality in association with increased traffic density and NO2 concentrations, which was higher among those regions with the lowest SES. For cancer mortality and traffic exposure, those in the most deprived region, had an incidence rate ratio (IRR) of 2.19 (95% CI: 1.70, 2.82) when comparing the highest exposure centile (top 90%) to the lowest (lowest 25%). By contrast, in the least deprived area, the IRR for the same exposure contrast was.1.07 (95% CI: 0.95, 1.20). For NO2 in the most deprived regions, the IRR for cancer mortality in the highest exposed group was 1.44 (95% CI: 1.10, 1.88) while in the least deprived area, the IRR for the highest exposed group was 1.11 (95% CI: 1.01, 1.23). CONCLUSIONS Traffic density and NO2 were associated with an increased rate of respiratory cancer incidence and mortality in São Paulo. Residents from poor regions may suffer more from the impact of traffic air pollution.
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Affiliation(s)
- Adeylson Guimarães Ribeiro
- Department of Environmental Health, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP CEP 01246-904, Brazil.
| | - George Stanley Downward
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, the Netherlands.
| | - Clarice Umbelino de Freitas
- Center for Epidemiological Surveillance, State Department of Health, Av. Dr. Arnaldo, 351, São Paulo, SP CEP:01246-000, Brazil
| | - Francisco Chiaravalloti Neto
- Department of Epidemiology, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP CEP 01246-904, Brazil.
| | - Maria Regina Alves Cardoso
- Department of Epidemiology, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP CEP 01246-904, Brazil.
| | | | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, 20C Milam Hall, Corvallis, OR 97331, USA.
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, the Netherlands.
| | - Adelaide Cassia Nardocci
- Department of Environmental Health, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP CEP 01246-904, Brazil.
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Ribeiro AG, Baquero OS, Almeida SLD, Freitas CUD, Cardoso MRA, Nardocci AC. [Influence of vehicular traffic density on hospital admissions due to respiratory tract cancer in the city of São Paulo, Brazil]. CAD SAUDE PUBLICA 2019; 35:e00128518. [PMID: 30673059 DOI: 10.1590/0102-311x00128518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/10/2018] [Indexed: 11/22/2022] Open
Abstract
Pollution related to traffic is a major problem in urban centers and a large portion of the population is vulnerable to its health effects. This study sought to identify a potential association between hospital admissions due to respiratory tract cancer and vehicular traffic density in the city of São Paulo, Brazil. It is an ecological study of the public (Hospital Inpatient Authorization - AIH, in Portuguese) and private (Hospital Inpatient Communication - CIH, in Portuguese) health care systems, from 2004 to 2006, geocoded by individuals' residential addresses. Using a Besag-York-Mollié ecological model, we initially evaluated the relationship between number of cases of hospital admission due to respiratory tract cancer in each weighting area and the standardized co-variables: traffic density and Municipal Human Development Index (MHDI) as indicator of socioeconomic status. Using a classic Poisson model, we then evaluated the risk associated with growing traffic density categories. The Besag-York-Mollié model estimated a RR = 1.09 (95%CI: 1.02-1.15) and RR = 1.19 (95%CI: 1.10-1.29) of admission due to respiratory tract cancer for each increase of one standard deviation of traffic and MHDI, respectively. The Poisson model also showed a clear exposure-response gradient for admission due to respiratory tract cancer (IRR = 1.11; 95%CI: 1.07-1.15, for each 10 units of added traffic density). This study suggests that there is an association between residing in areas with high traffic density and hospital admissions due to respiratory tract cancer in the city of São Paulo.
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Affiliation(s)
| | - Oswaldo Santos Baquero
- Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brasil
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Unequal residential exposure to air pollution and noise: A geospatial environmental justice analysis for Ghent, Belgium. SSM Popul Health 2018; 7:100340. [PMID: 30623014 PMCID: PMC6304432 DOI: 10.1016/j.ssmph.2018.100340] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/24/2022] Open
Abstract
Following the growing empirical evidence on the health effects of air pollution and noise, the fair distribution of these impacts receives increasing attention. The existing environmental inequality studies often focus on a single environmental impact, apply a limited range of covariates or do not correct for spatial autocorrelation. This article presents a geospatial data analysis on Ghent (Belgium), combining residential exposure to air pollution and noise with socioeconomic variables and housing variables. The global results show that neighborhoods with lower household incomes, more unemployment, more people of foreign origin, more rental houses, and higher residential mobility, are more exposed to air pollution, but not to noise. Multiple regression models to explain exposure to air pollution show that residential mobility and percentage of rental houses are the strongest predictors, stressing the role of the housing market in explaining which people are most at risk. Applying spatial regression models leads to better models but reduces the importance of all covariates, leaving income and residential mobility as the only significant predictors for air pollution exposure. While traditional multiple regression models were not significant for explaining noise exposure, spatial regression models were, and also indicate the significant contribution of income to the model. This means income is a robust predictor for both air pollution and noise exposure across the whole urban territory. The results provide a good starting point for discussions about environmental justice and the need for policy action. The study also underlines the importance of taking spatial autocorrelation into account when analyzing environmental inequality. We found socioeconomic inequalities in exposure to air pollution and noise. Median household income was the most significant predictor overall. Residential mobility was an important predictor for air pollution exposure. Spatial autocorrelation distorts traditional multiple regression results. The results contribute to environmental justice debates.
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Cushing L, Blaustein-Rejto D, Wander M, Pastor M, Sadd J, Zhu A, Morello-Frosch R. Carbon trading, co-pollutants, and environmental equity: Evidence from California's cap-and-trade program (2011-2015). PLoS Med 2018; 15:e1002604. [PMID: 29990353 PMCID: PMC6038989 DOI: 10.1371/journal.pmed.1002604] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/07/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Policies to mitigate climate change by reducing greenhouse gas (GHG) emissions can yield public health benefits by also reducing emissions of hazardous co-pollutants, such as air toxics and particulate matter. Socioeconomically disadvantaged communities are typically disproportionately exposed to air pollutants, and therefore climate policy could also potentially reduce these environmental inequities. We sought to explore potential social disparities in GHG and co-pollutant emissions under an existing carbon trading program-the dominant approach to GHG regulation in the US and globally. METHODS AND FINDINGS We examined the relationship between multiple measures of neighborhood disadvantage and the location of GHG and co-pollutant emissions from facilities regulated under California's cap-and-trade program-the world's fourth largest operational carbon trading program. We examined temporal patterns in annual average emissions of GHGs, particulate matter (PM2.5), nitrogen oxides, sulfur oxides, volatile organic compounds, and air toxics before (January 1, 2011-December 31, 2012) and after (January 1, 2013-December 31, 2015) the initiation of carbon trading. We found that facilities regulated under California's cap-and-trade program are disproportionately located in economically disadvantaged neighborhoods with higher proportions of residents of color, and that the quantities of co-pollutant emissions from these facilities were correlated with GHG emissions through time. Moreover, the majority (52%) of regulated facilities reported higher annual average local (in-state) GHG emissions since the initiation of trading. Neighborhoods that experienced increases in annual average GHG and co-pollutant emissions from regulated facilities nearby after trading began had higher proportions of people of color and poor, less educated, and linguistically isolated residents, compared to neighborhoods that experienced decreases in GHGs. These study results reflect preliminary emissions and social equity patterns of the first 3 years of California's cap-and-trade program for which data are available. Due to data limitations, this analysis did not assess the emissions and equity implications of GHG reductions from transportation-related emission sources. Future emission patterns may shift, due to changes in industrial production decisions and policy initiatives that further incentivize local GHG and co-pollutant reductions in disadvantaged communities. CONCLUSIONS To our knowledge, this is the first study to examine social disparities in GHG and co-pollutant emissions under an existing carbon trading program. Our results indicate that, thus far, California's cap-and-trade program has not yielded improvements in environmental equity with respect to health-damaging co-pollutant emissions. This could change, however, as the cap on GHG emissions is gradually lowered in the future. The incorporation of additional policy and regulatory elements that incentivize more local emission reductions in disadvantaged communities could enhance the local air quality and environmental equity benefits of California's climate change mitigation efforts.
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Affiliation(s)
- Lara Cushing
- Department of Health Education, San Francisco State University, San Francisco, California, United States of America
- Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, California, United States of America
- * E-mail: (LC); (RMF)
| | - Dan Blaustein-Rejto
- Goldman School of Public Policy, University of California, Berkeley, Berkeley, California, United States of America
| | - Madeline Wander
- Program for Environmental and Regional Equity, University of Southern California, Los Angeles, California, United States of America
| | - Manuel Pastor
- Program for Environmental and Regional Equity, University of Southern California, Los Angeles, California, United States of America
| | - James Sadd
- Department of Geology, Occidental College, Los Angeles, California, United States of America
| | - Allen Zhu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, California, United States of America
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, California, United States of America
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- * E-mail: (LC); (RMF)
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Brunt H, Barnes J, Jones SJ, Longhurst JWS, Scally G, Hayes E. Air pollution, deprivation and health: understanding relationships to add value to local air quality management policy and practice in Wales, UK. J Public Health (Oxf) 2018; 39:485-497. [PMID: 27613763 DOI: 10.1093/pubmed/fdw084] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 07/16/2016] [Indexed: 11/13/2022] Open
Abstract
Background Air pollution exposure reduces life expectancy. Air pollution, deprivation and poor-health status combinations can create increased and disproportionate disease burdens. Problems and solutions are rarely considered in a broad public health context, but doing so can add value to air quality management efforts by reducing air pollution risks, impacts and inequalities. Methods An ecological study assessed small-area associations between air pollution (nitrogen dioxide and particulate matter), deprivation status and health outcomes in Wales, UK. Results Air pollution concentrations were highest in 'most' deprived areas. When considered separately, deprivation-health associations were stronger than air pollution-health associations. Considered simultaneously, air pollution added to deprivation-health associations; interactions between air pollution and deprivation modified and strengthened associations with all-cause and respiratory disease mortality, especially in 'most' deprived areas where most-vulnerable people lived and where health needs were greatest. Conclusion There is a need to reduce air pollution-related risks for all. However, it is also the case that greater health gains can result from considering local air pollution problems and solutions in the context of wider health-determinants and acting on a better understanding of relationships. Informed and co-ordinated air pollution mitigation and public health action in high deprivation and pollution areas can reduce risks and inequalities. To achieve this, greater public health integration and collaboration in local air quality management policy and practice is needed.
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Affiliation(s)
- H Brunt
- Air Quality Management Resource Centre, University of the West of England, Bristol, UK.,Health Protection Team, Public Health Wales, Cardiff, UK
| | - J Barnes
- Air Quality Management Resource Centre, University of the West of England, Bristol, UK
| | - S J Jones
- Health Protection Team, Public Health Wales,Cardiff, UK
| | - J W S Longhurst
- Air Quality Management Resource Centre, University of the West of England, Bristol, UK
| | - G Scally
- WHO Collaborating Centre for Healthy Urban Environments, University of the West of England, Bristol, UK
| | - E Hayes
- Air Quality Management Resource Centre, University of the West of England, Bristol, UK
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Urquhart GJ, Saunders P. Wider horizons, wiser choices: horizon scanning for public health protection and improvement. J Public Health (Oxf) 2018; 39:248-253. [PMID: 27160863 DOI: 10.1093/pubmed/fdw039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Systematic continuous thinking about the future helps organizations, professions and communities to both prepare for, and shape, the future. This becomes ever more critical given the accelerating rate at which new data emerge, and in some cases uncertainties around their reliability and interpretation. Businesses with the capability to filter and analyse vast volumes of data to create knowledge and insights requiring action have a competitive advantage. Similarly Government and the public sector, including public health can be more effective and efficient through the early identification of emerging issues (both threats and opportunities). Methods Horizon scanning approaches, and the use of resulting intelligence related to health protection and improvement were reviewed. Results Public health horizon scanning systems have to date focussed on health technologies and infectious diseases. While these have been successful there is a major gap in terms of non-infectious hazards and health improvement. Conclusion Any system to meet this need must recognize the changed environment for delivering front line public health services and the critical role of local authorities and the local democratic process. This presents opportunities and challenges and this paper explores those dynamics describing an existing environment and health horizon scanning system which could readily and rapidly be re-engineered to provide a national service.
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Affiliation(s)
- Graham J Urquhart
- Environmental Hazardsand Emergencies Department, Public Health England, Didcot, UK
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Landrigan PJ, Fuller R, Acosta NJR, Adeyi O, Arnold R, Basu NN, Baldé AB, Bertollini R, Bose-O'Reilly S, Boufford JI, Breysse PN, Chiles T, Mahidol C, Coll-Seck AM, Cropper ML, Fobil J, Fuster V, Greenstone M, Haines A, Hanrahan D, Hunter D, Khare M, Krupnick A, Lanphear B, Lohani B, Martin K, Mathiasen KV, McTeer MA, Murray CJL, Ndahimananjara JD, Perera F, Potočnik J, Preker AS, Ramesh J, Rockström J, Salinas C, Samson LD, Sandilya K, Sly PD, Smith KR, Steiner A, Stewart RB, Suk WA, van Schayck OCP, Yadama GN, Yumkella K, Zhong M. The Lancet Commission on pollution and health. Lancet 2018; 391:462-512. [PMID: 29056410 DOI: 10.1016/s0140-6736(17)32345-0] [Citation(s) in RCA: 1734] [Impact Index Per Article: 289.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 05/09/2017] [Accepted: 08/02/2017] [Indexed: 01/02/2023]
Affiliation(s)
- Philip J Landrigan
- Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | | | | | - Olusoji Adeyi
- Department of Health, Nutrition, and Population Global Practice, The World Bank, Washington, DC, USA
| | - Robert Arnold
- Department of Chemical and Environmental Engineering, University of Arizona, Tucson, AZ, USA
| | - Niladri Nil Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Canada
| | | | - Roberto Bertollini
- Scientific Committee on Health, Environmental and Emerging Risks of the European Commission, Luxembourg City, Luxembourg; Office of the Minister of Health, Ministry of Public Health, Doha, Qatar
| | - Stephan Bose-O'Reilly
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of LMU Munich, Munich, Germany; Department of Public Health, Health Services Research and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | | | - Patrick N Breysse
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas Chiles
- Department of Biology, Boston College, Chestnut Hill, MA, USA
| | | | | | - Maureen L Cropper
- Department of Economics, University of Maryland, College Park, MD, USA; Resources for the Future, Washington, DC, USA
| | - Julius Fobil
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Valentin Fuster
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | | | - Andy Haines
- Department of Social and Environmental Health Research and Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - David Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mukesh Khare
- Department of Civil Engineering, Indian Institute of Technology, Delhi, India
| | | | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Bindu Lohani
- Centennial Group, Washington, DC, USA; The Resources Center, Lalitpur, Nepal
| | - Keith Martin
- Consortium of Universities for Global Health, Washington, DC, USA
| | - Karen V Mathiasen
- Office of the US Executive Director, The World Bank, Washington, DC, USA
| | | | | | | | - Frederica Perera
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Janez Potočnik
- UN International Resource Panel, Paris, France; SYSTEMIQ, London, UK
| | - Alexander S Preker
- Department of Environmental Medicine and Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA; Health Investment & Financing Corporation, New York, NY, USA
| | | | - Johan Rockström
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
| | | | - Leona D Samson
- Department of Biological Engineering and Department of Biology, Center for Environmental Health Sciences, Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, University of Queensland, Brisbane, QLD, Australia
| | - Kirk R Smith
- Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, CA, USA
| | - Achim Steiner
- Oxford Martin School, University of Oxford, Oxford, UK
| | - Richard B Stewart
- Guarini Center on Environmental, Energy, and Land Use Law, New York University, New York, NY, USA
| | - William A Suk
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Onno C P van Schayck
- Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Gautam N Yadama
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Kandeh Yumkella
- United Nations Industrial Development Organization, Vienna, Austria
| | - Ma Zhong
- School of Environment and Natural Resources, Renmin University of China, Beijing, China
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Milojevic A, Niedzwiedz CL, Pearce J, Milner J, MacKenzie IA, Doherty RM, Wilkinson P. Socioeconomic and urban-rural differentials in exposure to air pollution and mortality burden in England. Environ Health 2017; 16:104. [PMID: 28985761 PMCID: PMC6389046 DOI: 10.1186/s12940-017-0314-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 10/02/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Socioeconomically disadvantaged populations often have higher exposures to particulate air pollution, which can be expected to contribute to differentials in life expectancy. We examined socioeconomic differentials in exposure and air pollution-related mortality relating to larger scale (5 km resolution) variations in background concentrations of selected pollutants across England. METHODS Ozone and particulate matter (sub-divided into PM10, PM2.5, PM2.5-10, primary, nitrate and sulphate PM2.5) were simulated at 5 km horizontal resolution using an atmospheric chemistry transport model (EMEP4UK). Annual mean concentrations of these pollutants were assigned to all 1,202,578 residential postcodes in England, which were classified by urban-rural status and socioeconomic deprivation based on the income and employment domains of the 2010 English Index of Multiple Deprivation for the Lower-level Super Output Area of residence. We used life table methods to estimate PM2.5-attributable life years (LYs) lost in both relative and absolute terms. RESULTS Concentrations of the most particulate fractions, but not of nitrate PM2.5 or ozone, were modestly higher in areas of greater socioeconomic deprivation. Relationships between pollution level and socioeconomic deprivation were non-linear and varied by urban-rural status. The pattern of PM2.5 concentrations made only a small contribution to the steep socioeconomic gradient in LYs lost due to PM2.5 per 103 population, which primarily was driven by the steep socioeconomic gradient in underlying mortality rates. In rural areas, the absolute burden of air pollution-related LYs lost was lowest in the most deprived deciles. CONCLUSIONS Air pollution shows modest socioeconomic patterning at 5 km resolution in England, but absolute attributable mortality burdens are strongly related to area-level deprivation because of underlying mortality rates. Measures that cause a general reduction in background concentrations of air pollution may modestly help narrow socioeconomic differences in health.
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Affiliation(s)
- Ai Milojevic
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Claire L. Niedzwiedz
- Centre for Research on Environment Society and Health, School of GeoSciences, University of Edinburgh, Drummond Street, Edinburgh, EH8 9XP UK
| | - Jamie Pearce
- Centre for Research on Environment Society and Health, School of GeoSciences, University of Edinburgh, Drummond Street, Edinburgh, EH8 9XP UK
| | - James Milner
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Ian A. MacKenzie
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh, EH9 3FE UK
| | - Ruth M. Doherty
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh, EH9 3FE UK
| | - Paul Wilkinson
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
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Ouidir M, Lepeule J, Siroux V, Malherbe L, Meleux F, Rivière E, Launay L, Zaros C, Cheminat M, Charles MA, Slama R. Is atmospheric pollution exposure during pregnancy associated with individual and contextual characteristics? A nationwide study in France. J Epidemiol Community Health 2017; 71:1026-1036. [DOI: 10.1136/jech-2016-208674] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 01/15/2023]
Abstract
BackgroundExposure to atmospheric pollutants is a danger for the health of pregnant mother and children. Our objective was to identify individual (socioeconomic and behavioural) and contextual factors associated with atmospheric pollution pregnancy exposure at the nationwide level.MethodAmong 14 921 women from the French nationwide ELFE (French Longitudinal Study of Children) mother-child cohort recruited in 2011, outdoor exposure levels of PM2.5, PM10 (particulate matter <2.5 µm and <10 µm in diameter) and NO2 (nitrogen dioxide) were estimated at the pregnancy home address from a dispersion model with 1 km resolution. We used classification and regression trees (CART) and linear regression to characterise the association of atmospheric pollutants with individual (maternal age, body mass index, parity, education level, relationship status, smoking status) and contextual (European Deprivation Index, urbanisation level) factors.ResultsPatterns of associations were globally similar across pollutants. For the CART approach, the highest tertile of exposure included mainly women not in a relationship living in urban and socially deprived areas, with lower education level. Linear regression models identified different determinants of atmospheric pollutants exposure according to the residential urbanisation level. In urban areas, atmospheric pollutants exposure increased with social deprivation, while in rural areas a U-shaped relationship was observed.ConclusionWe highlighted social inequalities in atmospheric pollutants exposure according to contextual characteristics such as urbanisation level and social deprivation and also according to individual characteristics such as education, being in a relationship and smoking status. In French urban areas, pregnant women from the most deprived neighbourhoods were those most exposed to health-threatening atmospheric pollutants.
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Socioeconomic Inequalities in Green Space Quality and Accessibility-Evidence from a Southern European City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080916. [PMID: 28809798 PMCID: PMC5580619 DOI: 10.3390/ijerph14080916] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 08/09/2017] [Accepted: 08/11/2017] [Indexed: 11/17/2022]
Abstract
Background: The provision of green spaces is an important health promotion strategy to encourage physical activity and to improve population health. Green space provision has to be based on the principle of equity. This study investigated the presence of socioeconomic inequalities in geographic accessibility and quality of green spaces across Porto neighbourhoods (Portugal). Methods: Accessibility was evaluated using a Geographic Information System and all the green spaces were audited using the Public Open Space Tool. Kendall’s tau-b correlation coefficients and ordinal regression were used to test whether socioeconomic differences in green space quality and accessibility were statistically significant. Results: Although the majority of the neighbourhoods had an accessible green space, mean distance to green space increased with neighbourhood deprivation. Additionally, green spaces in the more deprived neighbourhoods presented significantly more safety concerns, signs of damage, lack of equipment to engage in active leisure activities, and had significantly less amenities such as seating, toilets, cafés, etc. Conclusions: Residents from low socioeconomic positions seem to suffer from a double jeopardy; they lack both individual and community resources. Our results have important planning implications and might contribute to understanding why deprived communities have lower physical activity levels and poorer health.
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Rodrigues PCDO, Santos ESD, Hacon SDS, Ignotti E. Fatores de risco para mortalidade por doenças cardiovasculares associados à alta exposição ao tráfego veicular. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 20:423-434. [DOI: 10.1590/1980-5497201700030006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 02/13/2017] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Identificar áreas e fatores de risco para a mortalidade causada por doenças cardiovasculares (DC) associados à poluição do ar proveniente da alta exposição ao tráfego. Métodos: Estudo transversal da mortalidade por DC em 2.617 indivíduos de 45 a 85 anos residentes na zona urbana de Cuiabá e Várzea Grande, Mato Grosso, entre 2009 e 2011. Utilizou-se a proximidade residencial de até 150 metros de uma via de grande fluxo de veículos como proxy da alta exposição à poluição atmosférica proveniente do tráfego. A associação entre idade, sexo, renda e intensidade do trânsito com a exposição ao tráfego foi avaliada por meio de regressão logística múltipla. Foram realizadas análises estratificadas para observar a influência das estações do ano e dos grupos de causas. Utilizou-se modelo espacial de probabilidade de Bernoulli para identificação de áreas de risco. Resultados: Os principais fatores de risco para mortalidade por DC associados à alta exposição ao tráfego foram: residir em setores censitários com renda muito desigual (OR = 1,78; IC95% 1,36 - 2,33), trânsito intenso (OR = 1,20; IC95% 1,01 - 1,43) e sexo feminino (OR = 1,18; IC95% 1,01 - 1,38). O risco de mortalidade por DC aumenta cerca de 10% no período de seca. Foram identificadas nove áreas de risco. Conclusão: A alta exposição ao tráfego está associada à mortalidade por DC em Cuiabá e Várzea Grande. A desigualdade de renda, a intensidade do trânsito e o sexo feminino apresentaram-se como os principais determinantes dessa exposição, além da estação seca potencializá-la.
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Temam S, Burte E, Adam M, Antó JM, Basagaña X, Bousquet J, Carsin AE, Galobardes B, Keidel D, Künzli N, Le Moual N, Sanchez M, Sunyer J, Bono R, Brunekreef B, Heinrich J, de Hoogh K, Jarvis D, Marcon A, Modig L, Nadif R, Nieuwenhuijsen M, Pin I, Siroux V, Stempfelet M, Tsai MY, Probst-Hensch N, Jacquemin B. Socioeconomic position and outdoor nitrogen dioxide (NO 2) exposure in Western Europe: A multi-city analysis. ENVIRONMENT INTERNATIONAL 2017; 101:117-124. [PMID: 28159394 DOI: 10.1016/j.envint.2016.12.026] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/12/2016] [Accepted: 12/28/2016] [Indexed: 05/17/2023]
Abstract
BACKGROUND Inconsistent associations between socioeconomic position (SEP) and outdoor air pollution have been reported in Europe, but methodological differences prevent any direct between-study comparison. OBJECTIVES Assess and compare the association between SEP and outdoor nitrogen dioxide (NO2) exposure as a marker of traffic exhaust, in 16 cities from eight Western European countries. METHODS Three SEP indicators, two defined at individual-level (education and occupation) and one at neighborhood-level (unemployment rate) were assessed in three European multicenter cohorts. NO2 annual concentration exposure was estimated at participants' addresses with land use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE; http://www.escapeproject.eu/). Pooled and city-specific linear regressions were used to analyze associations between each SEP indicator and NO2. Heterogeneity across cities was assessed using the Higgins' I-squared test (I2). RESULTS The study population included 5692 participants. Pooled analysis showed that participants with lower individual-SEP were less exposed to NO2. Conversely, participants living in neighborhoods with higher unemployment rate were more exposed. City-specific results exhibited strong heterogeneity (I2>76% for the three SEP indicators) resulting in variation of the individual- and neighborhood-SEP patterns of NO2 exposure across cities. The coefficients from a model that included both individual- and neighborhood-SEP indicators were similar to the unadjusted coefficients, suggesting independent associations. CONCLUSIONS Our study showed for the first time using homogenized measures of outcome and exposure across 16 cities the important heterogeneity regarding the association between SEP and NO2 in Western Europe. Importantly, our results showed that individual- and neighborhood-SEP indicators capture different aspects of the association between SEP and exposure to air pollution, stressing the importance of considering both in air pollution health effects studies.
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Affiliation(s)
- Sofia Temam
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; Univ Paris-Sud, Kremlin-Bicêtre, France.
| | - Emilie Burte
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France
| | - Martin Adam
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Josep M Antó
- ISGlobal-Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Xavier Basagaña
- ISGlobal-Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Jean Bousquet
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; Centre Hospitalo-Universitaire, Montpellier, France
| | - Anne-Elie Carsin
- ISGlobal-Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Bruna Galobardes
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Dirk Keidel
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nicole Le Moual
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France
| | - Margaux Sanchez
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France
| | - Jordi Sunyer
- ISGlobal-Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, University Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joachim Heinrich
- Institute of Epidemiology, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine Ludwig Maximilians University, Munich, Germany
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Population Health and Occupational disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Debbie Jarvis
- Population Health and Occupational disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lars Modig
- Public Health and Clinical Medicine, Umea University, University Hospital, Umea, Sweden
| | - Rachel Nadif
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France
| | - Mark Nieuwenhuijsen
- ISGlobal-Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Isabelle Pin
- IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, Grenoble, France; IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, Univ Grenoble-Alpes, Grenoble, France; IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, CHU Grenoble, Grenoble, France; Pédiatrie, CHU Grenoble, Grenoble, France
| | - Valérie Siroux
- IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, Grenoble, France; IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, Univ Grenoble-Alpes, Grenoble, France; IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, CHU Grenoble, Grenoble, France
| | - Morgane Stempfelet
- InVS, French Institute for Public Health Surveillance, Saint-Maurice, France
| | - Ming-Yi Tsai
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Bénédicte Jacquemin
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; ISGlobal-Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
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Ferrero A, Esplugues A, Estarlich M, Llop S, Cases A, Mantilla E, Ballester F, Iñiguez C. Infants' indoor and outdoor residential exposure to benzene and respiratory health in a Spanish cohort. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 222:486-494. [PMID: 28063708 DOI: 10.1016/j.envpol.2016.11.065] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/20/2016] [Accepted: 11/21/2016] [Indexed: 06/06/2023]
Abstract
Benzene exposure represents a potential risk for children's health. Apart from being a known carcinogen for humans (group 1 according to IARC), there is scientific evidence suggesting a relationship between benzene exposure and respiratory problems in children. But results are still inconclusive and inconsistent. This study aims to assess the determinants of exposure to indoor and outdoor residential benzene levels and its relationship with respiratory health in infants. Participants were 1-year-old infants (N = 352) from the INMA cohort from Valencia (Spain). Residential benzene exposure levels were measured inside and outside dwellings by means of passive samplers in a 15-day campaign. Persistent cough, low respiratory tract infections and wheezing during the first year of life, and covariates (dwelling traits, lifestyle factors and sociodemographic data) were obtained from parental questionnaires. Multiple Tobit regression and logistic regression models were performed to assess factors associated to residential exposure levels and health associations, respectively. Indoor levels were higher than outdoor ones (1.46 and 0.77 μg/m3, respectively; p < 0.01). A considerable percentage of dwellings, 42% and 21% indoors and outdoors respectively, surpassed the WHO guideline of 1.7 μg/m3 derived from a lifetime risk of leukemia above 1/100 000. Monitoring season, maternal country of birth and parental tobacco consumption were associated with residential benzene exposure (indoor and outdoors). Additionally, indoor levels were associated with mother's age and type of heating, and outdoor levels were linked with zone of residence and distance from industrial areas. After adjustment for confounding factors, no significant associations were found between residential benzene exposure levels and respiratory health in infants. Hence, our study did not support the hypothesis for the benzene exposure effect on respiratory health in children. Even so, it highlights a public health concern related to the personal exposure levels, since a considerable number of children surpassed the abovementioned WHO guideline for benzene exposure.
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Affiliation(s)
- Amparo Ferrero
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain.
| | - Ana Esplugues
- Faculty of Nursing and Chiropody, Universitat de València, Av. Blasco Ibáñez, 13, 46010 Valencia, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain
| | - Marisa Estarlich
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain
| | - Sabrina Llop
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain
| | - Amparo Cases
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain
| | - Enrique Mantilla
- Center for Mediterranean Environmental Studies, (CEAM), Parque Tecnológico, Charles R. Darwin, 14, 46980 Paterna, Valencia, Spain
| | - Ferran Ballester
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Faculty of Nursing and Chiropody, Universitat de València, Av. Blasco Ibáñez, 13, 46010 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain
| | - Carmen Iñiguez
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain
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Latitude gradient influences the age of onset of rheumatoid arthritis: a worldwide survey. Clin Rheumatol 2016; 36:485-497. [PMID: 27995382 DOI: 10.1007/s10067-016-3481-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 11/07/2016] [Indexed: 02/04/2023]
Abstract
The age of onset of rheumatoid arthritis (RA) is an important outcome predictor. Northern countries report an age of RA onset of around 50 years, but apparently, variability exists across different geographical regions. The objective of the present study is to assess whether the age of onset of RA varies across latitudes worldwide. In a proof-of-concept cross-sectional worldwide survey, rheumatologists from preselected cities interviewed 20 consecutive RA patients regarding the date of RA onset (RAO, when the patient first noted a swollen joint). Other studied variables included location of each city, rheumatologist settings, latitudes (10° increments, south to north), longitudes (three regions), intracountry consistency, and countries' Inequality-adjusted Human Development Index (IHDI). Data from 2481 patients (82% females) were obtained from 126 rheumatologists in 77 cities of 41 countries. Worldwide mean age of RAO was 44 ± 14 years (95% CI 44-45). In 28% of patients, RA began before age 36 years and before age 46 years in 50% of patients. RAO was 8 years earlier around the Tropic of Cancer when compared with northern latitudes (p < 0.001, 95% CI 3.5-13). Multivariate analysis showed that females, western cities, and latitudes around the Tropic of Cancer are associated with younger age of RAO (R 2 0.045, p < 0.001). A positive correlation was found between the age of RAO and IHDI (r = 0.7, p < 0.01, R 2 0.5). RA often begins at an early age and onset varies across latitudes worldwide. We postulate that countries' developmental status and their geographical and geomagnetic location influence the age of RAO.
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Air Quality Strategies on Public Health and Health Equity in Europe-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121196. [PMID: 27918457 PMCID: PMC5201337 DOI: 10.3390/ijerph13121196] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/02/2016] [Accepted: 11/25/2016] [Indexed: 12/04/2022]
Abstract
Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO2) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO2 were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent impact on health equity from the strategies was found. The strategy types aiming to control air pollution in Europe and the health impact assessment methodology were also discussed in this review.
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