Effects of Pollution on Human Growth and Development: An Introduction

Noise or sound management in the neonatal intensive care unit for preterm or very low birth weight infants

BACKGROUND

Infants in the neonatal intensive care unit (NICU) are subjected to different types of stress, including sounds of high intensity. The sound levels in NICUs often exceed the maximum acceptable level recommended by the American Academy of Pediatrics, which is 45 decibels (dB). Hearing impairment is diagnosed in 2% to 10% of preterm infants compared to only 0.1% of the general paediatric population. Bringing sound levels under 45 dB can be achieved by lowering the sound levels in an entire unit; by treating the infant in a section of a NICU, in a 'private' room, or in incubators in which the sound levels are controlled; or by reducing sound levels at the individual level using earmuffs or earplugs. By lowering sound levels, the resulting stress can be diminished, thereby promoting growth and reducing adverse neonatal outcomes. This review is an update of one originally published in 2015 and first updated in 2020.

OBJECTIVES

To determine the benefits and harms of sound reduction on the growth and long-term neurodevelopmental outcomes of neonates.

SEARCH METHODS

We used standard, extensive Cochrane search methods. On 21 and 22 August 2023, a Cochrane Information Specialist searched CENTRAL, PubMed, Embase, two other databases, two trials registers, and grey literature via Google Scholar and conference abstracts from Pediatric Academic Societies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) or quasi-RCTs in preterm infants (less than 32 weeks' postmenstrual age (PMA) or less than 1500 g birth weight) cared for in the resuscitation area, during transport, or once admitted to a NICU or stepdown unit. We specified three types of intervention: 1) intervention at the unit level (i.e. the entire neonatal department), 2) at the section or room level, or 3) at the individual level (e.g. hearing protection).

DATA COLLECTION AND ANALYSIS

We used the standardised review methods of Cochrane Neonatal to assess the risk of bias in the studies. We used the risk ratio (RR) and risk difference (RD), with their 95% confidence intervals (CIs), for dichotomous data. We used the mean difference (MD) for continuous data. Our primary outcome was major neurodevelopmental disability. We used GRADE to assess the certainty of the evidence.

MAIN RESULTS

We included one RCT, which enroled 34 newborn infants randomised to the use of silicone earplugs versus no earplugs for hearing protection. It was a single-centre study conducted at the University of Texas Medical School in Houston, Texas, USA. Earplugs were positioned at the time of randomisation and worn continuously until the infants were 35 weeks' postmenstrual age (PMA) or discharged (whichever came first). Newborns in the control group received standard care. The evidence is very uncertain about the effects of silicone earplugs on the following outcomes. • Cerebral palsy (RR 3.00, 95% CI 0.15 to 61.74)and Mental Developmental Index (MDI) (Bayley II) at 18 to 22 months' corrected age (MD 14.00, 95% CI 3.13 to 24.87); no other indicators of major neurodevelopmental disability were reported. • Normal auditory functioning at discharge (RR 1.65, 95% CI 0.93 to 2.94) • All-cause mortality during hospital stay (RR 2.07, 95% CI 0.64 to 6.70; RD 0.20, 95% CI -0.09 to 0.50) • Weight (kg) at 18 to 22 months' corrected age (MD 0.31, 95% CI -1.53 to 2.16) • Height (cm) at 18 to 22 months' corrected age (MD 2.70, 95% CI -3.13 to 8.53) • Days of assisted ventilation (MD -1.44, 95% CI -23.29 to 20.41) • Days of initial hospitalisation (MD 1.36, 95% CI -31.03 to 33.75) For all outcomes, we judged the certainty of evidence as very low. We identified one ongoing RCT that will compare the effects of reduced noise levels and cycled light on visual and neural development in preterm infants.

AUTHORS' CONCLUSIONS

No studies evaluated interventions to reduce sound levels below 45 dB across the whole neonatal unit or in a room within it. We found only one study that evaluated the benefits of sound reduction in the neonatal intensive care unit for hearing protection in preterm infants. The study compared the use of silicone earplugs versus no earplugs in newborns of very low birth weight (less than 1500 g). Considering the very small sample size, imprecise results, and high risk of attrition bias, the evidence based on this research is very uncertain and no conclusions can be drawn. As there is a lack of evidence to inform healthcare or policy decisions, large, well designed, well conducted, and fully reported RCTs that analyse different aspects of noise reduction in NICUs are needed. They should report both short- and long-term outcomes.

Human biology and the study of precarity: How the intersection of uncertainty and inequality is taking us to new extremes

Inequality represents an extreme environment to which humans must respond. One phenomenon that contributes to this growing extreme is precarity or the intersection of uncertainty and some form of inequality. While precarity has an important intellectual history in the fields of sociology and sociocultural anthropology, it has not been well studied in the field of human biology. Rather human biologists have engaged with the study of closely related concepts such as uncertainty and resource insecurity. In this article, we propose that human biology take on the study of precarity as a novel way of investigating inequality. We first provide a brief intellectual history of precarity which is followed by a review of research on uncertainty and resource security in human biology which, while not exhaustive, illustrates some key gaps that precarity may aid us in addressing. We then review some of the pathways through which precarity comes to affect human biology and health and some of the evidence for why the unpredictable nature of precarity may make it a unique physiological stress. A case study based on research in Nuñoa, Peru provides an important example of how precarity can elucidate the influences of health in an extreme setting, albeit with insights that apply more broadly. We conclude that precarity holds important potential for the study of human biology, including helping us more effectively operationalize and study uncertainty, encouraging us to explore the predictability of resources and stressors, and reminding us to think about the intersectional nature of stressors.

Maternal exposure to metal components of PM2.5 and low birth weight in New Mexico, USA

Infants with low birth weight (LBW) are more likely to have health problems than normal weight infants. In studies examining the associations between particulate matter (PM) exposures and LBW, there is a tendency to focus on PM2.5 as a whole. However, insufficient information is available regarding the effects of different components of PM2.5 on birth weight. This study identified the associations between maternal exposure to 10 metal components of PM2.5 and LBW in offspring based on small area (divided by population size) level data in New Mexico, USA, from 2012 to 2016. This study used a pruned feed-forward neural network (pruned-FNN) approach to estimate the annual average exposure index to each metal component in each small area. The linear regression model was employed to examine the association between maternal PM2.5 metal exposures and LBW rate in small areas, adjusting for the female percentage and race/ethnicity compositions, marriage status, and educational level in the population. An interquartile range increase in maternal exposure to mercury and chromium of PM2.5 increased LBW rate by 0.43% (95% confidence interval (CI): 0.18-0.68%) and 0.63% (95% CI: 0.15-1.12%), respectively. These findings suggest that maternal exposure to metal components of air pollutants may increase the risk of LBW in offspring. With no similar studies in New Mexico, this study also posed great importance because of a higher LBW rate in New Mexico than the national average. These findings provide critical information to inform further epidemiological, biological, and toxicological studies.

Maternal exposure to metal components of PM2.5 and low birth weight in New Mexico, USA

Infants with low birth weight (LBW) are more likely to have health problems than normal weight infants. In studies examining the associations between particulate matter (PM) exposures and LBW, there is a tendency to focus on PM 2.5 as a whole. However, insufficient information is available regarding the effects of different components of PM 2.5 on birth weight. This study identified the associations between maternal exposure to 10 metal components of PM 2.5 and LBW in offspring based on small area (divided by population size) level data in New Mexico, USA, from 2012 to 2016. This study used a pruned feed-forward neural network (pruned-FNN) approach to estimate the annual average exposure index to each metal component in each small area. The linear regression model was employed to examine the association between maternal PM 2.5 metal exposures and LBW rate in small areas, adjusting for the female percentage and race/ethnicity compositions, marriage status and educational level in the population. An interquartile range increase in maternal exposure to mercury and chromium of PM 2.5 increased LBW rate by 0.43% (95% confidence interval (CI): 0.18%-0.68%) and 0.63% (95% CI: 0.15%-1.12%), respectively. These findings suggest that maternal exposure to metal components of air pollutants may increase the risk of LBW in offspring. With no similar studies in New Mexico, this study also posed great importance because of a higher LBW rate in New Mexico than the national average. These findings provide critical information to inform further epidemiological, biological, and toxicological studies.

A Comprehensive Review on Social Inequalities and Pregnancy Outcome-Identification of Relevant Pathways and Mechanisms

Scientific literature tends to support the idea that the pregnancy and health status of fetuses and newborns can be affected by maternal, parental, and contextual characteristics. In addition, a growing body of evidence reports that social determinants, measured at individual and/or aggregated level(s), play a crucial role in fetal and newborn health. Numerous studies have found social factors (including maternal age and education, marital status, pregnancy intention, and socioeconomic status) to be linked to poor birth outcomes. Several have also suggested that beyond individual and contextual social characteristics, living environment and conditions (or "neighborhood") emerge as important determinants in health inequalities, particularly for pregnant women. Using a comprehensive review, we present a conceptual framework based on the work of both the Commission on Social Determinants of Health and the World Health Organization (WHO), aimed at describing the various pathways through which social characteristics can affect both pregnancy and fetal health, with a focus on the structural social determinants (such as socioeconomic and political context) that influence social position, as well as on intermediary determinants. We also suggest that social position may influence more specific intermediary health determinants; individuals may, on the basis of their social position, experience differences in environmental exposure and vulnerability to health-compromising living conditions. Our model highlights the fact that adverse birth outcomes, which inevitably lead to health inequity, may, in turn, affect the individual social position. In order to address both the inequalities that begin in utero and the disparities observed at birth, it is important for interventions to target various unhealthy behaviors and psychosocial conditions in early pregnancy. Health policy must, then, support: (i) midwifery availability and accessibility and (ii) enhanced multidisciplinary support for deprived pregnant women.

Toolkit article: Approaches to measuring social inequities in health in human biology research

Across populations, human morbidity and mortality risks generally follow clear gradients, with socially-disadvantaged individuals and groups tending to have higher morbidity and mortality at all life stages relative to those more socially advantaged. Anthropologists specialize in understanding the proximate and ultimate factors that shape variation in human biological functioning and health and are therefore well-situated to explore the relationships between social position and health in diverse ecological and cultural contexts. While human biologists have developed sophisticated methods for assessing health using minimally-invasive methods, at a disciplinary level, we have room for conceptual and methodological improvement in how we frame, measure, and analyze the social inequities that might shape health inequities. This toolkit paper elaborates on some steps human biologists should take to enhance the quality of our research on health inequities. Specifically, we address: (1) how to frame unequal health outcomes (i.e., inequalities vs. disparities vs. inequities) and the importance of identifying our conceptual models of how these inequities emerge; (2) how to measure various axes of social inequities across diverse cultural contexts, and (3) approaches to community collaboration and dissemination. We end by discussing (4) future directions in human biology research of health inequities, including understanding the ultimate causes of sensitivity to social inequities and transitioning from research to action.

Phthalates removal from wastewater by different methods - a review

Phthalate esters are commonly used as plasticizers to improve the durability and workability of polymeric materials, locating and identifying them in various contexts has become a major challenge. Because of their ubiquitous use in plastic packaging and personal care items, as well as their tendency to leach out of these materials, phthalates have been detected in a variety of aquatic situations, including surface water, groundwater, drinking water, and wastewater. Phthalate esters have been shown to affect reproductive health and physical growth by disrupting the endocrine system. As a result, developing energy-efficient and effective technologies to eliminate these harmful substances from the atmosphere has become more important and urgent. This paper examines the existing techniques for treating phthalates and degradation mechanisms, as well as knowledge gaps and future research directions. These technologies include adsorption, electrochemical, photocatalysis, membrane filtration and microbial degradation. Adsorption and photo catalysis are the most widely used techniques for phthalate removal, according to the literature survey papers.

Pollution control in Africa: the interplay between financial integration and industrialization

We employ the pool mean group method of estimation and panel causality to investigate the effect of financial integration and industrial development on pollution in 36 African countries between 1990 and 2019. Result shows a unidirectional causality running from industrial development to financial integration and pollution in Africa. Also, the panel regression shows that financial integration insignificantly abates pollution in the short run, but significantly worsens the long-run pollution in the continent. Again, the result indicates that industrial development insignificantly heightens pollution in both periods, while interplay between financial integration and industrial development exerts a negative impact on both short- and long-run pollution in Africa. The study recommends that African leaders should harness the benefits of financial integration to accelerate African industrial development and ensure the full implementation of environmentally sustainable policies to checkmate pollution emissions.

Genotoxicity Response of Fibroblast Cells and Human Epithelial Adenocarcinoma In Vitro Model Exposed to Bare and Ozone-Treated Silica Microparticles

Indoor air pollutants (IAP), which can pose a serious risk to human health, include biological pollutants, nitric oxide (NO), nitrogen dioxide (NO2), volatile organic compounds (VOC), sulfur dioxide (SO2), carbon monoxide (CO), carbon dioxide (CO2), silica, metals, radon, and particulate matter (PM). The aim of our work is to conduct a multidisciplinary study of fine silica particles (<2.5 μm) in the presence or absence of ozone (O3), and evaluate their potential cytotoxicity using MTS, micronucleus, and the comet test in two cell lines. We analyzed A549 (human basal alveolar epithelial cell adenocarcinoma) and Hs27 (human normal fibroblasts) exposed to dynamic conditions by an IRC simulator under ozone flow (120 ppb) and in the presence of silica particles (40 μg/h). The viability of A549 and Hs27 cells at 48 and 72 h of exposure to silica or silica/ozone decreases, except at 72 h in Hs27 treated with silica/ozone. The micronucleus and comet tests showed a significant increase in the number of micronuclei and the % of DNA in the queue, compared to the control, in both lines in all treatments, even if in different cell times/types. We found that silica alone or with more O3 causes more pronounced genotoxic effects in A549 tumor cells than in normal Hs27 fibroblasts.

Recurrent Indoor Environmental Pollution and Its Impact on Health and Oxidative Stress of the Textile Workers in Bangladesh

Perennial indoor environmental pollution in the textile industrial area is a potential health hazard for workers engaged in this line of work, resulting in mental aberration to severe health risks. This study was designed to investigate the indoor environmental quality of textile industries and correlate its effect on the occupational health and well-being of the textile workers by measuring plasma oxidative stress status in textile workers and healthy control subjects. Environmental samples were collected from 15 textile industries located in Dhaka division, and 30 volunteer textile workers and 30 volunteer office workers (control) aged 18 to 57 years participated in the study. The concentration of plasma ascorbic acid (P-ASC), plasma malondialdehyde (P-MDA), and plasma conjugated diene (P-CD) was measured in both groups. The noise level (78.0 ± 0.68 dB) and the formaldehyde level (141.80 ± 4.47 µg/m³) were found to be significantly higher in the indoor environmental area compared with those in the control area (70.17 ± 0.25 dB and 108.0 ± 0.76 µg/m³, respectively). Furthermore, the daily average concentration of suspended particulate matters (PMs), that is, PM_2.5 (322.2 ± 13.46 µg/m³) and PM₁₀ (411.0 ± 17.57 µg/m³), was also found to be significantly higher in the indoor environmental air compared with that in the control area (78.59 ± 1.66 and 174.0 ± 2.33 µg/m³, respectively). The levels of P-MDA (0.37 ± 0.03 nmol/L) and P-CD (14.74 ± 0.61 nmol/L) were significantly increased, whereas the level of P-ASC level (0.46 ± 0.04 mg/dL) was markedly decreased in the textile workers compared with the healthy control subjects (0.18 ± 0.01 nmol/L of P-MDA, 10.04 ± 0.44 nmol/L of P-CD, and 1.29 ± 0.06 mg/dL of P-ASC). The textile plants were found to have significantly elevated levels of indoor environmental pollutants compared with those in the control area, and the textile workers were significantly exposed to oxidative stresses compared with the control subjects. The use of noise pads and high-efficiency air filters is perhaps highly instrumental to put an end to this prevailing situation. Moreover, to overcome the oxidative stresses among workers, supplementation of antioxidant vitamins (ie, ascorbic acid and/or vitamin E) may be beneficial. In addition, to prevent serious health-related issues, proper precautions should be taken to protect the occupational health of the textile workers.

Monitoring Bioaccumulation (in Gills and Muscle Tissues), Hematology, and Genotoxic Alteration in Ctenopharyngodon idella Exposed to Selected Heavy Metals

Health and environmental problems arising from metals present in the aquatic ecosystem are very well known. The present study investigated toxicological effects of LC₁₅ of metals such as copper, chromium, and lead for 24, 48, 72, and 96 h on hematological indices, RBC nucleus and cell morphology, and gill and muscle tissues of grass carp (Ctenopharyngodon idella). Experimental dose concentrations of copper were 1.5, 1.4, 1.2, and 1 mgL⁻¹. Similarly, dose concentrations of chromium were 25.5, 22.5, 20, and 18 mgL⁻¹ while those of lead were 250, 235, 225, and 216 mgL⁻¹, respectively. Maximum decrease in the concentration of Hb, RBCs, and monocytes was observed against chromium, while maximum increase in the concentration of lymphocytes was reported against lead. Abnormalities such as single and double micronuclei, deformed nucleus, nuclear shift, irregular nucleus, deformed cells, microcyte cells, and vacuolated and swollen cells were observed. Gill tissues absorbed maximum concentration of lead followed by chromium and copper. Muscle tissues also absorbed maximum concentration of lead followed by chromium and copper, respectively. Histological alterations such as epithelial lifting, interlamellar spaces, club gill filaments, gill bridging, curling filaments, swelling and fusion of cells, irregular cells, destruction of epithelial cells, cellular necrosis, and inflammatory cells were observed in gill tissues while inflammation and necrosis of muscle fibers, degeneration of muscle fibers, edema of muscle bundles, zig-zag of muscle fibers, and lesions were observed in muscle tissues of fish exposed with different doses of these heavy metals, indicating the toxicity of metals to aquatic fauna as well as to human being via food chain.

Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants

BACKGROUND

Infants in the neonatal intensive care unit (NICU) are subjected to stress, including sound of high intensity. The sound environment in the NICU is louder than most home or office environments and contains disturbing noises of short duration and at irregular intervals. There are competing auditory signals that frequently challenge preterm infants, staff and parents. The sound levels in NICUs often exceed the maximum acceptable level of 45 decibels (dB), recommended by the American Academy of Pediatrics. Hearing impairment is diagnosed in 2% to 10% of preterm infants versus 0.1% of the general paediatric population. Noise may cause apnoea, hypoxaemia, alternation in oxygen saturation, and increased oxygen consumption secondary to elevated heart and respiratory rates and may, therefore, decrease the amount of calories available for growth. Elevated levels of speech are needed to overcome the noisy environment in the NICU, thereby increasing the negative impacts on staff, newborns, and their families. High noise levels are associated with an increased rate of errors and accidents, leading to decreased performance among staff. The aim of interventions included in this review is to reduce sound levels to 45 dB or less. This can be achieved by lowering the sound levels in an entire unit, treating the infant in a section of a NICU, in a 'private' room, or in incubators in which the sound levels are controlled, or reducing the sound levels that reaches the individual infant by using earmuffs or earplugs. By lowering the sound levels that reach the neonate, the resulting stress on the cardiovascular, respiratory, neurological, and endocrine systems can be diminished, thereby promoting growth and reducing adverse neonatal outcomes.

OBJECTIVES

Primary objective To determine the effects of sound reduction on growth and long-term neurodevelopmental outcomes of neonates. Secondary objectives 1. To evaluate the effects of sound reduction on short-term medical outcomes (bronchopulmonary dysplasia, intraventricular haemorrhage, periventricular leukomalacia, retinopathy of prematurity). 2. To evaluate the effects of sound reduction on sleep patterns at three months of age. 3. To evaluate the effects of sound reduction on staff performance. 4. To evaluate the effects of sound reduction in the neonatal intensive care unit (NICU) on parents' satisfaction with the care.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, EMBASE, CINAHL, abstracts from scientific meetings, clinical trials registries (clinicaltrials.gov; controlled-trials.com; and who.int/ictrp), Pediatric Academic Societies Annual meetings 2000 to 2014 (Abstracts2ViewTM), reference lists of identified trials, and reviews to November 2014.

SELECTION CRITERIA

Preterm infants (< 32 weeks' postmenstrual age (PMA) or < 1500 g birth weight) cared for in the resuscitation area, during transport, or once admitted to a NICU or a stepdown unit.

DATA COLLECTION AND ANALYSIS

We performed data collection and analyses according to the Cochrane Neonatal Review Group.

MAIN RESULTS

One small, high quality study assessing the effects of silicone earplugs versus no earplugs qualified for inclusion. The original inclusion criteria in our protocol stipulated an age of < 48 hours at the time of initiating sound reduction. We made a deviation from our protocol and included this study in which some infants would have been > 48 hours old. There was no significant difference in weight at 34 weeks postmenstrual age (PMA): mean difference (MD) 111 g (95% confidence interval (CI) -151 to 374 g) (n = 23). There was no significant difference in weight at 18 to 22 months corrected age between the groups: MD 0.31 kg, 95% CI -1.53 to 2.16 kg (n = 14). There was a significant difference in Mental Developmental Index (Bayley II) favouring the silicone earplugs group at 18 to 22 months corrected age: MD 14.00, 95% CI 3.13 to 24.87 (n = 12), but not for Psychomotor Development Index (Bayley II) at 18 to 22 months corrected age: MD -2.16, 95% CI -18.44 to 14.12 (n =12).

AUTHORS' CONCLUSIONS

To date, only 34 infants have been enrolled in a randomised controlled trial (RCT) testing the effectiveness of reducing sound levels that reach the infants' ears in the NICU. Based on the small sample size of this single trial, we cannot make any recommendations for clinical practice. Larger, well designed, conducted and reported trials are needed.

The Effect of Earmuffs on Physiological Parameters in Preterm Infants: A Systematic Review

Noise may cause stress responses such as apnea, hypoxemia, changes in oxygen saturation and augmented oxygen consumption secondary to elevated heart and respiratory rates. Moreover, stress results in increased intracranial pressure, abnormal sleep patterns, hearing impairment, and bronchopulmonary dysplasia, retinopathy of prematurity, intraventricular hemorrhage, periventricular leukomalacia, retardate development and alterations in the neuroendocrine system. Herein, this study aimed to discuss the effects of earmuffs on physiological parameters in preterm infants. The relevant and available peer-reviewed publications from 2012 to 2018 from various databases were analyzed. For the assessment of the studies, the full-text accessible studies were included for analysis. The retrieved documents were analyzed using VOSviewer regarding the geographical distributions of the documents with their numbers and citations, keywords proposed by the researchers. All records with the term "earmuffs OR earmuff" in the "article title, abstract, keywords" were retrieved from different databases. Accordingly, 396 documents containing the word "earmuffs OR earmuff" were recorded. The search was then restricted for publications that contain the words "noise AND nursing AND preterm" in the title and abstracts (TITLE-ABS-KEY (earmuffs OR earmuff)) AND (noise AND nursing AND preterm) (Scopus=390; Web of Science=1, Medline=2; Cochrane=1; Embase=1= Pubmed=1=n=396). After inclusion and exclusion criteria, 7 documents were recorded and then evaluated for the present study. As a conclusion, the effects of earmuffs on physiological parameters of preterm infants have not been clearly understood and reported yet. Along with the present documents, it is not clear that the use of earmuffs reduces stress and provides physiological stability in preterm infants born between approximately 28-32 weeks. The studies with a larger sample size are needed for validation of information reported in the articles analyzed herein.

The Embodiment of War: Growth, Development, and Armed Conflict

Armed conflict regularly presents extremely adverse circumstances not only for combatants, but also for civilians. In fact, estimates from various wars over the past 70 years suggest that noncombatants comprise the majority of casualties. For survivors, war's effects are often embodied, leaving long-term effects on health and biology. Some of these effects, such as injuries and psychological trauma, are well known. Yet other effects may be subtle and may be elucidated by a developmental biological perspective. In early life, when growth rates are highest, conditions of war may have their greatest impact. Depending on local circumstances, a developing embryo, infant, or child growing in a place embroiled in armed conflict is likely to face—directly or indirectly—various stressors, including malnutrition, infectious disease, and/or psychological stress. Thus, the conditions of war and forced displacement may become embodied, getting under the skin for fundamental biological reasons.

Helminths and heavy metals in soils from a dumpsite in Ibadan city, Nigeria

Waste generation is inevitable because humans continue to generate waste due to increase in population, urbanization and advancement in technology. This generation of waste is of public health concern especially when the waste materials are deposited on dumpsites. This study assessed the helminths and heavy metal content of Awotan dumpsite in Ibadan city. Surface soils (0-15cm depth) of the dumpsite were randomly sampled at different dumpsite areas with the aid of a quadrat. Helminth content was determined using the zinc floatation method and the heavy metal concentrations of the soil were determined using Atomic Absorption Spectrophotometry (AAS). Some physicochemical properties of the soil were also determined. Results showed that the dumpsite soil was slightly alkaline with an average pH of 8.1 ± 0.2 while the overall mean electrical conductivity, temperature, moisture content and height above sea level were 545.9 ± 235.3μS/cm, 32.6 ± 2.2oC, 17.2 ± 4.8 % and 236±4.6 m respectively. The overall prevalence of soil helminths was 10.4% with Ascaris lumbricoides being more prevalent (8.8%). The heavy metal concentration of the soil followed the trend Pb (709.7± 1574.9mg/g) > Cu (316 ± 227.1mg/g) > Cr (48.8 ± 17.7mg/g) > Cd (9.7 ± 10.9mg/g). There was a low overall prevalence of soil helminths. However, the heavy metal concentrations exceeded USEPA permissible limits providing a possible source for underground water contamination in residential areas around the dumpsite. Human settlements close to the dumpsite should be discouraged by the government.

Physiochemical characteristics of aerosol particles in the typical microenvironment of hospital in Shanghai, China

Health risk of populations dwelling in the hospital has been a global concern, but has not been adequately examined. PM_2.5 and PM₁ samples were collected in two indoor locations (outpatient department and inpatient department) and one outdoor location (courtyard) of the hospital in Shanghai. The concentrations of size-fractionated trace metals and the morphology of single particles were determined to accurately assess the health risk for populations in the hospital. The results indicated that the mean concentrations of PM_2.5 and PM₁ were in the order of outpatient department>courtyard>inpatient department. The mean concentrations of PM₁ decreased with floors (first floor: 78.0μg/m³, second floor: 64.1μg/m³, fourth floor: 48.4μg/m³). However, the mean PM_2.5 concentrations were in the order of first floor (124.0μg/m³)>fourth floor (91.4μg/m³)>second floor (90.6μg/m³), which was likely associated with the number of patients. The PM_2.5 and PM₁ concentrations have begun to increase rapidly from 9:00am and decreased after 15:00pm in the first floor, whereas they remain relatively stable in the second and fourth floor. The abundance of Mg, Ca, Al and K in the fine particles and coarse particles were both higher than other elements for all floors. The concentrations of trace metals (e.g., Zn, Ba, Fe, Mn, Cr, Ca, Ti, Na, and K) except Mg and Al in the coarse particles (>2.5μm) decreased with floors, whereas Zn, Ba, Fe, and Cr in the fine particles (<2.5μm) displayed opposite variation. Trace metals in the first floor were mainly concentrated in the >2.5μm and 1-2.5μm, whereas they chiefly peaked at 0.25-0.5μm and below 0.25μm in the second and fourth floor. Single particles analysis showed that mineral particles, soot, and Fe-rich particles were mainly concentrated in the first floor, indicating the impacts of walking of patients, traffic emissions, and food cooking, respectively. Sulfate particles were internally mixed with soot, fly ash and Fe-rich particles in the second floor, which suggested that these sulfate particles probably underwent aging processes during the atmospheric long-range transport. In the fourth floor, fly ash, sulfate particles, Zn-rich particles, and biogenic particles were identified under the transmission electron microscopy (TEM). Higher abundance of sulfates and absence of chlorate hinted existence of heterogeneous reactions during long-range transport with the Cl^- replaced by SO₄^2-. The index of average daily intake (ADI), hazard quotient (HQ), and carcinogenic risks (CR) indicated that Cr pose carcinogenic risks to the surrounding populations, while non-carcinogenic risks of Mn, Zn, and Cr were not remarkable.

Long term effects of traffic noise on mortality in the city of Barcelona, 2004-2007

Numerous studies showing statistically significant associations between environmental noise and adverse health effects already exist for short-term (over one day at most) and long-term (over a year or more) noise exposure, both for morbidity and (albeit to a lesser extent) mortality. Recently, several studies have shown this association to be independent from confounders, mainly those of air pollutants. However, what has not been addressed is the problem of misalignment (i.e. the exposure data locations and health outcomes have different spatial locations). Without any explicit control of such misalignment inference is seriously compromised. Our objective is to assess the long-term effects of traffic noise on mortality in the city of Barcelona (Spain) during 2004-2007. We take into account the control of confounding, for both air pollution and socioeconomic factors at a contextual level and, in particular, we explicitly address the problem of misalignment. We employed a case-control design with individual data. We used deaths resulting from myocardial infarction, hypertension, or Type II diabetes mellitus in Barcelona between 2004 and 2007 as cases for the study, while for controls we used deaths (likewise in Barcelona and over the same period of time) resulting from AIDS or external causes (e.g. accidental falls, accidental poisoning by psychotropic drugs, drugs of abuse, suicide and self-harm, or injuries resulting from motor vehicle accidents). The controls were matched with the cases by sex and age. We used the annual average equivalent A-weighted sound pressure levels for daytime (7-21h), evening-time (21-23h) and night-time (23-7h), and controlled for the following confounders: i) air pollutants (NO2, PM10 and benzene), ii) material deprivation (at a census tract level) and iii) land use and other spatial variables. We explicitly controlled for heterogeneity (uneven distribution of both response and environmental exposures within an area), spatial dependency (of the observations of the response variables), temporal trends (long-term behaviour of the response variables) and spatial misalignment (between response and environmental exposure locations). We used a fully Bayesian method, through the Integrated Nested Laplace Approximation (INLA). Specifically, we plugged the whole model for the exposure into the health model and obtained a linear predictor defined on the entire spatial domain. Separate analyses were carried out for men and for women. After adjusting for confounders, we found that traffic noise was associated with myocardial infarction mortality along with Type II diabetes mellitus in men (in both cases, odds ratios (OR) were around 1.02) and mortality from hypertension in women (ORs around 1.01). Nevertheless, only in the case of hypertension in women, does the association remain statistically significant for all age groups considered (all ages, ≥65 years and ≥75 years).

Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants

BACKGROUND

Infants in the neonatal intensive care unit (NICU) are subjected to stress, including sound of high intensity. The sound environment in the NICU is louder than most home or office environments and contains disturbing noises of short duration and at irregular intervals. There are competing auditory signals that frequently challenge preterm infants, staff and parents. The sound levels in NICUs often exceed the maximum acceptable level of 45 decibels (dB), recommended by the American Academy of Pediatrics. Hearing impairment is diagnosed in 2% to 10% of preterm infants versus 0.1% of the general paediatric population. Noise may cause apnoea, hypoxaemia, alternation in oxygen saturation, and increased oxygen consumption secondary to elevated heart and respiratory rates and may, therefore, decrease the amount of calories available for growth. Elevated levels of speech are needed to overcome the noisy environment in the NICU, thereby increasing the negative impacts on staff, newborns, and their families. High noise levels are associated with an increased rate of errors and accidents, leading to decreased performance among staff. The aim of interventions included in this review is to reduce sound levels to 45 dB or less. This can be achieved by lowering the sound levels in an entire unit, treating the infant in a section of a NICU, in a 'private' room, or in incubators in which the sound levels are controlled, or reducing the sound levels that reaches the individual infant by using earmuffs or earplugs. By lowering the sound levels that reach the neonate, the resulting stress on the cardiovascular, respiratory, neurological, and endocrine systems can be diminished, thereby promoting growth and reducing adverse neonatal outcomes.

OBJECTIVES

Primary objectiveTo determine the effects of sound reduction on growth and long-term neurodevelopmental outcomes of neonates. Secondary objectives1. To evaluate the effects of sound reduction on short-term medical outcomes (bronchopulmonary dysplasia, intraventricular haemorrhage, periventricular leukomalacia, retinopathy of prematurity).2. To evaluate the effects of sound reduction on sleep patterns at three months of age.3. To evaluate the effects of sound reduction on staff performance.4. To evaluate the effects of sound reduction in the neonatal intensive care unit (NICU) on parents' satisfaction with the care.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, EMBASE, CINAHL, abstracts from scientific meetings, clinical trials registries (clinicaltrials.gov; controlled-trials.com; and who.int/ictrp), Pediatric Academic Societies Annual meetings 2000 to 2014 (Abstracts2View(TM)), reference lists of identified trials, and reviews to November 2014.

SELECTION CRITERIA

Preterm infants (< 32 weeks' postmenstrual age (PMA) or < 1500 g birth weight) cared for in the resuscitation area, during transport, or once admitted to a NICU or a stepdown unit.

DATA COLLECTION AND ANALYSIS

We performed data collection and analyses according to the Cochrane Neonatal Review Group.

MAIN RESULTS

One small, high quality study assessing the effects of silicone earplugs versus no earplugs qualified for inclusion. The original inclusion criteria in our protocol stipulated an age of < 48 hours at the time of initiating sound reduction. We made a deviation from our protocol and included this study in which some infants would have been > 48 hours old. There was no significant difference in weight at 34 weeks postmenstrual age (PMA): mean difference (MD) 111 g (95% confidence interval (CI) -151 to 374 g) (n = 23). There was no significant difference in weight at 18 to 22 months corrected age between the groups: MD 0.31 kg, 95% CI -1.53 to 2.16 kg (n = 14). There was a significant difference in Mental Developmental Index (Bayley II) favouring the silicone earplugs group at 18 to 22 months corrected age: MD 14.00, 95% CI 3.13 to 24.87 (n = 12), but not for Psychomotor Development Index (Bayley II) at 18 to 22 months corrected age: MD -2.16, 95% CI -18.44 to 14.12 (n =12).

AUTHORS' CONCLUSIONS

To date, only 34 infants have been enrolled in a randomised controlled trial (RCT) testing the effectiveness of reducing sound levels that reach the infants' ears in the NICU. Based on the small sample size of this single trial, we cannot make any recommendations for clinical practice. Larger, well designed, conducted and reported trials are needed.

Prenatal exposure to persistent organic pollutants and polybrominated diphenyl ethers in 10 Caribbean countries

Prenatal exposures to legacy persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs) and dioxin-like compounds (DLC), as well as polybrominated diphenyl ethers (PBDE), were analyzed in pregnant women from 10 Caribbean countries. A total of 438 samples were collected and descriptive statistics calculated and compared to comparable Canadian Health Measure Survey (CHMS) and U.S. National Health and Nutritional Examination Survey (NHANES) datasets. Maternal POPs blood concentrations were found to be generally relatively low in the Caribbean samples compared with the U.S. and Canada datasets. Evidence of exposure to DLC and PBDE was established. DLC levels ranged from a geometric mean low of 3.96 pg/g lipids in Antigua and Barbuda to a high of 11.4 pg/g lipids in St. Lucia. Several of the PBDEs (15, 17, 25, 28, 33, 100) were detected in less than 60% of the country' samples. For PBDE-47, significantly higher levels were found in Bermuda, while Jamaica recorded a significantly low level. The overall calculated concentration of PBDE-47 for the Caribbean (5.33 μg/kg lipids) was significantly lower than the concentrations measured for the U.S. (10.83 μg/kg lipids) and Canada (23.90 μg/kg lipids). This study confirms that prenatal expose to multiple environmental chemicals is taking place in the Caribbean and highlights the need to implement surveillance programs that continuously monitor, intervene, and evaluate the levels of these toxic environmental contaminants to ensure that they are reduced as much as possible and that the health risk to humans, in particular the unborn child, are minimized.

Assessment of trace metals using lichen transplant from automobile mechanic workshop in Ile-Ife metropolis, Nigeria

The level of air pollution around the automobile mechanic workshops has been generally overlooked. This study, examined the level of trace metals in automobile mechanic workshops and the suitability of using transplanted lichen thalli of Lepraria incana for measuring air pollution in such areas. Samples of the lichen thalli were transplanted into seven different sites and were attached to the bark of trees at each site. The samples were harvested from the sites after 3-month exposure. Concentrations of Pb, Cu, Cd, Fe, Zn, and S content were determined using an atomic absorption spectrophotometer. Results showed that there was a significant difference in the trace metals concentrations across the sites (p < 0.05). The analyzed lichen samples showed a range of 91.26-119.35 ppm for Fe, 30.23-61.32 ppm for Zn, 1.25-2.45 ppm for Cu, 0.017-0.043 ppm for Cd, 0.018-0.051 ppm, and 0.37-0.42 ppm for S. From the study, sites 6 and 7 presented higher concentrations of Cd, Pb, and Zn than other sites. The enrichment factor calculated showed that Zn, Cd, and Pb were greatly enriched from the workshops. The trend in the concentration of these heavy metals suggests that activities in these workshops might become a major source of certain heavy metals in the environment and if the pollution activities persist, it might become worrisome over time.

Assessment of Noise Exposure to Children: Considerations for the National Children's Study

Evidence has been accruing to indicate that young children are vulnerable to noise in their physical environment. A literature review identified that, in addition to hearing loss, noise exposure is associated with negative birth outcomes, reduced cognitive function, inability to concentrate, increased psychosocial activation, nervousness, feeling of helplessness, and increased blood pressure in children. While increasing attention has been given to the health effects of noise in children, research about noise exposure is sparse and often the measure of exposure is simply proximity to a noise source. The U.S. National Children's Study (NCS) provides a unique opportunity to investigate noise exposures to pregnant women and children using a number of assessment modalities at different life stages. Measurement of noise levels in homes and other environments, personal dosimetry measurements made over a period of days, and questionnaires addressing sources of noise in the environment, annoyance to noise, perceived noise level, use of head phones and ear buds, noisy activity exposures, and occupational exposures, are planned for evaluation within the NCS Vanguard pilot study. We describe the NCS planned approach to addressing noise exposure assessment in study visits over a child's lifetime.

An exploratory spatial analysis to assess the relationship between deprivation, noise and infant mortality: an ecological study

BACKGROUND

Few studies have explored how noise might contribute to social health inequalities, and even fewer have considered infant mortality or its risk factors as the health event of interest.In this paper, we investigate the impact of neighbourhood characteristics - both socio-economic status and ambient noise levels - on the spatial distribution of infant mortality in the Lyon metropolitan area, in France.

METHODS

All infant deaths (n = 715) occurring between 2000 and 2009 were geocoded at census block level. Each census block was assigned multi-component socio-economic characteristics and Lden levels, which measure exposure to noise. Using a spatial-scan statistic, we examined whether there were significant clusters of high risk of infant mortality according to neighbourhood characteristics.

RESULTS

Our results highlight the fact that infant mortality is non-randomly distributed spatially, with clusters of high risk in the south-east of the Lyon metropolitan area (RR = 1.44; p = 0.09). After adjustments for socio-economic characteristics and noise levels, this cluster disappears or shifts according to in line with different scenarios, suggesting that noise and socio-economic characteristics can partially explain the spatial distribution of infant mortality.

CONCLUSION

Our findings show that noise does have an impact on the spatial distribution of mortality after adjustments for socio-economic characteristics. A link between noise and infant mortality seems plausible in view of the three hypothetical, non-exclusive, pathways we propose in our conceptual framework: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an unhealthy behaviours pathway. The lack of studies makes it is difficult to compare our findings with others. They require further research for confirmation and interpretation.

Green space, social inequalities and neonatal mortality in France

Background

Few studies have considered using environmental amenities to explain social health inequalities.

Nevertheless, Green spaces that promote good health may have an effect on socioeconomic health inequalities. In developed countries, there is considerable evidence that green spaces have a beneficial effect on the health of urban populations and recent studies suggest they can have a positive effect on pregnancy outcomes. To investigate the relationship between green spaces and the spatial distribution of infant mortality taking account neighborhood deprivation levels.

Methods

The study took place in Lyon metropolitan area, France. All infant deaths that occurred between 2000 and 2009 were geocoded at census block level. Each census block was assigned greenness and socioeconomic deprivation levels. The spatial–scan statistic was used to identify high risk cluster of infant mortality according to these neighborhood characteristics.

Results

The spatial distribution of infant mortality was not random with a high risk cluster in the south east of the Lyon metropolitan area (p<0.003). This cluster disappeared (p=0.12) after adjustment for greenness level and socioeconomic deprivation, suggesting that these factors explain part of the spatial distribution of infant mortality. These results are discussed using a conceptual framework with 3 hypothetical pathways by which green spaces may have a beneficial effect on adverse pregnancy outcomes: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an environmental pathway.

Conclusions

These results add some evidence to the hypothesis that there is a relationship between access to green spaces and pregnancy outcomes but further research is required to confirm this.

The study on air pollution with nickel and vanadium in Croatia by using moss biomonitoring and ICP-AES

Moss samples were collected from 121 sampling sites all over Croatia during the summer and autumn of 2010. They were totally digested by using microwave digestion system and analysed by using atomic emission spectrometry with inductively coupled plasma (ICP-AES). Descriptive statistics and maps of distribution were made. The data obtained in this study were compared with those from the study in 2006 and additionally with the data obtained in the similar studies in neighbouring countries and Norway as pristine area. The median value of nickel is 3.16 mg kg(-1) and the content varies from 1.04 to 14.66 mg kg(-1). The content of vanadium ranges between 0.23 and 37.26 mg kg(-1) with the median value of 2.55 mg kg(-1). High contents of these elements are found in the vicinity of Rijeka, Zagreb and Sisak as a result of their emission from oil refinery, thermal power plant and industrial processes.

Soil metatranscriptomics for mining eukaryotic heavy metal resistance genes

Heavy metals are pollutants which affect all organisms. Since a small number of eukaryotes have been investigated with respect to metal resistance, we hypothesize that many genes that control this phenomenon remain to be identified. This was tested by screening soil eukaryotic metatranscriptomes which encompass RNA from organisms belonging to the main eukaryotic phyla. Soil-extracted polyadenylated mRNAs were converted into cDNAs and 35 of them were selected for their ability to rescue the metal (Cd or Zn) sensitive phenotype of yeast mutants. Few of the genes belonged to families known to confer metal resistance when overexpressed in yeast. Several of them were homologous to genes that had not been studied in the context of metal resistance. For instance, the BOLA ones, which conferred cross metal (Zn, Co, Cd, Mn) resistance may act by interfering with Fe homeostasis. Other genes, such as those encoding 110- to 130-amino-acid-long, cysteine-rich polypeptides, had no homologues in databases. This study confirms that functional metatranscriptomics represents a powerful approach to address basic biological processes in eukaryotes. The selected genes can be used to probe new pathways involved in metal homeostasis and to manipulate the resistance level of selected organisms.

Levels of persistent organic pollutant and their predictors among young adults

Exposure to persistent organic pollutants (POPs), such as polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethane (p,p'-DDE), and hexachlorobenzene (HCB) continues to be of concern due to their ubiquitous distribution and high persistence. Current toxicant body burden is still a primary concern within the Akwesasne Mohawk Nation since other studies conducted within the community have shown relationships between these POPs and endocrine disruption. In this article we describe the levels of these toxicants in young adults of the Akwesasne Mohawk Nation between the ages of 17 and 21 years of age (mean age 18.1 years), and investigate potential influences of their current body burden. Seventeen congeners in fourteen chromatographic peaks were detected in 50% or more of the individuals sampled (geometric mean [GM] of the sum of these congeners=0.43 ppb). Congeners 118, 138[+163+164] and 153 had the highest rate of detection (≥98%) within the Akwesasne young adults. Of the other organochlorines, HCB (GM=0.04 ppb) and p,p'-DDE (GM=0.38 ppb) were found in 100% and 99% of the sample respectively. Significantly higher levels of PCBs were found among individuals who were breastfed as infants, were first born, or had consumed local fish within the past year. When compared to levels of p,p'-DDE, HCB, and 13 specific congeners reported by the CDC for youth between the ages of 12 and 19 years, the geometric means of several congeners (CBs 99, 105, 110, and 118) among the Akwesasne were higher than the reported CDC 90th percentile. In contrast, levels of CB 28 in Akwesasne young adults were ~50% or less than those of the CDC cohort. p,p'-DDE and HCB levels were generally higher in the CDC cohort (GM of 0.516 and 0.065 ppb, respectively for Mohawks vs. 2.51 and 0.123, respectively, for CDC). Concentrations of non-persistent PCBs among this sample of Akwesasne young adults were higher than those reported by the CDC suggesting continued exposure, but lower than those associated with severe contamination. Additional research into the concentration trends of individual PCB congeners within Akwesasne youth and young adults is warranted to further improve our insight into the determinants and influences of organochlorine concentrations within members of the Akwesasne community.

Air pollution exposure assessment methods utilized in epidemiological studies

The assessment of personal exposure to air pollution is a critical component of epidemiological studies associating air pollution and health effects. This paper critically reviewed 157 studies over 29 years that utilized one of five categories of exposure methods (proximity, air dispersion, hybrid, human inhalation, and biomarkers). Proximity models were found to be a questionable technique as they assume that closer proximity equates to greater exposure. Inhalation models and biomarker estimates were the most effective in assessing personal exposure, but are often cost prohibitive for large study populations. This review suggests that: (i) factors such as uncertainty, validity, data availability, and transferability related to exposure assessment methods should be considered when selecting a model; and (ii) although an entirely discreet new class of approach is not necessary, significant progress could be made through the development of a 'hybrid' model utilizing the strengths of several existing methods. Future work should systematically evaluate the performance of hybrid models compared to other individual exposure assessment methods utilizing geospatial information technologies (e.g. geographic information systems (GIS) and remote sensing (RS)) to more robustly refine estimates of ambient exposure and quantify the linkages and differences between outdoor, indoor and personal exposure estimates.

Human health effects of air pollution

Hazardous chemicals escape to the environment by a number of natural and/or anthropogenic activities and may cause adverse effects on human health and the environment. Increased combustion of fossil fuels in the last century is responsible for the progressive change in the atmospheric composition. Air pollutants, such as carbon monoxide (CO), sulfur dioxide (SO(2)), nitrogen oxides (NOx), volatile organic compounds (VOCs), ozone (O(3)), heavy metals, and respirable particulate matter (PM2.5 and PM10), differ in their chemical composition, reaction properties, emission, time of disintegration and ability to diffuse in long or short distances. Air pollution has both acute and chronic effects on human health, affecting a number of different systems and organs. It ranges from minor upper respiratory irritation to chronic respiratory and heart disease, lung cancer, acute respiratory infections in children and chronic bronchitis in adults, aggravating pre-existing heart and lung disease, or asthmatic attacks. In addition, short- and long-term exposures have also been linked with premature mortality and reduced life expectancy. These effects of air pollutants on human health and their mechanism of action are briefly discussed.

Effect of arsenic on the onset of menarcheal age

Ground water arsenic contamination is a major problem in the Bengal Delta plain. The present study investigates the effect of arsenic exposure on age at menarche in North 24-Parganas district, one of the worst affected districts. A higher mean menarcheal age of 12.50 years is reported from women residing in four arsenic affected villages in as compared to a control village (11.71 years). The differences in menarcheal age between three of the four affected villages and the control village are statistically significant (p < 0.05). The study indicates that arsenic exposure can have a negative effect on menarcheal age.