Late effects on the health-related quality of life in a cohort population decades after environmental radiation exposure

Serum calcium and magnesium levels and quality of life in environmentally exposed populations in Kazakhstan

The relationship between the levels of essential elements and various aspects of well-being in environmentally exposed populations still needs to be better understood. The present study aims to investigate the potential connections between serum concentrations of calcium (Ca), magnesium (Mg), and quality of life (QoL) in environmentally exposed populations in Kazakhstan. The present study involved 1881 nominally healthy individuals aged 18-52 years who were permanent residents of Abay, Borodulikha, Ust-Kamenogorsk, Kurchum, Uralsk, Aksay, and Berezovka settlements. These settlements were selected to represent different types of environmental exposure: radioactive fallout from the Semipalatinsk Nuclear Test Site (SNTS), non-ferrous metallurgy, and the condensate gas field, compared to environmentally unexposed territories. The Russian version of the SF-36 questionnaire was used to assess the participants' quality of life. Serum Ca levels were measured using colorimetry with O-cresolphthalein, and serum Mg concentrations were measured using colorimetry with xylidyl blue. Both elevated and decreased serum Ca levels were more frequently observed in the environmentally exposed populations. The prevalence of hypermagnesemia was highest among residents near the condensate gas field. Environmentally exposed populations residing near the SNTS and in Ust-Kamenogorsk exhibited lower scores in some QoL domains. In contrast, people near the condensate gas field showed comparable or even higher QoL scores than the control population. Only serum Mg demonstrated a significant association with the average QoL scores, while Ca did not show such an association. These findings have important implications for public health interventions.

Is Culture Important to the Relationship Between Quality of Life and Resilience? Global Implications for Preparing Communities for Environmental and Health Disasters

Background

Using a preventative approach, we investigated whether international subjective qualities of life are associated with resilience to adversity when culture is taken into account. Although resilience has been previously associated with good QoL, cross-cultural studies are scarce.

Methods

Sequential linear multiple regression models of WHOQOL SRPB data from 15 countries worldwide (N = 3,019) examined which qualities are most closely associated with resilience, when adjusting for culture and selected demographics. We also examined whether all cultures confirmed this positive association. Of 13 QoL facets identified from a literature summary, seven were associated with defining resilience and six reflected strategies for building resilience; these were tested together. Principal components analysis provided a dependent variable for resilience, covering inner strength and hope.

Results

The final model explained 52% of resilience overall, of which QoL explained 37% and culture explained 12% (p < 0.0001). Being older than 45 years was a significant covariate. Spiritual QoL from meaning in life, awe and wonder, wholeness and integration, and being kind to others was linked with strategies for building resilience (28%). Better psychological QoL from high levels of positive feelings and low negative feelings was associated with defining resilience (9%). Larger significant positive β’s were found for 10 cultures, so model “universality” was not confirmed.

Conclusion

A new cross-cultural psycho-spiritual model of resilience is presented. Assessing individual QoL profiles could identify suitable community members to build resilience locally in culturally acceptable styles. The WHOQOL SRPB evidence could inform international policy designed to prepare vulnerable cultures that are threatened with environmental and health disasters.

How will the sustainable development goals deliver changes in well-being? A systematic review and meta-analysis to investigate whether WHOQOL-BREF scores respond to change

Introduction

The Sustainable Development Goals (SDGs) 2015 aim to ‘…promote well-being for all’, but this has raised questions about how its targets will be evaluated. A cross-cultural measure of subjective perspectives is needed to complement objective indicators in showing whether SDGs improve well-being. The WHOQOL-BREF offers a short, generic, subjective quality of life (QoL) measure, developed with lay people in 15 cultures worldwide; 25 important dimensions are scored in environmental, social, physical and psychological domains. Although validity and reliability are demonstrated, clarity is needed on whether scores respond sensitively to changes induced by treatments, interventions and major life events. We address this aim.

Methods

The WHOQOL-BREF responsiveness literature was systematically searched (Web of Science, PubMed, EMBASE and Medline). From 117 papers, 15 (24 studies) (n=2084) were included in a meta-analysis. Effect sizes (Cohen’s d) assessed whether domain scores changed significantly during interventions/events, and whether such changes are relevant and meaningful to managing clinical and social change.

Results

Scores changed significantly over time on all domains: small to moderate for physical (d=0.37; CI 0.25 to 0.49) and psychological QoL (d=0.22; CI 0.14 to 0.30), and small for social (d=0.10; CI 0.05 to 0.15) and environmental QoL (d=0.12; CI 0.06 to 0.18). More importantly, effect size was significant for every domain (p<0.001), indicating clinically relevant change, even when differences are small. Domains remained equally responsive regardless of sample age, gender and evaluation interval.

Conclusion

International evidence from 11 cultures shows that all WHOQOL-BREF domains detect relevant, meaningful change, indicating its suitability to assess SDG well-being targets.

Health related quality of life and polychlorinated biphenyls and dibenzofurans exposure: 30 years follow-up of Yucheng cohort

BACKGROUND

Quality of life (QOL) can be affected by diseases, disasters, and exposure events to environmental factors. However, whether health-related QOL (HRQOL) might be adversely affected by exposure to dioxin-like chemicals 30 years ago is unknown.

METHODS

We studied people who were poisoned to polychlorinated biphenyls (PCBs) and dibebenzofurans (PCDFs) due to ingestion of contaminated rice oil in 1979 in central Taiwan, and were called Yucheng (oil-disease in Chinese) people. In 2008, we conducted a survey in 1305 exposed people by mailed questionnaire, which included HRQOL by World Health Organization (WHO) quality of life-BREF (WHOQOL-BREF) Taiwanese version. A total of 240 Yucheng subjects aged 18-65 years satisfactorily completed the Questionnaire. For comparison, we obtained information from the database of 2001 National Health Survey conducted by the National Health Research Institute and Bureau of Health Promotion, Department of Health, Taiwan. Data from age-, sex-, and county-matched background individuals were extracted using 1:3 match. HRQOL among Yucheng people with/without skin manifestation and unexposed referents were compared, while adjusting for other factors by multiple regression analyzes.

RESULTS

The Yucheng people had significantly reduced scores in the physical, psychological, social, and environmental domains as compared to the referents. Those with skin manifestations were more severely affected than those with no skin manifestations, suggesting a dose-related effect on QOL in exposed people.

CONCLUSION

We show for the very first time that poisoning due to persistent organic pollutants PCBs and PCDFs can affect QOL 30 years after the exposure, especially among those most severely poisoned.

Risk factors of depression after prolonged low-dose rate environmental radiation exposure

PURPOSE

More than 10,000 Taiwanese people were exposed to excessive protracted low-dose rate radiation from contaminated reinforcement bars, which were installed in buildings before 1992. This study was conducted to assess the prevalence of depression amongst the exposed and identify related determinants now that more than two decades have passed since this population was informed of their exposure to radiation.

MATERIALS AND METHODS

We used the Beck depression inventory (BDI)-1A questionnaire to survey 2143 eligible people during their annual physical examinations between March 2009 and December 2009. In total, 1621 people participated in the survey. We employed multivariate logistic regression models with generalized estimating equations method to identify the determinants of depression.

RESULTS

The prevalence of depression (BDI-IA score ≥ 12) was 18.7%. Those who exhibited higher cumulative exposure [adjusted odds ratio (OR): 1.46, 95% confidence interval (CI): 1.02-2.07] and a previous history of depression (adjusted OR: 2.49, 95% CI: 1.36-4.58) were significantly associated with the risk of depression, whereas education level was inversely related to depression (adjusted OR: 0.71, 95% CI: 0.50-0.99).

CONCLUSION

Long-term, low-dose rate radiation exposure early in life might cause subsequent psychological stress and an increased risk of depression decades later.