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Hasanah A, Kharisma B, Remi SS, Adam AM, Siregar AYM. Food diversity: its relation to children's health and consequent economic burden. BMC Public Health 2024; 24:1155. [PMID: 38658917 PMCID: PMC11044496 DOI: 10.1186/s12889-024-18530-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 04/05/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND This study investigates the impact of low food diversity on the health status of children using the Dietary Diversity Score (DDS) and Dietary Serving Score (DSS) in a sub-district with the highest percentage of poor households. The economic burden of low food diversity was observed by analysing the cost of illness in the children with low food diversity. METHODS Data from 329 children were collected. We determined the impact of DDS and DSS and other factors on the health status of children aged 2-14 years, using a probit model. The cost of illness (e.g., typhus, stomach ulcers, coughs, flu, and fever) due to low food diversity was calculated from medical registration fees, medical action costs, transportation costs, and other costs. RESULTS The results shows that a 1% point increase in DDS or DSS potentially decreases children's health complaints by 10% and 8%, respectively. Given the current 26% prevalence of health complaints among children with low DDS, the annual economic burden reaches US$75.72 per child per household. In addition, the current 41% prevalence of children with low DDS resulted in an annual cost to the government of US$153.45 per child. CONCLUSIONS The effect of inadequate dietary diversity on children's health is potentially high and contributes to the economic burden on households and the government.
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Affiliation(s)
- Alfiah Hasanah
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia.
| | - Bayu Kharisma
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
| | - Sutyastie S Remi
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
| | - Asep Muhammad Adam
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
| | - Adiatma Y M Siregar
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
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Sherris AR, Loftus CT, Szpiro AA, Dearborn LC, Hazlehurst MF, Carroll KN, Moore PE, Adgent MA, Barrett ES, Bush NR, Day DB, Kannan K, LeWinn KZ, Nguyen RHN, Ni Y, Riederer AM, Robinson M, Sathyanarayana S, Zhao Q, Karr CJ. Prenatal polycyclic aromatic hydrocarbon exposure and asthma at age 8-9 years in a multi-site longitudinal study. Environ Health 2024; 23:26. [PMID: 38454435 PMCID: PMC10921622 DOI: 10.1186/s12940-024-01066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/23/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND AIM Studies suggest prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) may influence wheezing or asthma in preschool-aged children. However, the impact of prenatal PAH exposure on asthma and wheeze in middle childhood remain unclear. We investigated these associations in socio-demographically diverse participants from the ECHO PATHWAYS multi-cohort consortium. METHODS We included 1,081 birth parent-child dyads across five U.S. cities. Maternal urinary mono-hydroxylated PAH metabolite concentrations (OH-PAH) were measured during mid-pregnancy. Asthma at age 8-9 years and wheezing trajectory across childhood were characterized by caregiver reported asthma diagnosis and asthma/wheeze symptoms. We used logistic and multinomial regression to estimate odds ratios of asthma and childhood wheezing trajectories associated with five individual OH-PAHs, adjusting for urine specific gravity, various maternal and child characteristics, study site, prenatal and postnatal smoke exposure, and birth year and season in single metabolite and mutually adjusted models. We used multiplicative interaction terms to evaluate effect modification by child sex and explored OH-PAH mixture effects through Weighted Quantile Sum regression. RESULTS The prevalence of asthma in the study population was 10%. We found limited evidence of adverse associations between pregnancy OH-PAH concentrations and asthma or wheezing trajectories. We observed adverse associations between 1/9-hydroxyphenanthrene and asthma and persistent wheeze among girls, and evidence of inverse associations with asthma for 1-hydroxynathpthalene, which was stronger among boys, though tests for effect modification by child sex were not statistically significant. CONCLUSIONS In a large, multi-site cohort, we did not find strong evidence of an association between prenatal exposure to PAHs and child asthma at age 8-9 years, though some adverse associations were observed among girls.
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Affiliation(s)
- Allison R Sherris
- Department of Environmental and Occupational Health Sciences, University of Washington4225, Roosevelt Way NE, Suite 300, Seattle, WA, 98105, US.
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, University of Washington4225, Roosevelt Way NE, Suite 300, Seattle, WA, 98105, US
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA, US
| | - Logan C Dearborn
- Department of Environmental and Occupational Health Sciences, University of Washington4225, Roosevelt Way NE, Suite 300, Seattle, WA, 98105, US
| | - Marnie F Hazlehurst
- Department of Environmental and Occupational Health Sciences, University of Washington4225, Roosevelt Way NE, Suite 300, Seattle, WA, 98105, US
| | | | - Paul E Moore
- Vanderbilt University Medical Center, Nashville, TN, US
| | | | - Emily S Barrett
- Rutgers University School of Public Health, Piscataway, NJ, US
| | | | - Drew B Day
- Seattle Children's Research Institute, Seattle, WA, US
| | | | | | | | - Yu Ni
- San Diego State University, San Diego, CA, US
| | - Anne M Riederer
- Department of Environmental and Occupational Health Sciences, University of Washington4225, Roosevelt Way NE, Suite 300, Seattle, WA, 98105, US
| | | | | | - Qi Zhao
- University of Tennessee Health Science Center, Memphis, TN, US
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, University of Washington4225, Roosevelt Way NE, Suite 300, Seattle, WA, 98105, US
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Temkin AM, Evans S, Spyropoulos DD, Naidenko OV. A pilot study of chlormequat in food and urine from adults in the United States from 2017 to 2023. J Expo Sci Environ Epidemiol 2024:10.1038/s41370-024-00643-4. [PMID: 38355783 DOI: 10.1038/s41370-024-00643-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/16/2024]
Abstract
Chlormequat chloride is a plant growth regulator whose use on grain crops is on the rise in North America. Toxicological studies suggest that exposure to chlormequat can reduce fertility and harm the developing fetus at doses lower than those used by regulatory agencies to set allowable daily intake levels. Here we report, the presence of chlormequat in urine samples collected from people in the U.S., with detection frequencies of 69%, 74%, and 90% for samples collected in 2017, 2018-2022, and 2023, respectively. Chlormequat was detected at low concentrations in samples from 2017 through 2022, with a significant increase in concentrations for samples from 2023. We also observed high detection frequencies of chlormequat in oat-based foods. These findings and chlormequat toxicity data raise concerns about current exposure levels, and warrant more expansive toxicity testing, food monitoring, and epidemiological studies to assess health effects of chlormequat exposures in humans. IMPACT: This study reports the detection of chlormequat, an agricultural chemical with developmental and reproductive toxicity, in the U.S. population and U.S. food supplies for the first time. While similar levels of the chemical were found in urine sampled from 2017 to 2022, markedly increased levels were found in samples from 2023. This work highlights the need for more expansive monitoring of chlormequat in U.S. foods and in human specimens, as well as toxicological and epidemiological study on chlormequat, as this chemical is an emerging contaminant with documented evidence of low-dose adverse health effects in animal studies.
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Affiliation(s)
| | - Sydney Evans
- Environmental Working Group, Washington, DC, USA
| | - Demetri D Spyropoulos
- Department of Pathology & Laboratory Medicine, Medical University of South Carolina,, Charleston, SC, USA
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Merianos AL, Matt GE, Stone TM, Jandarov RA, Hoh E, Dodder NG, Quintana PJE, Lopez-Galvez N, Stone L, Mahabee-Gittens EM. Contamination of surfaces in children's homes with nicotine and the potent carcinogenic tobacco-specific nitrosamine NNK. J Expo Sci Environ Epidemiol 2023:10.1038/s41370-023-00629-8. [PMID: 38104233 DOI: 10.1038/s41370-023-00629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Tobacco smoke exposure (TSE) through secondhand and thirdhand smoke is a modifiable risk factor that contributes to childhood morbidity. Limited research has assessed surface TSE pollution in children's environments as a potential source of thirdhand smoke exposure, and none have examined levels of the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) on surfaces. OBJECTIVE This study measured surface NNK and nicotine in children's homes and associations with sociodemographics and parent-reported TSE behaviors. We assessed correlations of surface NNK and nicotine with dust NNK, dust nicotine, and child cotinine. METHODS Home surface wipe NNK and nicotine data from 84 children who lived with smokers were analyzed. Tobit and simple linear regression analyses were conducted to assess associations of surface NNK and nicotine with child characteristics. Spearman's (ρ) correlations assessed the strength of associations between environmental markers and child cotinine. RESULTS Nearly half (48.8%) of children's home surfaces had detectable NNK and 100% had detectable nicotine. The respective geometric means (GMs) of surface NNK and nicotine loadings were 14.0 ng/m2 and 16.4 µg/m2. Surface NNK positively correlated with surface nicotine (ρ = 0.54, p < 0.001) and dust NNK (ρ = 0.30, p = 0.020). Surface nicotine positively correlated with dust NNK (ρ = 0.42, p < 0.001) and dust nicotine (ρ = 0.24, p = 0.041). Children with household incomes ≤$15,000 had higher surface NNK levels (GM = 18.7 ng/m2, p = 0.017) compared to children with household incomes >$15,000 (GM = 7.1 ng/m2). Children with no home smoking bans had higher surface NNK (GM = 18.1 ng/m2, p = 0.020) and surface nicotine (GM = 17.7 µg/m2, p = 0.019) levels compared to children with smoking bans (GM = 7.5 ng/m2, 4.8 µg/m2, respectively). IMPACT Although nicotine on surfaces is an established marker of thirdhand smoke pollution, other thirdhand smoke contaminants have not been measured on surfaces in the homes of children living with smokers. We provide evidence that the potent carcinogenic tobacco-specific nitrosamine NNK was detectable on surfaces in nearly half of children's homes, and nicotine was detectable on all surfaces. Surface NNK was positively correlated with surface nicotine and dust NNK. Detectable surface NNK levels were found in homes with indoor smoking bans, indicating the role of NNK as a persistent thirdhand smoke pollutant accumulating on surfaces as well as in dust.
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Affiliation(s)
- Ashley L Merianos
- University of Cincinnati, School of Human Services, PO Box 210068, Cincinnati, OH, 45221-0068, USA.
| | - Georg E Matt
- Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA
| | - Timothy M Stone
- Department of Environmental and Public Health Sciences, Division of Biostatistics and Bioinformatics, University of Cincinnati, College of Medicine, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA
| | - Roman A Jandarov
- Department of Environmental and Public Health Sciences, Division of Biostatistics and Bioinformatics, University of Cincinnati, College of Medicine, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA
| | - Eunha Hoh
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Nathan G Dodder
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Penelope J E Quintana
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Nicolas Lopez-Galvez
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Lara Stone
- Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, University of Cincinnati, College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA
| | - E Melinda Mahabee-Gittens
- Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, University of Cincinnati, College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA
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Yao L, Liu L, Dong M, Yang J, Zhao Z, Chen J, Lv L, Wu Z, Wang J, Sun X, Self S, Bhatti P. Trimester-specific prenatal heavy metal exposures and sex-specific postpartum size and growth. J Expo Sci Environ Epidemiol 2023; 33:895-902. [PMID: 35490160 PMCID: PMC9617807 DOI: 10.1038/s41370-022-00443-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND There has been limited research considering the effects of prenatal exposure to multiple heavy metals on early childhood size and growth. OBJECTIVE We evaluated prenatal exposures to 15 heavy metals in association with measures of weight, length, and head circumference (HC) measured at birth, and 1, 3 and 6 months of age in a study of 358 mother-child pairs. METHODS Urinary concentrations were measured in the first and third trimesters of pregnancy and examined, using sex-stratified general linear models, in association with average standardized size and changes in size (growth) over the first 6 months of life. Confounding effects among metals were explored. RESULTS Increased first trimester Hg and V were associated with decreased average HC among males and weight among females, respectively. Increased first trimester V was associated with a decline in weight among females over time. Increased third trimester Cs, Rb and Tl were associated with increased average weight and HC among males. Increased third trimester Se was associated with increased HC among females over time. Evidence for confounding was observed between Cs, Rb and Tl in association with weight and HC. SIGNIFICANCE We observed multiple biologically plausible associations between prenatal heavy metal exposures and postnatal size and growth. IMPACT We have taken a comprehensive and novel approach to evaluating the impacts of prenatal heavy metal exposures on size and growth during early childhood. Our detailed analyses consider exposures to 15 different heavy metals at two time points during pregnancy, as well as multiple metrics of size and growth collected at birth and 1, 3 and 6 months of age.
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Affiliation(s)
- Lena Yao
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Lili Liu
- Department of Toxicology, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangdong Province Hospital for Occupational Disease Prevention, Guangzhou, China
| | - Ming Dong
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangdong Province Hospital for Occupational Disease Prevention, Guangzhou, China
| | - Jinmei Yang
- Department of Toxicology, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangdong Province Hospital for Occupational Disease Prevention, Guangzhou, China
| | - Zhiqiang Zhao
- Department of Toxicology, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangdong Province Hospital for Occupational Disease Prevention, Guangzhou, China
| | - Jiabin Chen
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangdong Province Hospital for Occupational Disease Prevention, Guangzhou, China
| | - Lijuan Lv
- Guangdong Maternal and Child Hospital, Guangzhou, China
| | - Zhaoxia Wu
- Nanhai Maternity and Child Healthcare Hospital of Foshan, Foshan, China
| | - Jin Wang
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin Sun
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Steven Self
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Parveen Bhatti
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
- Cancer Control Research, BC Cancer Research Institute, Vancouver, BC, Canada.
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Al-Yateem N, Lajam AMA, Othman MMG, Ahmed MAA, Ibrahim S, Halimi A, Ahmad FR, Subu MA, Dias JM, Rahman SA, Saifan AR, Hijazi H. The impact of cultural healthcare practices on Children's health in the United Arab Emirates: a qualitative study of traditional remedies and implications. Front Public Health 2023; 11:1266742. [PMID: 37876720 PMCID: PMC10593472 DOI: 10.3389/fpubh.2023.1266742] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023] Open
Abstract
Aim This qualitative study investigates the impact of cultural practices on children's health in the United Arab Emirates (UAE) by examining the use of traditional remedies and home treatments by mothers. Methods Twenty-five participants, all mothers who had employed traditional treatments or home remedies for their children during periods of illness, were included in the study. The participants represented a diverse range of educational backgrounds, from school diploma holders to university degree graduates, with ages spanning from 20 to 50 years. Hailing from different Arabic countries and cultural subgroups, the majority of participating mothers were from the UAE. Results Through in-depth interviews, three major themes emerged from the participants' experiences. Firstly, a strong connection between culture, religion, and healthcare practices was evident. Many mothers opted for cultural remedies as their first line of defense against illnesses due to the practices' strong foundations in their cultural heritage. Herbal remedies, Quranic healing, and other traditional methods were perceived to be both effective and spiritually comforting, reinforcing participants' sense of cultural identity. Secondly, participants highlighted unintended consequences of relying solely on traditional treatments. Some instances were reported where the use of ineffective remedies resulted in delays in seeking appropriate medical care for their children, potentially compromising their health. Additionally, certain misconceptions regarding the safety and efficacy of traditional remedies were identified, emphasizing the need for evidence-based healthcare education. Conclusion This qualitative study sheds light on the intricate interplay between culture, traditional remedies, and children's health in the UAE. The incorporation of diverse participants from various Arabic countries and cultural subgroups enriches the study's applicability to broader Arabic cultures. By recognizing the significance of cultural healthcare practices and striking a balance with evidence-based care, healthcare providers can create a more inclusive and effective healthcare environment for children in the UAE. Future research should explore diverse samples and develop targeted interventions to further advance cultural awareness and understanding in healthcare practices.
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Affiliation(s)
- Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- School of Nursing, Paramedicine and Healthcare Sciences, Faculty of Science and Health Charles Sturt University, Bathurst, NSW, Australia
| | - Amal Muneer Abobakr Lajam
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Maryam Ahmed Ali Ahmed
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Shayma Ibrahim
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Aram Halimi
- Student Research Committee, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatma Refaat Ahmad
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Muhammad Arsyad Subu
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Nursing and Midwifery, Binawan University, Jakarta, Indonesia
| | - Jacqueline Maria Dias
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Syed Azizur Rahman
- Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Heba Hijazi
- Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Lekše R, Godec D, Prosen M. Determining the Impact of Lifestyle on the Health of Primary School Children in Slovenia Through Mixed Membership Focus Groups. J Community Health 2023; 48:857-869. [PMID: 37160527 PMCID: PMC10169174 DOI: 10.1007/s10900-023-01231-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
Lifestyle choices made by children and adolescents can lead to a variety of health problems. It is therefore crucial to evaluate the state health-related lifestyles of primary school children's and identify areas for improvement. The aim of this study was to investigate the experiences and perspectives of those involved in educating current generations of primary school children about their lifestyle and the associated health implications of their behavior. Four focus groups were formed, comprising parents, primary school teachers, health professionals, and leisure activity teachers, with five participants in each group. Semi-structured interviews were conducted with each group as part of the qualitative research paradigm of the study. The study revealed three central themes, emphasizing the need to promote health and educate children about healthy behaviors, environmental influences, and health literacy. Community nurses need to take a proactive role in promoting school health. Although adults, peers, and the environment exert a strong influence on children's lifestyles, they often fail to live up to their responsibilities and allow harmful habits to form. To instill positive behaviors and an optimistic attitude towards a healthy lifestyle, all those involved in a child's education need to collaborate. Health-related topics should be included or reinforced in primary school curricula, and parents and school staff should receive appropriate training.
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Affiliation(s)
- Rebeka Lekše
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Polje 42, Izola, 6310 Slovenia
| | - Dijana Godec
- Health Promotion Centre, Gregorčičeva cesta 8, Ilirska Bistrica, 6250 Slovenia
| | - Mirko Prosen
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Polje 42, Izola, 6310 Slovenia
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Heersema LA, Cunniff L, Eiden AL, Sharma I, Mishra J, Bhatti A. Intersection of policy and Immunization Information Systems (IIS). BMC Public Health 2023; 23:1828. [PMID: 37730618 PMCID: PMC10510248 DOI: 10.1186/s12889-023-16457-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/03/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Immunization information systems (IIS) are confidential, population-based computerized databases that record vaccination doses administered to persons residing within a given geopolitical area. We sought to highlight the evolution of IIS policy over the last two decades, as IIS play a pivotal role in achieving equitable and high vaccine uptake. METHODS Legal epidemiological research methods were used to assess relevant IIS statutes and administrative codes across all 50 states, the District of Columbia, Philadelphia, and New York City. Where relevant, laws were cross-checked or supplemented with state and local health department resources. Comparisons to previous legal studies enabled evaluation of trends in IIS laws over time. RESULTS The compilation of current laws provides an updated overview of the diverse interstate and intrastate policies within the US that govern the capabilities and implementation of IIS. The findings of this study show the progress that has been made in the past decade in improving policies that enable IIS to be utilized across the life-course. Conversely, gaps in IIS data collection, limited interoperability with local and national health information systems, and inconsistent access to view or utilize IIS records due to existing policies, continue to limit the full potential of IIS. CONCLUSIONS In the United States (US), IIS are implemented and managed at the state and local level, creating variability in IIS policies and implementation. Findings from this study serve as a comprehensive benchmark of current IIS laws that may aid policy stakeholders who are exploring amendments to jurisdictional IIS laws.
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Affiliation(s)
- Lara A Heersema
- Merck & Co., Inc, 351 North Sumneytown Pike, North Wales, PA, 19454, USA
| | - Luke Cunniff
- Merck & Co., Inc, 351 North Sumneytown Pike, North Wales, PA, 19454, USA.
| | - Amanda L Eiden
- Merck & Co., Inc, 351 North Sumneytown Pike, North Wales, PA, 19454, USA
| | - Isha Sharma
- Merck & Co., Inc, 351 North Sumneytown Pike, North Wales, PA, 19454, USA
| | - Jaya Mishra
- Merck & Co., Inc, 351 North Sumneytown Pike, North Wales, PA, 19454, USA
- Medicine and Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexandra Bhatti
- Merck & Co., Inc, 351 North Sumneytown Pike, North Wales, PA, 19454, USA
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Abdollahi S, Waygood EOD, Aliyas Z, Cloutier MS. An Overview of How the Built Environment Relates to Children's Health. Curr Environ Health Rep 2023; 10:264-277. [PMID: 37507592 DOI: 10.1007/s40572-023-00405-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE OF REVIEW Explore the varied pathways between the built environment and children's health. The review begins by describing how the built environment and transport infrastructure relate to conditions that lead to health outcomes. The review examines emissions, noise, and traffic dangers in relation to children's physical, mental, and social health. RECENT FINDINGS Evidence is increasing for walkable neighborhoods and health-related behavior such as physical activity. However, diverse land uses (often supporting walkability) were also found to increase traffic injuries. Cognitive impacts of motorways on children at schools were found. Finally, the relationships between social activities and built environment are beginning. The built environment's influence on various physical health outcomes is increasingly clear and is often through a transport pathway. However, the links with mental and social health are less developed, though recent findings show significant results. Having accessible child-relevant destinations is an important consideration for children's health.
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Affiliation(s)
- Shabnam Abdollahi
- Department of Civil, Geological and Mining Engineering, Polytechnique Montréal, Montréal, H3T 1J4, Canada
| | - E Owen D Waygood
- Department of Civil, Geological and Mining Engineering, Polytechnique Montréal, Montréal, H3T 1J4, Canada.
| | - Zeinab Aliyas
- Centre Urbanisation Culture Société, Institut National de La Recherche Scientifique, Montreal, H7B 1V7, Canada
| | - Marie-Soleil Cloutier
- Centre Urbanisation Culture Société, Institut National de La Recherche Scientifique, Montreal, H7B 1V7, Canada
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Calvert HG, McQuilkin M, Havlicak A, Lewis T, Turner L. Acceptability, appropriateness, and feasibility of Rural School Support Strategies for behavioral interventions: a mixed methods evaluation over two years of a hybrid type 3 implementation-effectiveness trial. Implement Sci Commun 2023; 4:92. [PMID: 37568206 PMCID: PMC10416374 DOI: 10.1186/s43058-023-00478-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Positive Behavioral Interventions and Supports (PBIS) is a framework for implementing evidence-based interventions for preventing behavioral issues and improving climate in schools. The implementation of school-wide PBIS with fidelity is complex, requiring leadership commitment, teaming, and coordination of systems for tracking behaviors and consequences. Putting these components in place while ensuring alignment with the values and needs of the school community can be difficult for schools with fewer resources, such as rural schools. Implementation supports are needed, including strategies such as technical assistance, but it is unclear whether lower-cost modalities such as virtual support are acceptable, appropriate, and feasible and whether perceptions vary throughout the implementation process. METHODS A type 3 hybrid implementation-effectiveness trial is taking place in 40 Idaho schools, testing a bundle of implementation supports selected to meet the needs of schools in rural areas. Supports include technical assistance from an implementation support practitioner (ISP), didactic trainings, virtual learning sessions, and an online resource portal. Surveys and interviews in the first 2 years of implementation (fall 2019 to spring 2021) explored outcomes of acceptability, appropriateness, and feasibility regarding the implementation supports among more than 150 school stakeholders. RESULTS Evaluations showed high acceptability and appropriateness of the PBIS concepts and training. The 20 schools receiving additional implementation support rated the technical assistance and support from the project's ISPs as the most acceptable and appropriate resource. Reasons for acceptability were the relationship built with the ISP, the ISP's expertise, and being a "neutral party." Although in-person support from the ISP was preferred, remote support was acceptable and increased feasibility of attendance. Virtual learning sessions were acceptable for learning and collaboration, particularly in the second year of implementation, once ISPs had developed closer relationships with school teams. CONCLUSIONS School staff found training, technical assistance, and virtual learning sessions to be acceptable and appropriate. Virtual formats of training and technical assistance decreased in acceptability but increased feasibility of attendance. In-person support was preferred during initial implementation, and virtual support was more acceptable thereafter. TRIAL REGISTRATION This trial was prospectively registered on ClinicalTrials.gov ( NCT03736395 ), on November 9, 2018.
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Affiliation(s)
- Hannah G Calvert
- Center for School and Community Partnerships, College of Education, Boise State University, 1910 W University Drive, Boise, ID, 83725-1742, USA.
| | - Michaela McQuilkin
- Center for School and Community Partnerships, College of Education, Boise State University, 1910 W University Drive, Boise, ID, 83725-1742, USA
| | - Ashley Havlicak
- School of Public and Population Health, College of Health Sciences, Boise State University, 1910 W University Dr, Boise, ID, 83725-1742, USA
| | - Teri Lewis
- Center for School and Community Partnerships, College of Education, Boise State University, 1910 W University Drive, Boise, ID, 83725-1742, USA
| | - Lindsey Turner
- Center for School and Community Partnerships, College of Education, Boise State University, 1910 W University Drive, Boise, ID, 83725-1742, USA
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11
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da Silva Rodrigues D, Santos Bastos Soares A, Dizioli Franco Bueno C. The use of cannabinoids in children with epilepsy: A systematic review. Epilepsy Behav 2023; 145:109330. [PMID: 37390729 DOI: 10.1016/j.yebeh.2023.109330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
INTRODUCTION Epileptic syndromes affecting children can sometimes be refractory to pharmacological treatments. Cannabinoids, especially cannabidiol, began to be studied to contribute to the treatment of these syndromes, configuring an expanding research area. The aim of this paper was to evaluate the scientific evidence available in the literature regarding the use of cannabinoids in the therapy of children with epilepsy. METHOD This is a systematic literature review, carried out according to the structure of the Preferred Reporting Items for Systematic Reviews and meta-analyses (PRISMA), in the SCIELO, Cochrane Library, and MEDLINE databases. Observational studies or clinical trials were included, conducted in humans, addressing the use of cannabinoids in pediatric patients with epilepsy, published in the last 10 years. RESULTS AND DISCUSSION In all, 626 studies were found and analyzed, of which 29 were considered eligible for the research; studies indicated good efficacy, safety, and tolerability of cannabidiol in several syndromes, with emphasis on Lennox-Gastaut and Dravet syndromes, in addition to practical issues were perceived regarding the applicability and expectations of patients and physicians. CONCLUSION The use of cannabidiol was considered effective and safe, yet the studies were mostly carried out in the same countries.
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12
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Nguyen M, Flores M, Van Vo A, Omaleki V, Streuli S, Fielding-Miller R. Barriers and facilitators to COVID-19 testing among staff and parents from San Diego schools. BMC Public Health 2023; 23:1068. [PMID: 37277867 DOI: 10.1186/s12889-023-15854-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 05/09/2023] [Indexed: 06/07/2023] Open
Abstract
COVID-19 testing is an important risk mitigation strategy for COVID-19 prevention in school settings, where the virus continues to pose a public health challenge for in-person learning. Socially vulnerable school communities with the highest proportion of low-income, minority, and non-English speaking families have the least testing access despite shouldering a disproportionate burden of COVID-19 morbidity and mortality. Through the Safer at School Early Alert (SASEA) program, we investigated community perceptions of testing in San Diego County schools, with a focus on barriers and facilitators from the perspective of socially vulnerable parents and school staff. Using a mixed-methods approach, we administered a community survey and conducted focus group discussions (FGDs) with staff and parents from SASEA-affiliated schools and childcares. We recruited 299 survey respondents and 42 FGD participants. Protecting one's family (96.6%) and protecting one's community (96.6%) were marked as key motivators to testing uptake. School staff in particular reported that the reassurance of a negative status mitigated concerns about COVID-19 infection in schools. Participants expressed that COVID-19-related stigma, loss of income as a result of isolation/quarantine requirements, and lack of multilingual materials were the most significant barriers to testing. Our findings suggest that the testing barriers faced by school community members are predominantly structural. Testing uptake efforts must provide support and resources to manage the social and financial consequences of testing while continuously communicating its benefits. There is a clear need to continue to incorporate testing as a strategy to maintain school safety and facilitate access for vulnerable community members.
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Affiliation(s)
- Megan Nguyen
- San Diego Herbert Wertheim School of Public Health, University of California, San Diego, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Marlene Flores
- San Diego Herbert Wertheim School of Public Health, University of California, San Diego, USA.
| | - Anh Van Vo
- San Diego Herbert Wertheim School of Public Health, University of California, San Diego, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Vinton Omaleki
- San Diego Herbert Wertheim School of Public Health, University of California, San Diego, USA
| | - Samantha Streuli
- San Diego Herbert Wertheim School of Public Health, University of California, San Diego, USA
| | - Rebecca Fielding-Miller
- San Diego Herbert Wertheim School of Public Health, University of California, San Diego, USA
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Petroff RL, Cavalcante RG, Langen ES, Dolinoy DC, Padmanabhan V, Goodrich JM. Mediation effects of DNA methylation and hydroxymethylation on birth outcomes after prenatal per- and polyfluoroalkyl substances (PFAS) exposure in the Michigan mother-infant Pairs cohort. Clin Epigenetics 2023; 15:49. [PMID: 36964604 PMCID: PMC10037903 DOI: 10.1186/s13148-023-01461-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/05/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are chemicals that are resistant to degradation and ubiquitous in our environments. PFAS may impact the developing epigenome, but current human evidence is limited to assessments of total DNA methylation. We assessed associations between first trimester PFAS exposures with newborn DNA methylation, including 5-methylcytosine (5-mC) and 5-hydroxymethylcytosine (5-hmC). DNA methylation mediation of associations between PFAS and birth outcomes were explored in the Michigan Mother Infant Pairs cohort. Nine PFAS were measured in maternal first trimester blood. Seven were highly detected and included for analysis: PFHxS, PFOA, PFOS, PFNA, PFDA, PFUnDA, and MeFOSAA. Bisulfite-converted cord blood DNA (n = 141) and oxidative-bisulfite-converted cord blood (n = 70) were assayed on Illumina MethylationEPIC BeadChips to measure total DNA methylation (5-mC + 5-hmC) and 5-mC/5-hmC. Correcting for multiple comparisons, beta regressions were used to assess associations between levels of PFAS and total methylation, 5-mC, or 5-hmC. Nonlinear mediation analyses were used to assess the epigenetic meditation effect between PFAS and birth outcomes. RESULTS PFAS was significantly associated with total methylation (q < 0.05: PFHxS-12 sites; PFOS-19 sites; PFOA-2 sites; PFNA-3 sites; PFDA-4 sites). In 72 female infants and 69 male infants, there were sex-specific associations between five PFAS and DNA methylation. 5-mC and 5-hmC were each significantly associated with thousands of sites for PFHxS, PFOS, PFNA, PFDA, PFUnDA, and MeFOSAA (q < 0.05). Clusters of 5-mC and 5-hmC sites were significant mediators between PFNA and PFUnDA and decreased gestational age (q < 0.05). CONCLUSIONS This study demonstrates the mediation role of specific types of DNA methylation on the relationship between PFAS exposure and birth outcomes. These results suggest that 5-mC and 5-hmC may be more sensitive to the developmental impacts of PFAS than total DNA methylation.
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Affiliation(s)
- Rebekah L Petroff
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Raymond G Cavalcante
- Epigenomics Core, Biomedical Research Core Facilities, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Elizabeth S Langen
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Dana C Dolinoy
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Epigenomics Core, Biomedical Research Core Facilities, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Vasantha Padmanabhan
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Pediatrics Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
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Kupsco A, Bloomquist TR, Hu H, Reddam A, Tang D, Goldsmith J, Rundle AG, Baccarelli AA, Herbstman JB. Mitochondrial DNA copy number dynamics and associations with the prenatal environment from birth through adolescence in a population of Dominican and African American children. Mitochondrion 2023; 69:140-146. [PMID: 36804466 PMCID: PMC10006332 DOI: 10.1016/j.mito.2023.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/17/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
Mitochondrial DNA copy number (mtDNAcn) dynamics throughout childhood are poorly understood. We profiled mtDNAcn from birth through adolescence and evaluated how the prenatal environment influences mtDNAcn across childhood. Data were collected from children from New York City followed through 18 years. Using duplexed qRT-PCR, we quantified mtDNAcn relative to nuclear DNA in blood collected from the umbilical cord (n = 450), children aged 5-7 (n = 510), and adolescents aged 15-18 (n = 278). We examined mtDNAcn across childhood with linear mixed-effects models (LMM). Relative mtDNAcn was lowest at birth (mean ± SD: 0.67 ± 0.35) and increased in childhood (1.24 ± 0.50) then slightly declined in adolescence (1.13 ± 0.44). We observed no differences in mtDNAcn by sex or race/ethnicity. mtDNAcn was positively associated with prenatal environmental tobacco smoke exposure (0.077 [ 0.01, 0.14] change in relative mtDNAcn) but negatively associated with maternal completion of high school (-0.066 [-0.13, 0.00]), with the receipt of public assistance at birth (-0.074 [-0.14, -0.01]), and when mother born outside the U.S (-0.061 [-0.13, 0.003]). Infant birth outcomes were not associated with mtDNAcn. MtDNAcn levels were dynamic through childhood and associated with some prenatal factors, underscoring the need for the investigation of longitudinal mtDNAcn for human health research.
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Affiliation(s)
- Allison Kupsco
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States.
| | - Tessa R Bloomquist
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Heng Hu
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Aalekhya Reddam
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Deliang Tang
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Jeff Goldsmith
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
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15
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Smith TJS, Keil AP, Buckley JP. Estimating Causal Effects of Interventions on Early-life Environmental Exposures Using Observational Data. Curr Environ Health Rep 2023; 10:12-21. [PMID: 36418665 DOI: 10.1007/s40572-022-00388-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW We discuss how epidemiologic studies have used observational data to estimate the effects of potential interventions on early-life environmental exposures. We summarize the value of posing questions about interventions, how a group of techniques known as "g-methods" can provide advantages for estimating intervention effects, and how investigators have grappled with the strong assumptions required for causal inference. RECENT FINDINGS We identified nine studies that estimated health effects of hypothetical interventions on early-life environmental exposures. Of these, six examined air pollution. Interventions evaluated by these studies included setting exposure levels at a specific value, shifting exposure distributions, and limiting exposure levels to less than a threshold value. Only one study linked exposure contrasts to a specific intervention on an exposure source, however. There is growing interest in estimating intervention effects of early-life environmental exposures, in part because intervention effects are directly related to possible public health actions. Future studies can build on existing work by linking research questions to specific hypothetical interventions that could reduce exposure levels. We discuss how framing questions around interventions can help overcome some of the barriers to causal inference and how advances related to machine learning may strengthen studies by sidestepping the overly restrictive assumptions of parametric regression models. By leveraging advancements in causal inference and exposure science, an intervention framework for environmental epidemiology can guide actionable solutions to improve children's environmental health.
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Affiliation(s)
- Tyler J S Smith
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alexander P Keil
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Jessie P Buckley
- Departments of Environmental Health & Engineering and Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W7515, Baltimore, MD, 21205, USA.
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Arthur NSM, Blewett LA. Contributions of Key Components of a Medical Home on Child Health Outcomes. Matern Child Health J 2023; 27:476-486. [PMID: 36460883 DOI: 10.1007/s10995-022-03539-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 06/20/2022] [Accepted: 09/09/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES The medical home model is a widely accepted model of team-based primary care. We examined five components of the medical home model in order to better understand their unique contributions to child health outcomes. METHODS We analyzed data from the 2016-2017 National Survey of Children's Health (NSCH) to assess five key medical home components - usual source of care, personal doctor/nurse, family-centered care, referral access, and coordinated care - and their associations with child outcomes. Health outcomes included emergency department (ED) visits, unmet health care needs, preventive medical visits, preventive dental visits, health status, and oral health status. We used multivariate regression controlling for child characteristics including age, sex, primary household language, race/ethnicity, income, parental education, health insurance coverage, and special healthcare needs. RESULTS Children who were not white, living in non-English households, with less family income or education, or who were uninsured had lower rates of access to a medical home and its components. A medical home was associated with beneficial child outcomes for all six of the outcomes and the family-centered care component was associated with better results in five outcomes. ED visits were less likely for children who received care coordination (aOR 0.81, CI 0.70-0.94). CONCLUSIONS FOR PRACTICE Our study highlights the role of key components of the medical home and the importance of access to family-centered health care that provides needed coordination for children. Health care reforms should consider disparities in access to a medical home and specific components and the contributions of each component to provide quality primary care for all children.
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Affiliation(s)
- Natalie Schwehr Mac Arthur
- State Health Access Data Assistance Center (SHADAC), School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Lynn A Blewett
- State Health Access Data Assistance Center (SHADAC), School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Cothran DJ, Kulinna PH. "He's a little skinny and he's a little wide.": a mixed design investigation of American Indian student perceptions of healthy bodies. BMC Public Health 2023; 23:239. [PMID: 36737762 PMCID: PMC9896662 DOI: 10.1186/s12889-023-15048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Childhood is a critical developmental time of wellness patterns, yet little is known about what children know and believe. Even less is known about non-majority cultures like American Indian youth. The purpose of this study was to explore American Indian students' understandings of nutrition and physical activity. METHODS This mixed methods study took place in 10 schools in an American Indian community in the Southwestern U.S. Ninety American Indian students in grades 3-12 (8-19 years old) were interviewed. The interview included an 8-point body size chart. Numerical data were analyzed via t-test statistics while a constant comparison process and analysis was used for the interview data. RESULTS Students rated approximately 85% of students in Category 5 or smaller on the scale while placing 60% of adults at or above that size. There was a general trend of a larger body type for boys seen as healthy compared to that for girls. Students generally believed that their classmates were larger than the healthy body size. For students, a healthy body was the result of compliance with "eat right and exercise" rules. They exhibited little understanding of nutrition or physical activity and there were few developmental differences in understanding. Health was a corporeal concept and violators of the eat right and exercise rules were seen as lazy. CONCLUSIONS Students held narrow and corporeal focused notions of health focused on simple rules. People who violated the rules were "lazy", a concept that seemed to underlie multiple constructs and a finding that holds true in other investigations. Students also reported few adult role models, a topic that should be explored with expanded family groups to better represent the multi-generational (e.g. grandparents, uncles, aunts) family housing common in the community. The findings are limited to a single American Indian community and a mixed design of relatively small numbers. This addition to the literature from a non-majority cultural group expands our knowledge of student perspectives on health. These findings can be used to create more effective curricula and interventions. Schools need more effective, but also alternately framed approaches that promote broader views of health.
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Affiliation(s)
- Donetta J. Cothran
- grid.411377.70000 0001 0790 959XSchool of Public Health, Indiana University, 1025 East 7th Street, 47405 Bloomington, IN USA
| | - Pamela Hodges Kulinna
- grid.215654.10000 0001 2151 2636Arizona State University, 7271 E. Sonoran Arroyo Mall Santa Catalina Hall Rm. 330Q, 85212 Mesa, AZ USA
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18
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Raimondi S, Gandini S, Rubio Quintanares GH, Abecasis A, Lopalco PL, D’Ecclesiis O, Chiocca S, Tomezzoli E, Cutica I, Mazzoni D, Amparo N, Pingarilho M, Carmagnola D, Dallavia C, Zuccotti G, Ronchini C, Bellerba F, Dewald F, Kaiser R, Incardona F. European Cohorts of patients and schools to Advance Response to Epidemics (EuCARE): a cluster randomised interventional and observational study protocol to investigate the relationship between schools and SARS-CoV-2 infection. BMC Infect Dis 2023; 23:1. [PMID: 36597074 PMCID: PMC9808677 DOI: 10.1186/s12879-022-07947-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 12/13/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Contradictory results were reported on the role of school closure/reopening on the overall SARS-CoV-2 transmission rate, as well as on which kind and level of mitigation measures implemented in schools may be effective in limiting its diffusion. Some recent studies were reassuring, showing that opening did not increase the community spread, although teachers and families are worried about the high class density. On the other hand, distance learning was associated with a negative impact on learning, sociability and psychological health, especially in vulnerable children. As it becomes clear that the SARS-CoV-2 pandemic will last for a long time, there is a high need for studies and solutions to support safe schools opening based on scientific evidence of harms and benefits. The Lolli-Methode (LM) is a strategy for epidemiological surveillance and early intervention aiming at SARS-CoV-2 outbreaks' reduction in schools, relying on polymerase chain reaction analysis of saliva samples. METHODS In this cluster randomised trial protocol, we aim to determine whether the LM is useful to support schools opening and to reduce clusters and attack rates in schools, compared with the standard of care (SoC) surveillance by public health departments. This multicenter study will enrol 440 classes (around 8800 students, teachers and other personnel) from two countries, cluster randomised to LM or SoC. The samples from the pools will be collected and tested using PCR-based techniques. Test results will be combined with questionnaires filled in by children, parents, schoolteachers, and principals, concerning ongoing mitigation measures, their perceived psychological impact and other health and socio-economic information. An ancillary observational study will be carried out to study the prevalence of SARS-CoV-2 in schools, frequencies and size of clusters and attack rates, to compare the effectiveness of the different preventive measures adopted and to evaluate psychological issues in students and teachers in relation to the pandemic's containment measures. DISCUSSION By the end of this study, we will have defined and characterised the applicability of the LM for SARS-CoV-2 surveillance, as well as the impact of pandemic preventive measures on children and teachers. Trial registration International Standard Randomised Controlled Trial Number: NCT05396040, 27.05.2022.
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Affiliation(s)
- Sara Raimondi
- grid.15667.330000 0004 1757 0843Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Gandini
- grid.15667.330000 0004 1757 0843Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gibran Horemheb Rubio Quintanares
- Institute of Virology, University Clinics of Cologne, Cologne, Germany. .,Paul Ehrlich Institut, Langen, Germany. .,Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | - Ana Abecasis
- grid.10772.330000000121511713Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, New University of Lisbon, Lisbon, Portugal
| | - Pier Luigi Lopalco
- grid.9906.60000 0001 2289 7785Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Oriana D’Ecclesiis
- grid.15667.330000 0004 1757 0843Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Susanna Chiocca
- grid.15667.330000 0004 1757 0843Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elisa Tomezzoli
- grid.15667.330000 0004 1757 0843Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Ilaria Cutica
- grid.4708.b0000 0004 1757 2822Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Davide Mazzoni
- grid.4708.b0000 0004 1757 2822Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Nuno Amparo
- grid.10772.330000000121511713Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, New University of Lisbon, Lisbon, Portugal ,Public Health Clusters’ Public Health Unit of Central Alentejo, Lisbon, Portugal
| | - Marta Pingarilho
- grid.10772.330000000121511713Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, New University of Lisbon, Lisbon, Portugal
| | - Daniela Carmagnola
- grid.4708.b0000 0004 1757 2822Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Claudia Dallavia
- grid.4708.b0000 0004 1757 2822Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Gianvincenzo Zuccotti
- grid.414189.10000 0004 1772 7935Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Chiara Ronchini
- grid.15667.330000 0004 1757 0843Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Bellerba
- grid.15667.330000 0004 1757 0843Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Felix Dewald
- Institute of Virology, University Clinics of Cologne, Cologne, Germany
| | - Rolf Kaiser
- Institute of Virology, University Clinics of Cologne, Cologne, Germany
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Ives C, Pan H, Edwards SW, Nelms M, Covert H, Lichtveld MY, Harville EW, Wickliffe JK, Zijlmans W, Hamilton CM. Linking complex disease and exposure data-insights from an environmental and occupational health study. J Expo Sci Environ Epidemiol 2023; 33:12-16. [PMID: 35347232 PMCID: PMC9515242 DOI: 10.1038/s41370-022-00428-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
The disparate measurement protocols used to collect study data are an intrinsic barrier to combining information from environmental health studies. Using standardized measurement protocols and data standards for environmental exposures addresses this gap by improving data collection quality and consistency. To assess the prevalence of environmental exposures in National Institutes of Health (NIH) public data repositories and resources and to assess the commonality of the data elements, we analyzed clinical measures and exposure assays by comparing the Caribbean Consortium for Research in Environmental and Occupational Health study with selected NIH environmental health resources and studies. Our assessment revealed that (1) environmental assessments are widely collected in these resources, (2) biological assessments are less prevalent, and (3) NIH resources can help identify common data for meta-analysis. We highlight resources to help link environmental exposure data across studies to support data sharing. Including NIH data standards in environmental health research facilitates comparing and combining study data, and the use of NIH resources and adoption of standard measures will allow integration of multiple studies and increase the scientific impact of individual studies.
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Affiliation(s)
- Cataia Ives
- RTI International, Research Triangle Park, NC, USA.
| | - Huaqin Pan
- RTI International, Research Triangle Park, NC, USA
| | | | - Mark Nelms
- RTI International, Research Triangle Park, NC, USA
| | - Hannah Covert
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Emily W Harville
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jeffrey K Wickliffe
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wilco Zijlmans
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
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DeLay K, Lin EZ, Koelmel JP, Bornman R, Obida M, Chevrier J, Godri Pollitt KJ. Personal air pollutant exposure monitoring in South African children in the VHEMBE birth cohort. Environ Int 2022; 170:107524. [PMID: 36260950 PMCID: PMC9982749 DOI: 10.1016/j.envint.2022.107524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 09/02/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
The burden of disease associated with environmental exposures disproportionately impacts residents of low- and middle-income countries. Children living in rural regions of these countries may experience higher exposure to insecticides from indoor residual spraying used for malaria control and household air pollution. This study evaluated environmental exposures of children living in a rural region of South Africa. Quantifying exposure levels and identifying characteristics that are associated with exposure in this geographic region has been challenging due to limitations with available monitoring techniques. Wearable passive samplers have recently been shown to be a convenient and reliable tool for assessing personal exposures. In this study, a passive sampler wristband, known as Fresh Air wristband, was worn by 49 children (five-years of age) residing in the Limpopo province of South Africa. The study leveraged ongoing research within the Venda Health Examination of Mothers, Babies, and their Environment (VHEMBE) birth cohort. A wide range of chemicals (35 in total) were detected using the wristbands, including polycyclic aromatic hydrocarbons (PAHs), organochlorine pesticides, phthalates, and organophosphate esters (OPEs) flame retardants. Higher concentrations of PAHs were observed among children from households that fell below the food poverty threshold, did not have access to electric cookstoves/burners, or reported longer times of cooking or burning materials during the sampling period. Concentrations of p,p'-DDD and p,p'-DDT were also found to be elevated for children from households falling below the food poverty threshold as well as for children whose households were sprayed for malaria control within the previous 1.5 years. This study demonstrates the feasibility of using passive sampler wristbands as a non-invasive method for personal exposure assessment of children in rural regions of South Africa to complex mixtures environmental contaminants derived from a combination of sources. Future studies are needed to further identify and understand the effects of airborne environmental contaminants on childhood development and strategies to mitigate exposures.
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Affiliation(s)
- Kayley DeLay
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06520, USA; Department of Chemical and Environmental Engineering, Yale School of Engineering and Applied Sciences, New Haven, CT 06520, USA
| | - Elizabeth Z Lin
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06520, USA
| | - Jeremy P Koelmel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06520, USA
| | - Riana Bornman
- University of Pretoria Institute for Sustainable Malaria Control and School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Muvhulawa Obida
- University of Pretoria Institute for Sustainable Malaria Control and School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Jonathan Chevrier
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06520, USA; Department of Chemical and Environmental Engineering, Yale School of Engineering and Applied Sciences, New Haven, CT 06520, USA.
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21
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Srivastav A, Richard C, McRell AS, Kaufman M. Safe Neighborhoods and Supportive Communities Protect Children from the Health Effects of Adverse Childhood Experiences (ACEs). J Child Adolesc Trauma 2022; 15:977-986. [PMID: 36439665 PMCID: PMC9684373 DOI: 10.1007/s40653-022-00466-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 06/16/2023]
Abstract
Protective factors such as safe, stable, nurturing relationships and environments can prevent the long-term effects of adverse childhood experiences (ACEs). Recently, policymakers and practitioners have sought to better understand environmental level influences on exposure to ACEs, given the crucial role of social determinants of health in alleviating racial health inequities. Thus, this study seeks to understand how ACEs can be mitigated through neighborhood-level factors; it examines the relationships among ACEs, safe and supportive neighborhoods, and overall health status by race/ethnicity using a national data sample. Data were obtained from 30,530 households with children who participated in the 2018 National Survey for Children's Health, a nationally representative survey. Using multivariable logistic regression, safe and supportive neighborhoods were assessed as potential moderators of the association between ACEs and overall health status by race/ethnicity. Two separate models were run for each moderator, controlling for sex, age, and gender of the child. The presence of a safe neighborhood weakened the association between ACEs and overall health status. This was demonstrated by lower odds of experiencing poor health. The presence of a supportive neighborhood showed a similar pattern. However, these patterns varied when disaggregating the data by race/ethnicity. This study underscores the importance of community-level prevention and intervention efforts to mitigate the health effects of ACEs. Public health efforts seeking to prevent poor health outcomes should consider the socio-environmental influences on health behaviors across the lifespan and continue to address the varying needs of historically disadvantaged populations.
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Affiliation(s)
- Aditi Srivastav
- Children’s Trust of South Carolina, Columbia, SC USA
- Department of Health Promotion Education and Behavior, University of South Carolina, Columbia, SC USA
| | | | - Amanda Stafford McRell
- Children’s Trust of South Carolina, Columbia, SC USA
- College of Social Work, University of South Carolina, Columbia, SC USA
| | - Menolly Kaufman
- Center for Health Systems Effectiveness, Oregon Health Sciences University, OR Portland, USA
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22
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Yim G, Reynaga L, Nunez V, Howe CG, Romano ME, Chen Y, Karagas MR, Toledo-Corral C, Farzan SF. Perinatal Metal and Metalloid Exposures and Offspring Cardiovascular Health Risk. Curr Environ Health Rep 2022; 9:714-34. [PMID: 35980568 DOI: 10.1007/s40572-022-00377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Toxic metal exposures have been associated with cardiovascular disease in adults and growing evidence suggests metal exposures also adversely affect cardiovascular phenotypes in childhood and adolescence. However, to our knowledge, the influence of perinatal metals exposure, particularly metal mixtures, in relation to cardiovascular-related outcomes have not been comprehensively reviewed. RECENT FINDINGS We summarized 17 contemporary studies (2017-2021) that investigated the impact of perinatal metal exposures on measures of cardiovascular health in children. Accumulating evidence supports a potential adverse impact of perinatal Pb exposure on BP in children. Fewer recent studies have focused on perinatal As, Hg, and Cd; thus, the cardiovascular impacts of these metals are less clear. Studies of metal mixtures demonstrate that interactions between metals may be complex and have identified numerous understudied elements and essential metals, including Mo, Co, Ni, Se, Zn, and Mn, which may influence cardiovascular risk. A key question that remains is whether perinatal metals exposure influences cardiovascular health into adulthood. Comparisons across studies remain challenging due to several factors, including differences in the timing of exposure/outcome assessments and exposure biomarkers, as well as variability in exposure levels and mixture compositions across populations. Future studies longitudinally investigating trajectories of cardiovascular outcomes could help determine the influence of perinatal metals exposure on long-term effects of clinical relevance in later life and whether interventions, which reduce metals exposures during this key developmental window, could alter disease development.
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Axelrad DA, Coffman E, Kirrane EF, Klemick H. The relationship between childhood blood lead levels below 5 µg/dL and childhood intelligence quotient (IQ): Protocol for a systematic review and meta-analysis. Environ Int 2022; 169:107475. [PMID: 36162279 PMCID: PMC9896788 DOI: 10.1016/j.envint.2022.107475] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND The causal association between childhood lead (Pb) exposure and decrements in intelligence quotient (IQ) is well-established, and no safe blood lead level (BLL) in children has been identified. An international pooled analysis of seven prospective studies published by Lanphear et al. in 2005 quantified the relationship between childhood BLL and IQ. Further studies of Pb and IQ have been published more recently with mean BLLs generally lower than in the studies analyzed by Lanphear et al. In this article, we present the protocol for a systematic review to estimate an updated Pb-IQ relationship focusing on BLLs below 5 µg per deciliter (µg/dL). STUDY QUESTION What is the quantitative relationship between childhood BLLs and IQ at ages 3-17 years at BLLs below 5 μg/dL? DATA SOURCES A comprehensive search of the scientific literature will utilize citation mapping and key word searching. In the citation mapping approach, we will identify seed references that are relevant to our study question, and will then identify more recent references that have cited at least one of the seed references. The key word search will be conducted in the PubMed, Biosis Previews, Scopus, and Web of Science databases. We will also search electronic grey literature databases for conference proceedings, dissertations, and preprints. STUDY ELIGIBILITY CRITERIA, STUDY SCREENING AND DATA EXTRACTION We will include studies that measured BLL in children at any age, assessed full-scale IQ of the same children (concurrent with or subsequent to BLL sample collection) at ages 3-17, and estimated a continuous quantitative relationship between BLL and IQ. We will consider only studies with a central tendency BLL < 10 µg/dL. The title and abstract of each record will be reviewed independently by two authors to determine whether the study in question satisfies the inclusion criteria. The full text of each article remaining after title-abstract screening will be reviewed independently by two authors to determine whether the study in question satisfies the inclusion criteria. Two authors will independently extract study characteristics and data from each included study. RISK OF BIAS ASSESSMENT Studies meeting inclusion criteria will be evaluated for risk of bias (RoB) using the Navigation Guide method applied in a previous systematic review of neurodevelopmental effects (Lam et al., 2017), with adaptation to our study question. Each study will be independently evaluated by two review authors. DATA ANALYSIS AND SYNTHESIS We intend to conduct a random-effects meta-analysis to summarize the effects of children's exposure to Pb on IQ scores. Additionally, we plan to perform sensitivity analyses using sub-group analyses and/or meta-regression techniques to assess the impact of study design and study population characteristics to examine potential heterogeneity of results across studies. We will assign a confidence level rating (high, moderate, low, or very low) to the effect estimate from the meta-analyses/meta-regressions.
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Affiliation(s)
| | - Evan Coffman
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, NC, USA.
| | - Ellen F Kirrane
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, NC, USA.
| | - Heather Klemick
- U.S. Environmental Protection Agency, Office of Policy, National Center for Environmental Economics, Washington, DC, USA.
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Deziel NC, Clark CJ, Casey JA, Bell ML, Plata DL, Saiers JE. Assessing Exposure to Unconventional Oil and Gas Development: Strengths, Challenges, and Implications for Epidemiologic Research. Curr Environ Health Rep 2022; 9:436-450. [PMID: 35522388 PMCID: PMC9363472 DOI: 10.1007/s40572-022-00358-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Epidemiologic studies have observed elevated health risks in populations living near unconventional oil and gas development (UOGD). In this narrative review, we discuss strengths and limitations of UOG exposure assessment approaches used in or available for epidemiologic studies, emphasizing studies of children's health outcomes. RECENT FINDINGS Exposure assessment challenges include (1) numerous potential stressors with distinct spatiotemporal patterns, (2) critical exposure windows that cover long periods and occur in the past, and (3) limited existing monitoring data coupled with the resource-intensiveness of collecting new exposure measurements to capture spatiotemporal variation. All epidemiologic studies used proximity-based models for exposure assessment as opposed to surveys, biomonitoring, or environmental measurements. Nearly all studies used aggregate (rather than pathway-specific) models, which are useful surrogates for the complex mix of potential hazards. Simple and less-specific exposure assessment approaches have benefits in terms of scalability, interpretability, and relevance to specific policy initiatives such as set-back distances. More detailed and specific models and metrics, including dispersion methods and stressor-specific models, could reduce exposure misclassification, illuminate underlying exposure pathways, and inform emission control and exposure mitigation strategies. While less practical in a large population, collection of multi-media environmental and biological exposure measurements would be feasible in cohort subsets. Such assessments are well-suited to provide insights into the presence and magnitude of exposures to UOG-related stressors in relation to spatial surrogates and to better elucidate the plausibility of observed effects in both children and adults.
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Affiliation(s)
- Nicole C. Deziel
- grid.47100.320000000419368710Department of Environmental Health Sciences, Yale School of Public Health, 60 College St., New Haven, CT 06510 USA
| | - Cassandra J. Clark
- grid.47100.320000000419368710Department of Environmental Health Sciences, Yale School of Public Health, 60 College St., New Haven, CT 06510 USA
| | - Joan A. Casey
- grid.21729.3f0000000419368729Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 630 West 168th Street, Room 16-416, New York, NY 10032 USA
| | - Michelle L. Bell
- Yale School of the Environment, 195 Prospect St., New Haven, CT 06511 USA
| | - Desiree L. Plata
- grid.116068.80000 0001 2341 2786Department of Civil and Environmental Engineering, Parsons Laboratory, Massachusetts Institute of Technology, 15 Vassar Street, Cambridge, MA 02139 USA
| | - James E. Saiers
- Yale School of the Environment, 195 Prospect St., New Haven, CT 06511 USA
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Sprague NL, Bancalari P, Karim W, Siddiq S. Growing up green: a systematic review of the influence of greenspace on youth development and health outcomes. J Expo Sci Environ Epidemiol 2022; 32:660-681. [PMID: 35614136 PMCID: PMC9482936 DOI: 10.1038/s41370-022-00445-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 05/05/2023]
Abstract
Youth growing up in places with more greenspaces have better developmental outcomes. The literature on greenspace and youth development is largely cross-sectional, thus limited in terms of measuring development and establishing causal inference. We conducted a systematic review of prospective, longitudinal studies measuring the association between greenspace exposure and youth development outcomes measured between ages two and eighteen. We searched Cochrane, PubMed, CINAHL, Scopus, and Environment Complete, and included prospective cohort, quasi-experimental, and experimental studies on greenspace and youth development. Study quality was assessed using a 10-item checklist adapted from a previously published review on greenspace and health. Twenty-eight studies met criteria for review and were grouped into five thematic categories based on reported outcomes: cognitive and brain development, mental health and wellbeing, attention and behavior, allergy and respiratory, and obesity and weight. Seventy-nine percent of studies suggest an association between greenspace and improved youth development. Most studies were concentrated in wealthy, Western European countries, limiting generalizability of findings. Key opportunities for future research include: (1) improved uniformity of standards in measuring greenspace, (2) improved measures to account for large latency periods between greenspace exposure and developmental outcomes, and (3) more diverse study settings and populations.
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Affiliation(s)
- Nadav L Sprague
- Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Pilar Bancalari
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Wasie Karim
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Shabnaz Siddiq
- Columbia University Mailman School of Public Health, New York, NY, USA
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Amaya-Castellanos C, Gamboa-Delgado EM, Santacruz-Chasoy E, Pelcastre-Villafuerte BE. Loss of ancestral food practices and perception of its effect on children's health among Inga indigenous grandmothers, Nariño, Colombia. BMC Public Health 2022; 22:1452. [PMID: 35907810 PMCID: PMC9338638 DOI: 10.1186/s12889-022-13828-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Novel foods and dietary practices, a lack of available land, and displacement by armed conflict have affected the ancestral food traditions practiced by the Inga community in Aponte, in Nariño, Colombia. These factors have led to problems with food security and malnutrition, which have impacted the growth and development of children. Therefore, this study is aimed at identifying the changes in ancestral food practices reported by Inga grandmothers, and the possibility of recuperating them in order to improve children's health. METHOD A qualitative study was conducted that included 24 mothers with children under five years old and 25 grandmothers in nine Inga communities. Participants were recruited using snowball sampling. Free listing was used to identify changes in food patterns, and semi-structured interviews were conducted with 20 grandmothers to delve deeper into the subject. A translator of the Inga language facilitated communication, and the Inga researcher validated the translation using audio recordings. Each interview was transcribed and categorized for the purpose of analysis, using the NVivo 12 software. RESULTS Free lists showed changes from a corn-based to a rice-based diet and a wide variety of non-ancestral food products. According to the grandmothers, "tiendas" have replaced traditional foods with those that are easy to prepare, which are attractive to mothers as well as to the children because of their flavor. Ancestral practices such as grinding, peeling, and log cooking are being abandoned. Government programs and daycare have incorporated new food that compete with traditional ones, with no clear evidence of an intercultural approach. Added to this is the dismissal by young mothers of the knowledge held by their grandmothers, which hinders the continuation of traditions. CONCLUSIONS The findings suggest that it is necessary to prevent the loss of the Inga food culture, and policies need to be created that promote and protect ancestral knowledge and that help to regain the value of the "chagra" farming system, with the support of elders, authorities who are recognized by the community, and government technicians, as recommended by the grandmothers who participated in this study.
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Affiliation(s)
- Claudia Amaya-Castellanos
- Departamento de Salud Pública, Escuela de Medicina, Universidad Industrial de Santander, Carrera 32 #29-31, Bucaramanga, Colombia. .,Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain.
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Payton C, Mishkin K, Davis CA, Katzburg J, Walker DK. A Review of the Maternal and Child Health APHA Policy Statements, 1970-2019. Matern Child Health J 2022:10.1007/s10995-022-03398-2. [PMID: 35522358 DOI: 10.1007/s10995-022-03398-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/23/2022] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The American Public Health Association (APHA) policy statements are written by members and approved by the APHA Governing Council. Policy statements inform APHA's position on key public health issues. Maternal and child health (MCH) is a broad discipline focused on health issues concerning women, children, youth, and families. APHA's MCH policies from the last 50 years were reviewed in celebration of the 100th anniversary of the MCH Section of APHA. METHODS A cross-sectional design was utilized to identify MCH-related statements within the larger APHA policy statement database from 1970 to 2019 (N = 1,110). The policy statements were coded as primary MCH (main focus was MCH) or secondary MCH (mentioned MCH subpopulations as vulnerable population). The primary MCH themes were also identified. RESULTS 545 (49%) of the APHA policy statements were related to MCH, including 226 (20%) coded as primary MCH and 319 (29%) secondary MCH. The primary MCH policy statements had a main focus on the following subpopulations: women (44%), children (33%), adolescents/young adults (15%), infants (12%), families (5%), and men (2%). Major themes included reproductive health/family planning, school health, children's health, pregnancy/childbirth, and breastfeeding/nutrition. CONCLUSIONS MCH policy statements remained an important part of APHA's policy and advocacy focus over time as indicated through the continuous high number and proportion of MCH policy statements. The historical overview of MCH policy provides insight into critical policy issues confronting the MCH field over the decades and provides guidance for future policy initiatives including a need for increased emphasis on diverse MCH populations. SIGNIFICANCE This analysis provides a 50 year overview of MCH themes as viewed by the policy statements published by APHA, the largest public health professional organization in the United States. These policy statements represent the cutting edge of MCH policy efforts and were written to influence national, state, and local public health policy. APHA policy statements should continue to address these important MCH topics in the future with an increased emphasis on diverse MCH populations. APHA policy making is a valuable national professional activity for the MCH field with the goal of improving the health for MCH communities.
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Affiliation(s)
- Colleen Payton
- School of Nursing and Public Health, Moravian University, 18018, Bethlehem, PA, USA.
| | | | - Cee Ann Davis
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 23298, Richmond, VA, USA
| | - Judith Katzburg
- VA Greater Los Angeles Healthcare System, 91343, North Hills, CA, United States
| | - Deborah Klein Walker
- Boston University School of Public Health and Tufts University School of Medicine, 02118, Boston, MA, USA
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Donley N, Bullard RD, Economos J, Figueroa I, Lee J, Liebman AK, Martinez DN, Shafiei F. Pesticides and environmental injustice in the USA: root causes, current regulatory reinforcement and a path forward. BMC Public Health 2022; 22:708. [PMID: 35436924 PMCID: PMC9017009 DOI: 10.1186/s12889-022-13057-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/22/2022] [Indexed: 12/20/2022] Open
Abstract
Many environmental pollutants are known to have disproportionate effects on Black, Indigenous and People of Color (BIPOC) as well as communities of low-income and wealth. The reasons for these disproportionate effects are complex and involve hundreds of years of systematic oppression kept in place through structural racism and classism in the USA. Here we analyze the available literature and existing datasets to determine the extent to which disparities in exposure and harm exist for one of the most widespread pollutants in the world – pesticides. Our objective was to identify and discuss not only the historical injustices that have led to these disparities, but also the current laws, policies and regulatory practices that perpetuate them to this day with the ultimate goal of proposing achievable solutions. Disparities in exposures and harms from pesticides are widespread, impacting BIPOC and low-income communities in both rural and urban settings and occurring throughout the entire lifecycle of the pesticide from production to end-use. These disparities are being perpetuated by current laws and regulations through 1) a pesticide safety double standard, 2) inadequate worker protections, and 3) export of dangerous pesticides to developing countries. Racial, ethnic and income disparities are also maintained through policies and regulatory practices that 4) fail to implement environmental justice Executive Orders, 5) fail to account for unintended pesticide use or provide adequate training and support, 6) fail to effectively monitor and follow-up with vulnerable communities post-approval, and 7) fail to implement essential protections for children. Here we’ve identified federal laws, regulations, policies, and practices that allow for disparities in pesticide exposure and harm to remain entrenched in everyday life for environmental justice communities. This is not simply a pesticides issue, but a broader public health and civil rights issue. The true fix is to shift the USA to a more just system based on the Precautionary Principle to prevent harmful pollution exposure to everyone, regardless of skin tone or income. However, there are actions that can be taken within our existing framework in the short term to make our unjust regulatory system work better for everyone.
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Mrozkowiak M, Stępień-Słodkowska M. The impact of a school backpack's weight, which is carried on the back of a 7-year-old students of both sexes, on the features of body posture in the frontal plane. BMC Sports Sci Med Rehabil 2022; 14:57. [PMID: 35366944 PMCID: PMC8976297 DOI: 10.1186/s13102-022-00448-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background The lifestyle of children has a significant impact on the future health of the whole society. Therefore, health education, prevention and monitoring of health determinants is important at every stage of ontogenesis. This requires a thorough knowledge of the schoolchild's environment, perceived as a wide set of stressors, including not only genetic but also epigenetic factors. One of them is the issue of the correct and abnormal body posture at school and on the way there. The goal of the study was to show the influence of the weight of the back carried container with school supplies on body posture. Method The research was carried out as part of a project that examined the impact of carrying weights, which are school supplies, by children on their posture. The research material consisted of data obtained from a group of 65 students (35 girls, 30 boys) aged 7 years. Body posture tests were carried out, using the projection moiré method in 4 positions: 1-habitual posture, 2-posture after 10-min of asymmetric axial load, 3-a posture after 1 min of the load removal, 4-a posture after two minutes of the load removal. Physical fitness was measured with the Sekita test. The obtained data were statistically analyzed. Results The significance of differences between the 1st and 2nd measurements was analyzed to determine the impact of the backpack load and the correlation with physical fitness, and to study its influence on the value of the differences in posture features. Considering the differences in the volume of posture features among boys between the 1st and 2nd measurement, the Wilcoxon’s rank test showed a statistically significant difference in the range of all analyzed variables, except for the torso bend angle to the right (KNT+), where no statistically significant change was noted. A statistically significant difference in the volume of all analyzed variables was observed among the girls. Conclusions Carrying school supplies on the back induces significant changes in the value of the features describing the body posture in the frontal plane. The greater weight of the container and carrying time, and intensity of physical effort is the greater the changes will be. Physical fitness has a various and sex-dependent influence on the value of changes in body posture features because of carrying school supplies. Among boys it significantly affects the asymmetry of the torso bend, shoulder height, the waist triangles height and width, whereas among girls it affects the asymmetry of the shoulders and the distance of the angles of the lower shoulder blades from the line of the spinous processes of the spine. Among boys the changes in the value of posture features are mostly influenced by endurance and speed, but strength, power and agility are of lower influence, whereas among girls only agility matters.
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Affiliation(s)
| | - Marta Stępień-Słodkowska
- Faculty of Physical Culture and Health, Institute of Physical Culture Sciences, University of Szczecin, Al. Piastów 40B blok 6, 71-065, Szczecin, Poland.
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30
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Preece AS, Knutz M, Lindh CH, Bornehag CG, Shu H. Prenatal phthalate exposure and early childhood wheeze in the SELMA study. J Expo Sci Environ Epidemiol 2022; 32:303-311. [PMID: 34475495 DOI: 10.1038/s41370-021-00382-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/20/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Prenatal maternal phthalate exposure has been associated with wheeze and asthma in children, but results are inconclusive. Previous studies typically assessed exposure in late pregnancy, included only a small number of old phthalates, and assessed outcomes in children aged 5 years or older. OBJECTIVE We explored associations between 1st trimester prenatal maternal exposure to a wider range of phthalates and wheeze in early childhood. METHODS First trimester concentrations of 14 metabolites from 8 phthalates and one alternative plasticizer were quantified in first-morning void urine from 1148 mothers in the Swedish SELMA study. Associations between log-transformed metabolite concentrations and parental reported ever wheeze among 24-month-old children were investigated with logistic regression models adjusted for parental asthma/rhinitis, sex of child, maternal education, smoking, and creatinine. RESULTS Metabolites of replacement phthalates di-iso-decyl phthalate (DiDP) and di-2-propylheptyl phthalate (DPHP) were associated with increased risk for wheeze (aOR 1.47, 95% CI 1.08-2.01 and aOR 1.49, 95% CI 1.04-2.15, respectively). The associations with DiDP and DPHP were stronger among children whose parents did not have asthma or rhinitis. In this group, wheeze was also associated with metabolites of butyl-benzyl phthalate (BBzP) and di-iso-nonyl phthalate (DiNP). SIGNIFICANCE Maternal phthalate exposure during early pregnancy may be a risk factor for wheeze in early childhood, especially among children whose parents do not have asthma or rhinitis symptoms.
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Affiliation(s)
- Anna-Sofia Preece
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Malin Knutz
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Huan Shu
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.
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31
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Carriedo A, Cecchini JA. A Longitudinal Examination of Withholding All or Part of School Recess on Children's Physical Activity and Sedentary Behavior: Evidence from a Natural Experiment. Early Child Educ J 2022; 51:605-614. [PMID: 35233160 PMCID: PMC8870077 DOI: 10.1007/s10643-022-01325-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
School recess is a daily opportunity for school-age students to be physically active. However, in some territories teachers often use recess for other purposes (e.g., children's poor classroom behavior might be punished with reduced time for recess). This study aimed to examine the impact of such practices on children's physical activity (PA) and the relationships between PA, gender, body mass index (BMI), and academic achievement. Forty-six first-grade students from two natural classrooms wore an accelerometer over the course of 6 weeks to measure their metabolic equivalent of task (METs) and sedentary behavior during school recess. Gender, age, BMI, the classroom to which students belonged, and academic achievement were also analyzed in two Generalized Estimating Equations models. Results revealed that boys achieved more METs and spent less time participating in sedentary behavior than girls during recess. Children within a healthy weight range of BMI yielded more METs than underweight and overweight/obese children. Academic achievement was positively associated with the METS and negatively with the sedentary behavior. Finally, withholding all or part of school recess significantly reduced children's PA and extended their sedentary behavior. The literature indicates that school recess plays an important role in promoting numerous children's health outcomes. Therefore, students should not be excluded from participation in all or part of recess.
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Affiliation(s)
- Alejandro Carriedo
- Department of Education Sciences, University of Oviedo, Oviedo, Spain
- Department of Education Sciences, Faculty of Teacher Training and Education, University of Oviedo, C/ Aniceto Sela, s/n, Office 215, Oviedo, Spain
| | - José A. Cecchini
- Department of Education Sciences, University of Oviedo, Oviedo, Spain
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Hubal EAC, DeLuca NM, Mullikin A, Slover R, Little JC, Reif DM. Demonstrating a systems approach for integrating disparate data streams to inform decisions on children's environmental health. BMC Public Health 2022; 22:313. [PMID: 35168583 PMCID: PMC8845296 DOI: 10.1186/s12889-022-12682-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background The use of systems science methodologies to understand complex environmental and human health relationships is increasing. Requirements for advanced datasets, models, and expertise limit current application of these approaches by many environmental and public health practitioners. Methods A conceptual system-of-systems model was applied for children in North Carolina counties that includes example indicators of children’s physical environment (home age, Brownfield sites, Superfund sites), social environment (caregiver’s income, education, insurance), and health (low birthweight, asthma, blood lead levels). The web-based Toxicological Prioritization Index (ToxPi) tool was used to normalize the data, rank the resulting vulnerability index, and visualize impacts from each indicator in a county. Hierarchical clustering was used to sort the 100 North Carolina counties into groups based on similar ToxPi model results. The ToxPi charts for each county were also superimposed over a map of percentage county population under age 5 to visualize spatial distribution of vulnerability clusters across the state. Results Data driven clustering for this systems model suggests 5 groups of counties. One group includes 6 counties with the highest vulnerability scores showing strong influences from all three categories of indicators (social environment, physical environment, and health). A second group contains 15 counties with high vulnerability scores driven by strong influences from home age in the physical environment and poverty in the social environment. A third group is driven by data on Superfund sites in the physical environment. Conclusions This analysis demonstrated how systems science principles can be used to synthesize holistic insights for decision making using publicly available data and computational tools, focusing on a children’s environmental health example. Where more traditional reductionist approaches can elucidate individual relationships between environmental variables and health, the study of collective, system-wide interactions can enable insights into the factors that contribute to regional vulnerabilities and interventions that better address complex real-world conditions. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12682-3.
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Affiliation(s)
- Elaine A Cohen Hubal
- Center for Public Health and Environmental Assessment, US EPA, Research Triangle Park, NC, USA.
| | - Nicole M DeLuca
- Center for Public Health and Environmental Assessment, US EPA, Research Triangle Park, NC, USA
| | - Ashley Mullikin
- Center for Public Health and Environmental Assessment, US EPA, Research Triangle Park, NC, USA
| | - Rachel Slover
- Center for Public Health and Environmental Assessment, US EPA, Research Triangle Park, NC, USA
| | - John C Little
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - David M Reif
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
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DZIARZHYNSKAYA NADZEYA, HINDZIUK ANDREY, HINDZIUK LARISA, SYSOEVA IRINA, KRUPSKAYA DARYA, URBAN ULIA, CHERNIAVSKAYA NATALYA, VISHNEVSKAYA ALEXANDRA, MAKAROVA ELENA, ERMAK SVETLANA, HINDZIUK NELLI. Airborne chemical pollution and children's asthma incidence rate in Minsk. J Prev Med Hyg 2022; 62:E871-E878. [PMID: 35603254 PMCID: PMC9104677 DOI: 10.15167/2421-4248/jpmh2021.62.4.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 10/28/2021] [Indexed: 11/12/2022]
Abstract
Introduction Asthma manifestations are closely connected with air pollution. Discovering interconnection between concentrations of air pollutants and asthma incidence rate among children provides information for developing effective measures to reduce air pollution and improve population health. Study purpose was to carry out hygienic analysis of the influence of atmospheric air quality on the incidence rate of bronchial asthma of children in Minsk in 2009-2018. Methods During 2019 retrospective health cohort study was conducted, data from stationary air quality monitoring posts were collected. Correlation analysis was conducted by determining the Pearson coefficient. Results Ten-year levels of asthma incidence rate had a moderate downward trend; the highest levels were registered among 5-9-year-old children. 74.7% of all cases of asthma were registered among children under 10 years: 33,61% among 1-4-year-old and 41.09% - among 5-9-year-old. Results of the study showed that concentrations of ammonia, particulate matter (dust/aerosol undifferentiated in composition) and lead in Minsk were characterized by downward trend, carbon oxide and nitrogen dioxide concentrations remained unstable, elevated levels of formaldehyde remained near highways with heavy traffic. Strong evidence was found for concentrations of particulate matter (dust/aerosol undifferentiated in composition) (R = 0.76-0.85, p < 0.05), lead (R = 0.69-0.97, p < 0.05), ammonia (R = 0.64-0.72, p < 0.05) nitrogen dioxide (R = 0.63-0.8, p < 0.05) and children's asthma incidence rate. Conclusions Obtained results indicate that particulate matter, lead, ammonia and nitrogen dioxide concentrations hesitation causes changes in children's asthma incidence levels. Not being the initial cause of the disease, they influence epidemic process and can be the target for preventive measures.
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Affiliation(s)
- NADZEYA DZIARZHYNSKAYA
- Belarusian State Medical University, Minsk, Belarus
- Correspondence: Nadzeya Dziarzhynskaya, Belarusian State Medical University, Minsk, Belarus; 2 Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus - E-mail:
| | | | | | | | - DARYA KRUPSKAYA
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | - ULIA URBAN
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | | | | | - ELENA MAKAROVA
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | - SVETLANA ERMAK
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | - NELLI HINDZIUK
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
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Gladson LA, Cromar KR, Ghazipura M, Knowland KE, Keller CA, Duncan B. Communicating respiratory health risk among children using a global air quality index. Environ Int 2022; 159:107023. [PMID: 34920275 DOI: 10.1016/j.envint.2021.107023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
Air pollution poses a serious threat to children's respiratory health around the world. Satellite remote-sensing technology and air quality models can provide pollution data on a global scale, necessary for risk communication efforts in regions without ground-based monitoring networks. Several large centers, including NASA, produce global pollution forecasts that may be used alongside air quality indices to communicate local, daily risk information to the public. Here we present a health-based, globally applicable air quality index developed specifically to reflect the respiratory health risks among children exposed to elevated outdoor air pollution. Additive, excess-risk air quality indices were developed using 51 different coefficients derived from time-series health studies evaluating the impacts of ambient fine particulate matter, nitrogen dioxide, and ozone on children's respiratory morbidity outcomes. A total of four indices were created which varied based on whether or not the underlying studies controlled for co-pollutants and in the adjustment of excess risks of individual pollutants. Combined with historical estimates of air pollution provided globally at a 25 × 25 km2 spatial resolution from the NASA's Goddard Earth Observing System composition forecast (GEOS-CF) model, each of these indices were examined in a global sample of 664 small and 140 large cities for study year 2017. Adjusted indices presented the most normal distributions of locally-scaled index values, which has been shown to improve associations with health risks, while indices based on coefficients controlling for co-pollutants had little effect on index performance. We provide the steps and resources need to apply our final adjusted index at the local level using freely-available forecasting data from the GEOS-CF model, which can provide risk communication information for cities around the world to better inform individual behavior modification to best protect children's respiratory health.
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Affiliation(s)
- Laura A Gladson
- Marron Institute of Urban Management, New York University, New York, USA; New York University Grossman School of Medicine, New York, NY, USA
| | - Kevin R Cromar
- Marron Institute of Urban Management, New York University, New York, USA; New York University Grossman School of Medicine, New York, NY, USA.
| | - Marya Ghazipura
- Marron Institute of Urban Management, New York University, New York, USA; New York University Grossman School of Medicine, New York, NY, USA
| | - K Emma Knowland
- Universities Space Research Association, Columbia, MD, USA; NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Christoph A Keller
- Universities Space Research Association, Columbia, MD, USA; NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Bryan Duncan
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
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Abstract
1,3-Butadiene (BD) is a petrochemical manufactured in high volumes. It is a human carcinogen and can induce lymphohematopoietic cancers, particularly leukemia, in occupationally-exposed workers. BD is an air pollutant with the major environmental sources being automobile exhaust and tobacco smoke. It is one of the major constituents and is considered the most carcinogenic compound in cigarette smoke. The BD concentrations in urban areas usually vary between 0.01 and 3.3 μg/m3 but can be significantly higher in some microenvironments. For BD exposure of the general population, microenvironments, particularly indoor microenvironments, are the primary determinant and environmental tobacco smoke is the main contributor. BD has high cancer risk and has been ranked the second or the third in the environmental pollutants monitored in most urban areas, with the cancer risks exceeding 10-5. Mutagenicity/carcinogenicity of BD is mediated by its genotoxic metabolites but the specific metabolite(s) responsible for the effects in humans have not been determined. BD can be bioactivated to yield three mutagenic epoxide metabolites by cytochrome P450 enzymes, or potentially be biotransformed into a mutagenic chlorohydrin by myeloperoxidase, a peroxidase almost specifically present in neutrophils and monocytes. Several urinary BD biomarkers have been developed, among which N-acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine is the most sensitive and is suitable for biomonitoring BD exposure in the general population. Exposure to BD has been associated with leukemia, cardiovascular disease, and possibly reproductive effects, and may be associated with several cancers, autism, and asthma in children. Collectively, BD is a ubiquitous pollutant that has been associated with a range of adverse health effects and diseases with children being a subpopulation with potentially greater susceptibility. Its adverse effects on human health may have been underestimated and more studies are needed.
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Affiliation(s)
- Wan-Qi Chen
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xin-Yu Zhang
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Szpak R, Lombardi NF, Dias FA, Borba HHL, Pontarolo R, Wiens A. Safety of Antiretroviral Therapy in the Treatment of HIV/AIDS in Children: Systematic Review and Meta-analysis. AIDS Rev 2021; 23:196-203. [PMID: 34082441 DOI: 10.24875/aidsrev.200001071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The safety of using different antiretroviral therapies (ART) in pediatric HIV/AIDS patients is not well-established. Therefore, this study aimed to assess the safety of ART in children. A systematic review of randomized clinical trials (RCTs) was conducted to assess the safety of ART used by pediatric patients living with HIV/AIDS. The electronic search was conducted in PubMed and Scopus, in addition to a manual search. Studies were included if they assessed the safety of ART compared to placebo or another ART. Direct and indirect meta-analyses were conducted regarding safety outcomes. The systematic review included 21 RCTs. The studies included more than 5500 participants, and age ranged from 3 months to 18 years. The drugs evaluated were nucleoside reverse transcriptase inhibitors (NRTI); non-NRTI; and protease inhibitors. The predominant route of infection was vertical. Direct meta-analyses were performed for the outcomes sleep disorders, hepatobiliary disorders, respiratory disorders, hypertransaminasemia, neutropenia, hospitalization, and death. For these outcomes, no statistically significant differences were found. Indirect meta-analyses were performed for the outcomes anemia, gastrointestinal disorders, liver disorders, severe adverse events (AE), AE that led to changes in treatment, fever, and skin manifestations. However, no statistically significant differences were found for these outcomes. In this study, non-significant differences were detected in the safety of different ART used in pediatric individuals. The choice of appropriate therapy should be based on its efficacy and the individual characteristics of each patient.
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Affiliation(s)
- Renata Szpak
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba-PR, Brazil
| | - Natália F Lombardi
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba-PR, Brazil
| | - Frederico A Dias
- Centro de Medicamentos do Paraná, Paraná State Health Secretariat, Curitiba-PR, Brazil
| | - Helena H L Borba
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba-PR, Brazil
| | - Roberto Pontarolo
- Pharmacy Department, Federal University of Paraná. Curitiba-PR, Brazil
| | - Astrid Wiens
- Pharmacy Department, Federal University of Paraná. Curitiba-PR, Brazil
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Martínez García L, Samsó Jofra L, Alonso-Coello P, Ansuategi E, Asso Mistral L, Ballesteros M, Canelo-Aybar C, Casino G, Gallego Iborra A, Niño de Guzmán Quispe EP, Requeijo C, Roqué I Figuls M, Salas K, Ubeda M, Urreta I, Rosenbaum S. Teaching and learning how to make informed health choices: Protocol for a context analysis in Spanish primary schools. F1000Res 2021; 10:312. [PMID: 34631019 PMCID: PMC8474100 DOI: 10.12688/f1000research.51961.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction The Informed Health Choices (IHC) project developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore the educational context for teaching and learning critical thinking about health in Spanish primary schools. Methods During the 2020-2021 school year, we will conduct 1) a systematic assessment of educational documents and resources, and 2) semi-structured interviews with key education and health stakeholders. In the systematic assessment of educational documents and resources, we will include state and autonomous communities' curriculums, school educational projects, and commonly used textbooks and other health teaching materials. In the semi-structured interviews, we will involve education and health policy makers, developers of learning resources, developers of health promotion and educational interventions, head teachers, teachers, families, and paediatric primary care providers. We will design and pilot a data extraction form and a semi-structured interview guide to collect the data. We will perform a quantitative and a qualitative analysis of the data to explore how critical thinking about health is being taught and learned in Spanish primary schools. Conclusion We will identify opportunities for and barriers to teaching and learning critical thinking about health in Spanish primary schools. We will formulate recommendations-for both practice and research purposes-on how to use, adapt (if needed), and implement the IHC resources in this context.
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Eukane Ansuategi
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Osakidetza, OSI Donostialdea, University Hospital of Donostia, Library Service, Donostia, Spain
| | - Laia Asso Mistral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | - Monica Ballesteros
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Gonzalo Casino
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Marta Roqué I Figuls
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Karla Salas
- Health Services Research Group - Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mar Ubeda
- Osakidetza, OSI Donostialdea, University Hospital of Donostia, Library Service, Donostia, Spain
| | - Iratxe Urreta
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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Pistollato F, Carpi D, Mendoza-de Gyves E, Paini A, Bopp SK, Worth A, Bal-Price A. Combining in vitro assays and mathematical modelling to study developmental neurotoxicity induced by chemical mixtures. Reprod Toxicol 2021; 105:101-119. [PMID: 34455033 PMCID: PMC8522961 DOI: 10.1016/j.reprotox.2021.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/30/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022]
Abstract
Prenatal and postnatal co-exposure to multiple chemicals at the same time may have deleterious effects on the developing nervous system. We previously showed that chemicals acting through similar mode of action (MoA) and grouped based on perturbation of brain derived neurotrophic factor (BDNF), induced greater neurotoxic effects on human induced pluripotent stem cell (hiPSC)-derived neurons and astrocytes compared to chemicals with dissimilar MoA. Here we assessed the effects of repeated dose (14 days) treatments with mixtures containing the six chemicals tested in our previous study (Bisphenol A, Chlorpyrifos, Lead(II) chloride, Methylmercury chloride, PCB138 and Valproic acid) along with 2,2'4,4'-tetrabromodiphenyl ether (BDE47), Ethanol, Vinclozolin and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)), on hiPSC-derived neural stem cells undergoing differentiation toward mixed neurons/astrocytes up to 21 days. Similar MoA chemicals in mixtures caused an increase of BDNF levels and neurite outgrowth, and a decrease of synapse formation, which led to inhibition of electrical activity. Perturbations of these endpoints are described as common key events in adverse outcome pathways (AOPs) specific for DNT. When compared with mixtures tested in our previous study, adding similarly acting chemicals (BDE47 and EtOH) to the mixture resulted in a stronger downregulation of synapses. A synergistic effect on some synaptogenesis-related features (PSD95 in particular) was hypothesized upon treatment with tested mixtures, as indicated by mathematical modelling. Our findings confirm that the use of human iPSC-derived mixed neuronal/glial models applied to a battery of in vitro assays anchored to key events in DNT AOP networks, combined with mathematical modelling, is a suitable testing strategy to assess in vitro DNT induced by chemical mixtures.
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Affiliation(s)
| | - Donatella Carpi
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | | | - Alicia Paini
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | | | - Andrew Worth
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Anna Bal-Price
- European Commission, Joint Research Centre (JRC), Ispra, Italy.
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Okeke EN, Wagner Z, Abubakar IS. Maternal Cash Transfers Led To Increases In Facility Deliveries And Improved Quality Of Delivery Care In Nigeria. Health Aff (Millwood) 2021; 39:1051-1059. [PMID: 32479220 DOI: 10.1377/hlthaff.2019.00893] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Ninety-nine percent of global maternal deaths occur in low- and middle-income countries. The high mortality rates are often attributed to a large portion of births occurring outside of formal health care facilities. This has prompted the creation of programs to promote the use of formal delivery care. However, poor-quality care in health facilities in low- and middle-income countries is well documented. It is not clear that shifting births into health facilities in these settings necessarily leads to better-quality care. We present results from a randomized controlled trial in Nigeria that evaluated a conditional cash transfer intervention that paid pregnant women to deliver in a health facility. We found that the intervention led to a 41 percent increase in facility deliveries. We also found improvements in the quality of delivery care (as a result of more births taking place in formal health care settings) and in overall satisfaction with care. We found no evidence of a reduction in preventable complications that led to maternal deaths, though we found some improvements in self-reported health. Our results indicate that promoting facility deliveries can improve the quality of care received, even in settings where formal care quality is poor. However, modest quality improvements might not be sufficient to substantially improve health outcomes.
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Affiliation(s)
- Edward N Okeke
- Edward N. Okeke is a senior policy researcher in the Department of Economics, Sociology, and Statistics, RAND Corporation, in Arlington, Virginia, and a professor of policy analysis in the Pardee RAND Graduate School, in Santa Monica, California
| | - Zachary Wagner
- Zachary Wagner is an associate policy researcher in the Department of Economics, Sociology, and Statistics, RAND Corporation, in Santa Monica, California
| | - Isa S Abubakar
- Isa S. Abubakar is a professor of community medicine at Bayero University and Aminu Kano Teaching Hospital, both in Kano, Nigeria
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Abstract
After increasing for nearly two decades, rates of neonatal abstinence syndrome have recently leveled off, reaching a plateau as early as 2014. These findings may represent successful efforts to prevent and treat opioid use before and during pregnancy.
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Affiliation(s)
- Ashley A Leech
- Ashley A. Leech ( ashley. leech@vanderbilt. edu ) is an assistant professor of health policy at Vanderbilt University School of Medicine and faculty member of the Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, in Nashville, Tennessee
| | - William O Cooper
- William O. Cooper is the Cornelius Vanderbilt Professor of Health Policy and Pediatrics at Vanderbilt University School of Medicine and faculty member of the Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center
| | - Elizabeth McNeer
- Elizabeth McNeer is a biostatistician in the Department of Biostatistics at Vanderbilt University School of Medicine and at the Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center
| | - Theresa A Scott
- Theresa A. Scott is a senior application developer at the Vanderbilt Center for Child Health Policy, Pediatrics, and Mildred Stahlman Division of Neonatology, Vanderbilt University Medical Center
| | - Stephen W Patrick
- Stephen W. Patrick is an associate professor of pediatrics and health policy at Vanderbilt University School of Medicine, practicing neonatologist in the Division of Neonatology at Vanderbilt University Medical Center, and director of the Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center
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Hyland C, Bradshaw PT, Gunier RB, Mora AM, Kogut K, Deardorff J, Sagiv SK, Bradman A, Eskenazi B. Associations between pesticide mixtures applied near home during pregnancy and early childhood with adolescent behavioral and emotional problems in the CHAMACOS study. Environ Epidemiol 2021; 5:e150. [PMID: 34131613 DOI: 10.1097/EE9.0000000000000150] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/15/2021] [Indexed: 11/26/2022] Open
Abstract
Supplemental Digital Content is available in the text. Studies suggest that exposure to pesticides during pregnancy and early childhood is associated with adverse child neurodevelopment. Research to date has focused primarily on exposure to single pesticides or pesticide classes in isolation; there are little data on the effect of exposure to pesticide mixtures on child and adolescent neurodevelopment.
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Van Horne YO, Farzan SF, Johnston JE. Metal-mixtures in toenails of children living near an active industrial facility in Los Angeles County, California. J Expo Sci Environ Epidemiol 2021; 31:427-441. [PMID: 33935287 PMCID: PMC8893014 DOI: 10.1038/s41370-021-00330-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 05/15/2023]
Abstract
BACKGROUND Children residing in communities near metalworking industries are vulnerable to multiple toxic metal exposures. Understanding biomarkers of exposure to multiple toxic metals is important to characterize cumulative burden and to distinguish potential exposure sources in such environmental justice neighborhoods impacted by industrial operations. Exposure to metal mixtures has not been well-characterized among children residing in the United States, and is understudied in communities of color. METHODS In this study we used toenail clippings, a noninvasive biomarker, to assess exposure to arsenic (As), cadmium (Cd), mercury (Hg), manganese (Mn), lead (Pb), antimony (Sb), selenium (Se), and vanadium (V). We used nonnegative matrix factorization (NMF) to identify "source" signatures and patterns of exposure among predominantly working class Latinx children residing near an industrial corridor in Southeast Los Angeles County. Additionally, we investigated the association between participant demographic, spatial, and dietary characteristics with identified metal signatures. RESULTS Through NMF, we identified three groupings (source factors) for the metal concentrations in children's toenails. A grouping composed of Sb, Pb, As, and Cd, was identified as a potential industrial source factor, reflective of known airborne elemental emissions in the industrial corridor. We further identified a manganese source factor primarily composed of Mn, and a potential dietary source factor driven by Se and Hg. We observed differences in the industrial source factor by age of participants, while the dietary source factor varied by neighborhood. CONCLUSION Utilizing an unsupervised dimension reduction technique (NMF), we identified a "source signature" of contamination in toenail samples from children living near metalworking industry. Investigating patterns and sources of exposures in cumulatively burdened communities is necessary to identify appropriate public health interventions.
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Affiliation(s)
- Yoshira Ornelas Van Horne
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Shohreh F Farzan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jill E Johnston
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Zhang X, Smith N, Spear E, Stroustrup A. Neighborhood characteristics associated with COVID-19 burden-the modifying effect of age. J Expo Sci Environ Epidemiol 2021; 31:525-537. [PMID: 33947953 PMCID: PMC8095472 DOI: 10.1038/s41370-021-00329-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Neighborhood characteristics have been linked to community incidence of COVID-19, but the modifying effect of age has not been examined. OBJECTIVE We adapted a neighborhood-wide analysis study (NWAS) design to systematically examine associations between neighborhood characteristics and COVID-19 incidence among different age groups. METHODS The number of daily cumulative cases of COVID-19 by zip code area in Illinois has been made publicly available by the Illinois Department of Public Health. The number of COVID-19 cases was reported for eight age groups (under 20, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80+). We reviewed this data published from May 23 through June 17, 2020 with complete data for all eight age groups and linked the data to neighborhood characteristics measured by the American Community Survey (ACS). Geographic age-specific cumulative incidence (cases per 1000 people) of COVID-19 was calculated by dividing the number of daily cumulative cases by the population of the same age group at each zip code area. The association between individual characteristics and COVID-19 incidence was examined using Poisson regression models. RESULTS At the zip code level, neighborhood socioeconomic status was a more important risk factor of COVID-19 incidence in children and working-age adults than in seniors. Social demographics and housing conditions were important risk factors of COVID-19 incidence in older age groups. We additionally observed significant associations between transportation-related variables and COVID-19 incidences in multiple age groups. SIGNIFICANCE We concluded that age modified the association between neighborhood characteristics and COVID-19 incidence.
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Affiliation(s)
- Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Norah Smith
- The Bronx High School of Science, Bronx, NY, USA
| | - Emily Spear
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Annemarie Stroustrup
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Neonatology, Cohen Children's Medical Center, Northwell Health, New Hyde Park, NY, USA
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Moruzi K, Chen SWS, Venzo P. Public Health, Polio, and Pandemics: Fear and Anxiety about Health in Children's Literature. Child Lit Educ 2021; 53:97-111. [PMID: 35599955 PMCID: PMC7920846 DOI: 10.1007/s10583-021-09439-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 06/15/2023]
Abstract
In this article, we begin by discussing approximately thirty picture books dealing with the COVID-19 pandemic published digitally in the United States, the United Kingdom, Australia, and other English-speaking countries in the first six months of 2020. The worldwide impact of COVID-19 resulted in the rapid global digital publication of numerous English-language children's picture books aimed at informing child readers about public health concerns and how children could contribute to improving health outcomes. This exploration of contemporary picture books is intertwined with examinations of two other public health crises that appeared in literature for children: the discussion of British children's health in the Junior Red Cross Magazine in the 1920s and the American polio outbreak discussed in educational materials and fiction in the 1940s and 1950s. These comparisons not only enable us to situate the COVID-19 pandemic within a history of transnational responses to concerns about children's health but also to expand our understanding of how children are positioned to take individual responsibility for community public health issues. This wide range of Anglophone texts published in the United Kingdom, the United States, and around the world demonstrates the extent to which adults attempt to guide children towards specific behaviours to promote individual health. They also reflect a common understanding of childhood in which children have an obligation to contribute to societal wellbeing through their individual actions.
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Affiliation(s)
- Kristine Moruzi
- Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | | | - Paul Venzo
- Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
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Abstract
In studies of maternal exposure to air pollution, a children's health outcome is regressed on exposures observed during pregnancy. The distributed lag nonlinear model (DLNM) is a statistical method commonly implemented to estimate an exposure-time-response function when it is postulated the exposure effect is nonlinear. Previous implementations of the DLNM estimate an exposure-time-response surface parameterized with a bivariate basis expansion. However, basis functions such as splines assume smoothness across the entire exposure-time-response surface, which may be unrealistic in settings where the exposure is associated with the outcome only in a specific time window. We propose a framework for estimating the DLNM based on Bayesian additive regression trees. Our method operates using a set of regression trees that each assume piecewise constant relationships across the exposure-time space. In a simulation, we show that our model outperforms spline-based models when the exposure-time surface is not smooth, while both methods perform similarly in settings where the true surface is smooth. Importantly, the proposed approach is lower variance and more precisely identifies critical windows during which exposure is associated with a future health outcome. We apply our method to estimate the association between maternal exposures to PM$_{2.5}$ and birth weight in a Colorado, USA birth cohort.
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Affiliation(s)
- Daniel Mork
- Statistics Department, Colorado State University, 1877 Campus Delivery, Fort Collins, CO, USA 80523
| | - Ander Wilson
- Statistics Department, Colorado State University, 1877 Campus Delivery, Fort Collins, CO, USA 80523
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Birks LE, van Wel L, Liorni I, Pierotti L, Guxens M, Huss A, Foerster M, Capstick M, Eeftens M, El Marroun H, Estarlich M, Gallastegi M, Safont LG, Joseph W, Santa-Marina L, Thielens A, Torrent M, Vrijkotte T, Wiart J, Röösli M, Cardis E, Vermeulen R, Vrijheid M. Radiofrequency electromagnetic fields from mobile communication: Description of modeled dose in brain regions and the body in European children and adolescents. Environ Res 2021; 193:110505. [PMID: 33245886 DOI: 10.1016/j.envres.2020.110505] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Little is known about radiofrequency electromagnetic fields (RF) from mobile technology and resulting dose in young people. We describe modeled integrated RF dose in European children and adolescents combining own mobile device use and surrounding sources. METHODS Using an integrated RF model, we estimated the daily RF dose in the brain (whole-brain, cerebellum, frontal lobe, midbrain, occipital lobe, parietal lobe, temporal lobes) and the whole-body in 8358 children (ages 8-12) and adolescents (ages 14-18) from the Netherlands, Spain, and Switzerland during 2012-2016. The integrated model estimated RF dose from near-field sources (digital enhanced communication technology (DECT) phone, mobile phone, tablet, and laptop) and far-field sources (mobile phone base stations via 3D-radiowave modeling or RF measurements). RESULTS Adolescents were more frequent mobile phone users and experienced higher modeled RF doses in the whole-brain (median 330.4 mJ/kg/day) compared to children (median 81.8 mJ/kg/day). Children spent more time using tablets or laptops compared to adolescents, resulting in higher RF doses in the whole-body (median whole-body dose of 81.8 mJ/kg/day) compared to adolescents (41.9 mJ/kg/day). Among brain regions, temporal lobes received the highest RF dose (medians of 274.9 and 1786.5 mJ/kg/day in children and adolescents, respectively) followed by the frontal lobe. In most children and adolescents, calling on 2G networks was the main contributor to RF dose in the whole-brain (medians of 31.1 and 273.7 mJ/kg/day, respectively). CONCLUSION This first large study of RF dose to the brain and body of children and adolescents shows that mobile phone calls on 2G networks are the main determinants of brain dose, especially in temporal and frontal lobes, whereas whole-body doses were mostly determined by tablet and laptop use. The modeling of RF doses provides valuable input to epidemiological research and to potential risk management regarding RF exposure in young people.
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Affiliation(s)
- Laura Ellen Birks
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Luuk van Wel
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Ilaria Liorni
- Foundation for Research on Information Technologies in Society (IT'IS), Zurich, Switzerland
| | - Livia Pierotti
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Milena Foerster
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Myles Capstick
- Foundation for Research on Information Technologies in Society (IT'IS), Zurich, Switzerland
| | - Marloes Eeftens
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, the Netherlands; Department of Psychology, Education and Child Studies - Erasmus University Rotterdam, the Netherlands
| | - Marisa Estarlich
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Faculty of Nursing and Chiropody, Universitat de València, Spain
| | - Mara Gallastegi
- BIODONOSTIA Health Research Institute, Dr. Begiristain Pasealekua, San Sebastian, Spain
| | - Llúcia González Safont
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Wout Joseph
- Department of Information Technology, Ghent University/IMEC, Technologiepark 126, Ghent, 9052, Belgium
| | - Loreto Santa-Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; BIODONOSTIA Health Research Institute, Dr. Begiristain Pasealekua, San Sebastian, Spain; Department of Health of the Basque Government, Public Health Division of Gipuzkoa, Donostia-San Sebastián, Spain
| | - Arno Thielens
- Department of Information Technology, Ghent University/IMEC, Technologiepark 126, Ghent, 9052, Belgium
| | - Maties Torrent
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Tanja Vrijkotte
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Joe Wiart
- Télécom ParisTech, LTCI University Paris Saclay, Chair C2M, Paris, France
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Elisabeth Cardis
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; School of Public Health, Imperial College London, London, UK
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
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Lome-Hurtado A, Lartigue-Mendoza J, Trujillo JC. Modelling local patterns of child mortality risk: a Bayesian Spatio-temporal analysis. BMC Public Health 2021; 21:29. [PMID: 33407261 PMCID: PMC7789513 DOI: 10.1186/s12889-020-10016-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, child mortality rate has remained high over the years, but the figure can be reduced through proper implementation of spatially-targeted public health policies. Due to its alarming rate in comparison to North American standards, child mortality is particularly a health concern in Mexico. Despite this fact, there remains a dearth of studies that address its spatio-temporal identification in the country. The aims of this study are i) to model the evolution of child mortality risk at the municipality level in Greater Mexico City, (ii) to identify municipalities with high, medium, and low risk over time, and (iii) using municipality trends, to ascertain potential high-risk municipalities. METHODS In order to control for the space-time patterns of data, the study performs a Bayesian spatio-temporal analysis. This methodology permits the modelling of the geographical variation of child mortality risk across municipalities, within the studied time span. RESULTS The analysis shows that most of the high-risk municipalities were in the east, along with a few in the north and west areas of Greater Mexico City. In some of them, it is possible to distinguish an increasing trend in child mortality risk. The outcomes highlight municipalities currently presenting a medium risk but liable to become high risk, given their trend, after the studied period. Finally, the likelihood of child mortality risk illustrates an overall decreasing tendency throughout the 7-year studied period. CONCLUSIONS The identification of high-risk municipalities and risk trends may provide a useful input for policymakers seeking to reduce the incidence of child mortality. The results provide evidence that supports the use of geographical targeting in policy interventions.
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Affiliation(s)
- Alejandro Lome-Hurtado
- Economics Department, Universidad Autónoma Metropolitana, Unidad Azcapotzalco, Av. San Pablo 180, Col. Reynosa Tamaulipas, Alcaldía Azcapotzalco, C.P, 02200, CDMX, Mexico
| | - Jacques Lartigue-Mendoza
- Universidad Anáhuac México, Economics and Business School, Avenida de las Torres 131, Colonia Olivar de los Padres, C.P, 01780, Ciudad de México, Mexico.
| | - Juan C Trujillo
- Department of Environment and Geography, University of York, York, North Yorkshire, YO10 5NG, UK
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Farzan SF, Howe CG, Chen Y, Gilbert-Diamond D, Korrick S, Jackson BP, Weinstein AR, Karagas MR. Prenatal and postnatal mercury exposure and blood pressure in childhood. Environ Int 2021; 146:106201. [PMID: 33129000 PMCID: PMC7775884 DOI: 10.1016/j.envint.2020.106201] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/29/2020] [Accepted: 10/08/2020] [Indexed: 05/25/2023]
Abstract
Elevated blood pressure in childhood is an important risk factor for hypertension in adulthood. Environmental exposures have been associated with elevated blood pressure over the life course and exposure to mercury (Hg) has been linked to cardiovascular effects in adults. As subclinical vascular changes begin early in life, Hg may play a role in altered blood pressure in children. However, the evidence linking early life Hg exposure to altered blood pressure in childhood has been largely inconsistent. In the ongoing New Hampshire Birth Cohort Study, we investigated prenatal and childhood Hg exposure at multiple time points and associations with blood pressure measurements in 395 young children (mean age 5.5 years, SD 0.4). Hg exposure was measured in children's toenail clippings at age 3 and in urine at age 5-6 years, as well as in maternal toenail samples collected at ∼28 weeks gestation and 6 weeks postpartum, the latter two samples reflecting early prenatal and mid-gestation exposures, respectively. Five measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were averaged for each child using a standardized technique. In covariate-adjusted linear regression analyses, we observed that a 0.1 μg/g increase in child toenail Hg at age 3 or a 0.1 μg/L urine Hg at age 5-6 were individually associated with greater DBP (toenail β: 0.53 mmHg; 95% CI: -0.02, 1.07; urine β: 0.48 mmHg; 95% CI: 0.10, 0.86) and MAP (toenail β: 0.67 mmHg; 95% CI: 0.002, 1.33; urine β: 0.55 mmHg; 95% CI: 0.10, 1.01). Neither early prenatal nor mid-gestation Hg exposure, as measured by maternal toenails, were related to any changes to child BP. Simultaneous inclusion of both child urine Hg and child toenail Hg in models suggested a potentially stronger relationship of urine Hg at age 5-6 with DBP and MAP, as compared to toenail Hg at age 3. Our findings suggest that Hg exposure during childhood is associated with alterations in BP. Childhood may be an important window of opportunity to reduce the impacts of Hg exposure on children's blood pressure, and in turn, long-term health.
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Affiliation(s)
- Shohreh F Farzan
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.
| | - Caitlin G Howe
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, NH, USA
| | - Susan Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, USA
| | - Adam R Weinstein
- Department of Medical Education and Pediatrics, Geisel School of Medicine, Hanover, NH, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, NH, USA
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Barkjohn KK, Norris C, Cui X, Fang L, He L, Schauer JJ, Zhang Y, Black M, Zhang J, Bergin MH. Children's microenvironmental exposure to PM 2.5 and ozone and the impact of indoor air filtration. J Expo Sci Environ Epidemiol 2020; 30:971-980. [PMID: 32963288 DOI: 10.1038/s41370-020-00266-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 09/04/2020] [Accepted: 09/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND In highly polluted urban areas, personal exposure to PM2.5 and O3 occur daily in various microenvironments. Identifying which microenvironments contribute most to exposure can pinpoint effective exposure reduction strategies and mitigate adverse health impacts. METHODS This work uses real-time sensors to assess the exposures of children with asthma (N = 39) in Shanghai, quantifying microenvironmental exposure to PM2.5 and O3. An air cleaner was deployed in participants' bedrooms where we hypothesized exposure could be most efficiently reduced. Monitoring occurred for two 48-h periods: one with bedroom filtration (portable air cleaner with HEPA and activated carbon filters) and the other without. RESULTS Children spent 91% of their time indoors with the majority spent in their bedroom (47%). Without filtration, the bedroom and classroom environments were the largest contributors to PM2.5 exposure. With filtration, bedroom PM2.5 exposure was reduced by 75% (45% of total exposure). Although filtration status did not impact O3, the largest contribution of O3 exposure also came from the bedroom. CONCLUSIONS Actions taken to reduce bedroom PM2.5 and O3 concentrations can most efficiently reduce total exposure. As real-time pollutant monitors become more accessible, similar analyses can be used to evaluate new interventions and optimize exposure reductions for a variety of populations.
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Affiliation(s)
- Karoline K Barkjohn
- Duke University, Civil and Environmental Engineering, 121 Hudson Hall, Box 90287, Durham, NC, 27708, USA.
| | - Christina Norris
- Duke University, Civil and Environmental Engineering, 121 Hudson Hall, Box 90287, Durham, NC, 27708, USA
| | - Xiaoxing Cui
- Duke University, Nicholas School of the Environment, 9 Circuit Dr, Durham, NC, 27710, USA
| | - Lin Fang
- Tsinghua University, School of Architecture, Beijing, 100084, China
| | - Linchen He
- Duke University, Nicholas School of the Environment, 9 Circuit Dr, Durham, NC, 27710, USA
| | - James J Schauer
- University of Wisconsin at Madison, Civil and Environmental Engineering, 1415 Engineering Dr, Madison, WI, 53706, USA
| | - Yinping Zhang
- Tsinghua University, School of Architecture, Beijing, 100084, China
| | - Marilyn Black
- Underwriters Laboratories Inc., 2211 Newmarket Parkway, Marietta, GA, 30067, USA
| | - Junfeng Zhang
- Duke University, Nicholas School of the Environment, 9 Circuit Dr, Durham, NC, 27710, USA
| | - Michael H Bergin
- Duke University, Civil and Environmental Engineering, 121 Hudson Hall, Box 90287, Durham, NC, 27708, USA
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Basto-Abreu A, Barrientos-Gutiérrez T, Vidaña-Pérez D, Colchero MA, Hernández-F M, Hernández-Ávila M, Ward ZJ, Long MW, Gortmaker SL. Cost-Effectiveness Of The Sugar-Sweetened Beverage Excise Tax In Mexico. Health Aff (Millwood) 2020; 38:1824-1831. [PMID: 31682510 DOI: 10.1377/hlthaff.2018.05469] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
An excise tax of 1 peso per liter on sugar-sweetened beverages was implemented in Mexico in 2014. We estimated the cost-effectiveness of this tax and an alternative tax scenario of 2 pesos per liter. We developed a cohort simulation model calibrated for Mexico to project the impact of the tax over ten years. The current tax is projected to prevent 239,900 cases of obesity, 39 percent of which would be among children. It could also prevent 61,340 cases of diabetes, lead to gains of 55,300 quality-adjusted life-years, and avert 5,840 disability-adjusted life-years. The tax is estimated to save $3.98 per dollar spent on its implementation. Doubling the tax to 2 pesos per liter would nearly double the cost savings and health impact. Countries with comparable conditions could benefit from implementing a similar tax.
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Affiliation(s)
- Ana Basto-Abreu
- Ana Basto-Abreu is an assistant professor at the Center for Population Health Research, National Institute of Public Health, in Cuernavaca, Mexico
| | - Tonatiuh Barrientos-Gutiérrez
- Tonatiuh Barrientos-Gutiérrez ( tbarrientos@insp. mx ) is the director of the Center for Population Health Research, National Institute of Public Health
| | - Dèsirée Vidaña-Pérez
- Dèsirée Vidaña-Pérez is a researcher at the Center for Population Health Research, National Institute of Public Health
| | - M Arantxa Colchero
- M. Arantxa Colchero is an associate professor of health economics at the Center for Health Systems Research, National Institute of Public Health
| | - Mauricio Hernández-F
- Mauricio Hernández-F. is a research assistant at the Center for Research and Nutrition Health, National Institute of Public Health
| | - Mauricio Hernández-Ávila
- Mauricio Hernández-Ávila is director of economic and social benefits, Mexican Institute of Social Security, in Mexico City
| | - Zachary J Ward
- Zachary J. Ward is a programmer analyst at the Harvard T. H. Chan School of Public Health, in Boston, Massachusetts
| | - Michael W Long
- Michael W. Long is an assistant professor in the Milken Institute School of Public Health, George Washington University, in Washington, D.C
| | - Steven L Gortmaker
- Steven L. Gortmaker is a professor of the practice of health sociology at the Harvard T. H. Chan School of Public Health
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